August /September 2002
Diabetes -The Medical Perspective
"Pre-diabetes" is the term used when a person's
blood glucose levels are higher than normal but not high enough
for a diagnosis of diabetes. Doctors sometimes also call this
state of high blood glucose "Impaired Glucose Tolerance"
or "Impaired Fasting Glucose," or maybe even just
talk about "borderline diabetes."
Doctors can use either the fasting plasma glucose test or
the oral glucose tolerance test to detect pre-diabetes. Both
require a person to fast overnight.
Who should be tested for pre-diabetes?
- If you are overweight and aged 45 or older
- If your weight is normal and you're over age 45, you
should ask your doctor if testing is appropriate.
For adults younger than 45 and overweight, you may request
testing if you have any other risk factors for diabetes or
pre-diabetes. These include high blood pressure, low high
density lipoprotein cholesterol and high triglycerides, a
family history of diabetes, a history of gestational diabetes
or giving birth to a baby weighing more than 9 pounds, or
belonging to an ethnic or minority group at high risk for
diabetes, such as African American or Hispanic.
Research has shown that if you take action to control your
blood glucose when you have pre-diabetes, you may delay or
prevent type 2 diabetes from ever developing.
How can you take control of your blood glucose? Treatment
usually includes losing a modest amount of weight through
diet and moderate exercise. But don't worry if you can't get
to your ideal body weight, a loss of just 10 to 15 pounds
can make a huge difference!
Diabetes and Food
Eating out is entertainment as well as just a meal. During
the summer months we often eat out more often—either
because we’re on vacation, or have more activities,
or because it’s too hot to cook.
Staying within your meal plan when eating out may seem to
put a damper on the entertainment part of eating out. Try
to remember that the long-term goal is to be as healthy as
you can be. It may not be as fun to plan ahead, but it can
still be fun!
Some tips for eating out:
- Think about how food is cooked: breading, frying, and
adding sauces will add many calories. Chicken and fish may
be good choices, but not if they are breaded and fried or
have added sauce.
- Avoid "super" sizes. Although they may be good
value money-wise, they are not good value calorie-wise.
- For Mexican food, pile on lettuce, salsa, and tomatoes.
Go easy on cheese, sour cream, and guacomole. Avoid beans
refried in lard, deep-fried taco shells, or dishes where
the tortilla is filled and then fried.
- For Oriental eating, choose plenty of vegetables, preferably
steamed. Avoid deep-fried wontons, and keep an eye on portion
Exercise as a Part of Living
The four basic parts to a total fitness program are aerobic
endurance, muscle strength and endurance, flexibility, and
body composition. The best fitness programs offer these parts
in balance with each other.
Aerobic exercise is activity that puts an increased demand
on the body to deliver oxygen to the muscles. Aerobic means
"with oxygen." Although everything we do, we do
"with oxygen," aerobic exercise or activity uses
more oxygen than normal.
Aerobic exercises benefit the cardiovascular system. The
cardiovascular system includes the heart (cardio) and all
the blood vessels (vascular). Aerobic exercises include jogging,
dancing, and bicycling.
There are several ways to test cardiovascular fitness. One
way is with a "stress test" where the heart and
blood pressure are monitored while the person increases his/her
level of exercise, such as on a treadmill or stationary bike.
An easier way is to measure a person’s heart rate. The
stronger the heart, the more efficient it is at pumping. A
normal heart rate is about 72 beats/minute. A trained athlete
may have a heart rate in the 60’s or 50’s, or
even lower. You can calculate your heart rate from your radial
pulse (wrist) or carotid pulse (neck).
Recipes to Try
Blueberry Pie with Cottage Cheese Pie Crust
(8 or 10 servings)
1 cup flour
1/2 tsp. salt
3 tbls. butter flavored shortening
1/2 cup low-fat cottage cheese
- Combine flour and salt.
- Cut shortening into flour until mixture resembles coarse
- Mix in cottage cheese until it forms a soft dough. May
use immediately or chill.
- Roll dough between sheets of wax paper.
- Fit into 9 inch pie pan.
- Bake at 475° 6-8 minutes, until lightly browned.
Per serving (1/10th pie or 1/8th):
|87 calories (108)
||3 grams protein (3)
|0 mg cholesterol (1)
||10 grams carbohydrate (12)
|4 grams total fat (5)
||40% calories from fat (40%)
2 12-ounce pkgs. frozen unsweetened blueberries
1/2 cup Splenda®
3 tbsp. cornstarch dissolved in 4 tbls. water
1 tsp. vanilla
1 tbls. lemon juice
- Partially defrost blueberries.
- Combine all other ingredients in a saucepan.
- Add blueberries and heat over medium heat, stirring constantly,
until blueberries are completely thawed and mixture thickens.
- Pour into pie shell.
Per serving without shell (1/10th pie or 1/8th):
|48 calories (60)
||0 grams protein (0)
|11 grams carbohydrate (14)
||0 gram fat (0)
|0 mg cholesterol (0)
||0% calories from fat (0%)
There are many choices of oral hypoglycemic medications for
the person who has type 2 diabetes.
- Sulfonylureas stimulate the beta cells of the pancreas
to secrete more insulin. Common sulfonylureas include Glimepiride
(Amaryl), Glipizide (Glucotrol), Glipizide-GITS (Glucotrol
XL, which is a controlled release medication), Glyburide
(Micronase, DiaBeta), and Glyburide micronized (Glynase).
- Biguanides improve the body’s own insulin action
at the liver and decrease liver glucose production. A common
biguanide is Metformin (Glucophage).
- Glucosidase inhibitors act at the intestine and slow carbohydrate
digestion and glucose absorption. Common glucosidase inhibitors
are Acarbose (Precose) and Miglitol (Glyset).
- Thiazolidinediones enhance tissue sensitivity to the
body’s own insulin in the muscle. Common thiazolidinediones
are Rosigliazone (Avandia) and Pioglitazone (Actos).
- Meglitinindes stimulate the beta cells of the pancreas
to secrete more insulin. Common Meglitinindes include Repaglinide
(Prandin) and Nateglinide (Starlix).
Knowing the type of oral hypoglycemic medication that you
have been prescribed, and the dose, can be a great help when
you are talking to health care providers who may not have
your entire record available.
a free consumer health education resource which is consistently
rated number one. The website is authoritative and up-to-date,
using the National Institutes of Health and other reputable
sources as references for information concerning over 500
diseases and conditions. There are also lists of hospitals
and physicians, and information on prescription and over-the-counter
The Discovery Health Channel will join with the American
Diabetes Association to produce a night of programming to
coincide with November’s Diabetes Awareness Month. Watch
for public service announcements of this broadcast.
Diabetes | Food & Diabetes
| Medications & Diabetes
| Current Issue | Archive