October/ November 2003
Diabetes -the Medical Perspective
For people with diabetes, the flu can be more than aches
and pains. It can mean longer illness, hospitalization, even
death! Diabetes can make the immune system more vulnerable
to severe cases of flu. In fact, people with diabetes are
almost three times more likely to die with influenza, “the
flu”, or pneumonia.
So take control!
When you live with diabetes you are careful about the food
and meals you eat, you try to exercise each day, and you see
your doctor regularly. Now add an annual flu vaccine to your
routine. Call your doctor’s office to make sure a flu
shot is okay for you.
Check the schedule for flu shots in your local paper or clinic.
You might also ask your doctor about a pneumonia vaccine.
This vaccine protects against pneumococcal disease, which
is the most common form of pneumonia. This vaccine is safe
to take at the same time as the flu shot, and for most people
one dose one time provides years of protection.Both the flu
shot and pneumococcal vaccines are covered by Medicare, Part
B. Be sure to take your Medicare card.
Can a Flu Shot Give Me the Flu?
No. Flu vaccines do not contain a live virus, so they cannot
infect you. Some people coincidentally have a cold a week
or two following immunization. This is not a result of their
The flu is not a cold.
Do I Need a Flu Shot Every Year?
Yes. Flu viruses vary from year to year, so it is important
to get a shot every year to be sure.
Do I Need To Get a Pneumonia Vaccine Every Year?
No. Usually one vaccine will last years and years.
Diabetes and Food
The Nutrition Facts on food labels are packed with information,
whether you have diabetes or not. Right at the top is one
of the most important pieces of information – serving
size! Although you may know how much you want to eat, knowing
the serving size is the first step towards using your meal
plan and managing your diabetes.
For example, look at several Nutrition Facts labels on bread.
Some have a serving size of one slice, while others have a
serving size of 2 slices. In this case, the serving size information
can help you choose a product that will fit both your food
preferences and your meal plan.
The next important piece of information is the calories per
serving. It would be logical to assume that if one slice of
bread was 70 calories that two slices of bread would be 140
calories. However, the manufacturers would try to keep the
calories per serving roughly equal. The only way to do that
is to make the slices thinner, and perhaps smaller. Two slices
of bread may not equal the 70 calories of one slice –
it may be closer to 90 calories.
How you adjust your meal plan to account for these few extra
calories depends on the meal plan you are using – the
plate method, the Food Guide Pyramid, the exchange lists,
or carbohydrate counting. Talk to your dietitian and start
reading food labels from the top!
Exercise as a Part of Living
Researchers at the Centers for Disease Control in Atlanta,
Georgia, recently published the results of a study they conducted
with adults who have diabetes. They interviewed 2,896 people,
asking them how often they had walked for exercise during
the previous 2 weeks, the average number of minutes they spent
walking each time, and how much their heart and breathing
rates increased while walking.
The average age of the participants was 59 years old and
the average length of time that they had diabetes was 11 years.
About one-third used insulin.
Compared with participants who reported no walking, those
who walked at least 2 hours per week had a much lower mortality
rate from any disease (39%) and a much lower risk of dying
from a heart disease (34% lower). Those who walked longer
had an even lower mortality rate. Those who perceived the
intensity of their walking to be fairly high also had a lower
mortality rate than those who didn’t feel they were
really working at it.
At your next visit, talk to your doctor about your walking
Recipes to Try
Banana Walnut Muffins
1-½ cups flour
½ teas. salt
¾ cup chopped walnuts
¼ teas. nutmeg
½ cup toasted wheat germ
2 ripe bananas, mashed
¼ cup brown sugar, not packed
¾ cup milk, non-fat
¼ cup Splenda®
4 tbsp. margarine, softened
1 tbsp. baking powder 1 egg
1 teas. cinnamon
1. Preheat oven to 400º. Fit muffin pan with 12 paper
2. Mix flour, walnuts, wheat germ, brown sugar, Splenda®,
baking powder, cinnamon, salt, and nutmeg in a large bowl.
Stir in remaining ingredients. Mix until just blended.
3. Fill muffin liners with mix.
4. Bake until a toothpick comes out clean, about 20 minutes.
Per serving: 200 calories 6 grams protein
24 grams carbohydrate 18 mg cholesterol
9 grams total fat 42 % calories from fat
Salmon and Asparagus Salad
4 cups water 3 cups cooked rice
4 6-ounce salmon fillets 1 cup thawed frozen baby peas
1 tbsp. margarine ½ teas. salt
2 cups asparagus, cut in 1” pieces ¼ teas. pepper
1. Use 4 cups of water in a skillet to steam or poach salmon
until salmon flakes with a fork. Remove salmon and discard
2. Heat margarine in skillet and add asparagus, cooking until
3. Stir in rice, peas, salmon, salt, and pepper. Cook about
1 minute, just to heat, stirring to prevent sticking.
Per serving: 380 calories 29 grams protein
28 grams carbohydrate 71 mg cholesterol
16 grams total fat 38% calories from fat
It is very important to remember the exact name of your medications.
If remembering is a problem, write the name of your medications
on a card, and keep that card in your wallet.
Recently there has been confusion reported between Lantus®
(insulin glargine) and Lente® (zinc insulin suspension)
insulins. Their names look-a-like and sound-a-like in some
respects. Does it make a big difference? Yes, it can.
Lente® is quicker acting but does not last as long as
Lantus®. Lantus® is usually given at bedtime while
Lente® is often given in the morning.
The company who makes one type of lente insulin called Novolin®
L (Lente®, human insulin zinc suspension [rDNA origin])
is discontinuing this product. While insulin glargine (Lantus®)
is an option, there is a difference in absorption rate, when
the drug is most active, and how long the effects of the insulin
If your pharmacist or doctor changes the name of your insulin,
make sure you understand how the drugs are similar and how
they differ. A change in insulin may be changing one brand
for another, resulting in little or no effect for you. However,
it may also be changing the insulin type. Although this may
also result in little or no effect on you, there is a likelihood
that some effects will be different.
Although the primary audience is for parents of children
with diabetes, the website Children with Diabetes at http://www.childrenwithdiabetes.com/index_cwd.htm
has information for everyone. The homepage is fairly crowded,
but if you take time to read through it, there will be some
new information just for you.
has a new section for readers favorite recipes. Each recipe
is posted on a separate page to make printing easier. The
recipes have a nutritional analysis for calories, carbohydrates,
protein, and fat, as well as listing exchanges.
The American Association of Diabetes Educators has joined
with Merck & Co., Inc. to spread the word about heart
disease risk to those with diabetes. Visit the webpage http://www.aadenet.org/EducationalCampaigns/HeartPart/page1.html
or to receive a free Diabetes: Know the Heart Part brochure
mailed directly to you, call 1-800-224-4089.
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