October /November 2002
Diabetes -The Medical Perspective
- Do you often feel full after eating a small amount?
- Do you often feel bloated after eating?
- Do you usually feel nauseated after meals or in the morning?
- Do you have unexplained vomiting of undigested food?
- Do you have stomach cramping or pain?
- Do you often have diarrhea or constipation?
- Do you talk to your doctor or health care provider about
these "stomach" problems?
You should! Gastrointestinal problems like those above could
be a symptom of gastropathy. Gastropathy is the condition
that occurs when the stomach empties too slowly.
The first sign of a problem with slow emptying of the stomach
may be blood sugar levels that seem out of control and unpredictable
even when you are doing everything right! The reason is
that if food doesn't leave the stomach and get absorbed as
blood glucose, there may be a mismatch in timing between your
insulin or oral diabetes medicine and your blood sugar level
In addition, if you take oral medication, it may not get
fully absorbed. If it doesn't get fully absorbed, it won't
be effective. Your blood sugar could either be low because
food isn't absorbed, or high because your medication is not
absorbed. Either of these conditions could occur in the same
person, at different times.
Talk to your doctor if you think you might have gastropathy.
Medications can often help lessen the symptoms.
Flu and Pneumonia Shot
If you have diabetes, a flu shot could save your life. During
flu season, many people with diabetes are hospitalized and
could die from flu and pneumonia complications. Call your
doctor or county health department to schedule an appointment
Foot Care Awareness Program
Do not lose a foot or leg due to diabetes. Call 1-800-323-4769
during November and December to get a referral to a local
foot doctor who can provide a free foot exam (statewide).
Diabetes and Food
Gastropathy, the condition that occurs when the stomach
empties too slowly, can sometimes be helped by a change in
diet. Many people who have the bloating, early feelings of
fullness, blood sugar fluctuations, and changes in bowel habits
that accompany gastropathy find that they have less trouble
with the condition when they follow these dietary guidelines:
- Eat a low-fat diet (fat slows down gastric emptying).
- Eat a low-fiber diet (some fiber can collect in the stomach
and not be passed through to the intestine easily).
- Eat small, frequent meals.
- Switch to liquids, such as fruit juices, broth or clear
soups when having a lot of difficulty with gastric emptying.
Avoiding fiber may mean avoiding most fruits and vegetables,
at least for awhile. However, vegetable and fruit juices,
baby food fruits and vegetables, applesauce, and bananas may
be tolerated when other fruits and vegetables are not. Although
it is easy to get frustrated, pay attention to your symptoms,
and go slowly. Your stomach may change from day to day, so
have a plan in mind to switch to and try to keep your blood
sugar as normal as possible.
Exercise as a Part of Living
Water aerobics is not just splashing around in the pool but
can be just as fun. It is an effective way to build strength
and aerobic capacity. And, you don't even have to know how
Water aerobics is also suitable for most people because
it's a non-weight-bearing exercise -- your feet and legs do
not support all your body weight while you exercise. The water
supports most of your weight! This water support makes water
aerobics ideal for people with nerve damage, arthritis, or
old injuries that are aggravated by high-impact exercise.
To ensure your safety, talk to your doctor before starting
any exercise regimen. Also, wear an ID bracelet or necklace
so that people around you will be aware that you have diabetes
if anything should go wrong.
Recipes to Try
Sweet Potato Salad
2 pounds sweet potatoes
1/2 cup non-fat yogurt, plain
1/2 cup low-fat mayonnaise
1 tablespoon curry powder
1 teaspoon ginger
1/2 cup golden raisins
6 1/2 cup servings
- Simmer potatoes in water until tender, about 10 minutes.
Peel and dice.
- Combine yogurt, mayonnaise, curry powder, and ginger
in a medium bowl.
- Add potatoes and raisins. Toss to coat.
4 grams protein
0 mg cholesterol
50 grams carbohydrate
3.5 grams total fat
13% calories from fat
1/2 cup servings will yield 12 servings per recipe,
and above nutrients are halved (e.g. 123 calories).
2 cups unsifted flour
1/2 teaspoon baking soda
1 1/2 teaspoon baking powder
1/2 teaspoon salt
1 cup low-fat buttermilk
non-fat cooking spray
- Pre-heat oven to 350º. Spray a 9" round pan with
non-fat cooking spray.
- Mix dry ingredients.
- Add buttermilk and stir to make a soft dough.
- Knead dough on lightly floured board for about 1 minute.
Shape into a round loaf and place loaf in pan.
- Bake for 40 minutes or until sounds hollow when tapped.
4 grams protein
1/8th of a loaf
1 mg cholesterol
25 grams carbohydrate
1 gram fat
4% calories from fat
Oral hypoglycemic medications may have side effects. Know
the type of oral hypoglycemic medication(s) you are taking
and the dose(s). Discuss any side effects with your doctor.
If you are taking:
- Sulfonylureas - common side effects include weight gain,
mild gastrointestinal disturbances, alcohol intolerance,
mild skin irritations and hypoglycemia or low blood glucose
- Biguanides - common side effects may include nausea,
diarrhea or mild gastrointestinal disturbances and loss
- Glucosidase inhibitors - common side effects include nausea,
diarrhea, mild gastrointestinal disturbances, bloating and
- Thiazolidinediones - side effects vary among the brands
available, and can include adverse effects to the liver.
Your doctor should run blood tests to check how well your
liver is working every month for the first eight months
- Meglitinindes - there is a chance for low blood sugar,
Diabetes Self-Management is a bimonthly magazine established
in 1983. They don’t publish personal experiences, personality
profiles, or "breakthroughs." Instead, they give
people up-to-date, practical "how-to" information
on nutrition, exercise, new drugs, medical advances, self-help,
and the many other topics people need to know about to maximize
their health. Yearly (six issues) subscription is $15.97.
You can subscribe on the web at www.diabetesselfmanagement.com
or you can also call toll-free 1-800-234-0923 Monday to
Friday 8:00 - 11:00 and Saturday 9:30 - 6:00 Eastern Time.
Or, if you prefer, write to:
PO Box 52890
Boulder, CO 80322
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