Diabetes -The Medical Perspective
Steroids are a group of medications commonly used in medicine
that can have effects on blood glucose for those who have
diabetes as well as for those who don’t. Steroids are
also called corticostroids or glucocoticoids. While there
are many, many different steroids, some of the most commonly
prescribed are hydrocortisone, prednisone and dexamethasone.
Steroids are often used to reduce inflammation as in asthma
or arthritis, or to help lessen the symptoms of immune disorders
such as Lupus.
A side effect of steroids is their impact on insulin. Steroids
increase “insulin resistance” making the insulin
less effective. This will cause blood glucose levels to rise
if you have diabetes. If you don’t have diabetes and
your pancreas is able to make additional insulin, your blood
glucose will stay within a normal range. If the pancreas can’t
make enough insulin to keep your blood glucose within a normal
range while you are taking steroids, you have what is called
Very often steroid-induced diabetes goes away when you quit
taking the steroids. If you have to continue with steroids
long-term, the diabetes may remain. Sometimes steroid-induced
diabetes is an early indicator and the person will develop
diabetes later in life even when not taking steroids.
Steroids are very effective medications for inflammation
and immune disorders. Because of their side effects, doctors
usually prescribe the lowest dose for the shortest amount
Talk to your doctor if you have questions about any medications
you are taking.
Diabetes and Food
It is winter again and many people are loading up on vitamin
C to ward off colds. Whether that really works or not is still
being debated. However, one group of scientists believes it
is better to get your vitamin C from food, especially if you
have diabetes and are taking vitamin C supplements on a regular
Scientists at the University of Minnesota followed 2,000
postmenopausal women with diabetes for 15 years. They found
that those who took a vitamin C supplement of 300mg. or more
per day were more likely to develop heart disease or have
a stroke than those who took less than 100 mg. of supplemental
vitamin C per day or none at all.
This study does not show that supplemental vitamin C causes
heart disease – just that the two were associated. The
scientists agree that more research needs to be done. To be
on the safe side though, they recommend getting adequate amounts
of vitamin C from food.
The current recommended dietary intake for vitamin C is
90 mg. per day for men and 75 mg. per day for women. The easiest
way to get this amount is to eat at least five servings of
fruits and vegetables each day.
Exercise as a Part of Living
Strength or resistance training is good for muscles and bones.
For this type of exercise, free weights, machines, or elastic
bands can be used.
Strength training for those who have diabetes can help to
reduce body fat and increase muscle mass. More muscle mass
will reduce insulin resistance and improve blood glucose levels
for those treating their diabetes with diet alone, with oral
medications, or with insulin.
An additional benefit of strength training is the improved
ability to do every day chores because of improved muscle
strength. Bone mass will also be improved so the risk of osteoporosis
is less. Strength training also might help lessen the risk
of heart disease.
However, if you have diabetes and any type of vascular disease,
retinopathy (eye disease), neuropathy (nerve disease) or high
blood pressure, talk to your doctor before beginning any strength
training. Avoiding heavy weights or any rapid bursts of activity
may need to be included in your training program.
Recipes To Try
Cabbage and Leek Soup
about 10 1-cup servings
- 2 tablespoons olive oil
- 2 carrots, grated
- 2 small leeks, chopped
- 1 teaspoon caraway seeds
- 2 medium onions, chopped
- 2 small potatoes, peeled and diced
- 2 tablespoons minced garlic
- 6 cups chicken broth
- 4 cups shredded cabbage
- Salt and pepper to taste
- Heat oil in large pot. Add leeks, onion and garlic. Cook
and stir until tender, about five to ten minutes.
- Stir in broth, carrots, and caraway seeds. Bring to a
- Stir in potatoes. Simmer until potatoes are cooked, about
- Stir in cabbage. Continue to simmer until cabbage is
wilted, about 15 minutes. Add salt and pepper, if desired.
Add water while simmering if needed to cover the vegetables.
Fat 4 grams
Protein 3 grams
Calories from fat 32%
Carbohydrate 18 grams
Cholesterol 0 grams
Fiber 2 grams
Little Cream Puffs
- 1/2 cup water
- 2 eggs
- 3 tablespoons margarine
- 1 /2 cup lite whipped topping
- 1/8 teaspoon salt
- Non-stick cooking spray
- 1/2 cup flour
- Preheat oven to 375°. Spray a baking sheet with non-stick
- In a medium pan, heat water, margarine and salt until
- Remove from heat. Add flour, stirring well.
- Add eggs, one at a time, stirring well after each.
- Drop by teaspoonfuls on baking sheet. Bake for 25 minutes.
- Cool on rack. Cut puffs horizontally about three-fourths
of the way through. Add a teaspoonful of topping. Refrigerate.
Fat 2 grams
Protein 1 gram
Calories from fat 58%
Carbohydrate 2 grams
Cholesterol 18 grams
Fiber 0 grams
If you’re taking a short-acting insulin before meals,
you may be interested in research about an inhaled insulin
being evaluated in clinical trials.
About 300 people with diabetes took part in a research project
comparing the inhaled insulin with the short-acting insulin.
Researchers found that for blood glucose control the inhaled
insulin before meals with a long-acting insulin injected in
the evening was as effective as injected short-acting insulin
before meals with the same long-acting insulin in the evening.
Researchers were concerned that the inhaled insulin might
not be good for the lungs. They found the lung function to
be fine, but those inhaling insulin did develop a cough occasionally.
Those inhaling the insulin reported their quality of life
improved. They also gained less weight than the group receiving
all injected insulin.
Researchers are now conducting long-term studies to make
sure that there are no effects when insulin is inhaled over
longer periods of time.
The website www.diabetic-lifestyle.com/
includes sections titled Recipes; What’s for Dinner;
Entertaining; Health Updates, What’s Hot; Travel; Just
for Kids; Burning Calories, and Cooking Tips. Clicking on
each area will provide an archive of past articles, back to
1997. It is an internet only magazine and not available in
The National Kidney Foundation of Illinois in partnership
with the Illinois Diabetes Prevention and Control Program
will hold free Kidney Early Evaluation Programs (KEEP) in
various locations across the state. The KEEP screening is
available to individuals 18 years or older with family history
of diabetes, high blood or kidney disease or diagnosed with
diabetes or high blood pressure. Contact Kim Fowler at 312-321-1500.
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