February 2006/ March 2006
Diabetes -The Medical Perspective
There’s one more reason to keep your blood glucose
under control, to lower your risk for heart disease!
risk of heart disease is 10 times higher in people with diabetes.
New research has shown that people with diabetes can lower
their risk of heart disease by 50% by controlling their blood
glucose. Blood glucose control can be achieved by frequent
self-monitoring of blood glucose, taking prescribed medication,
making healthy food choices, and staying physically active.
By keeping glucose levels as close to the target range as
possible, a person with diabetes can lower their risk of
heart attack and stroke.
Your doctor can tell you if you
are keeping your blood glucose under control by a Hemoglobin
A1c (HbA1c) test. The HbA1c test reflects a person’s
glucose level over the past 2-3 months. People with diabetes
should aim to keep their HbA1c level close to the normal
value of 6 percent or less.
Making healthy food choices,
staying physically active and taking prescribed medication
can help you get closer to your target HbA1c level. Limit
foods high in fat and cholesterol. Eat at least 5 servings
of fruits and vegetable a day. Be physically active at least
30 minutes a day. Take medication following your health care
provider’s instruction. All of these tips can help
you achieve better blood glucose control.
For heart health,
people with diabetes should also monitor their cholesterol
and blood pressure regularly as well as blood glucose. By
keeping blood glucose, blood pressure, and cholesterol as
close to normal as possible, people with diabetes can keep
their heart strong and live long healthy lives!
Diabetes and Food
The plate method is a simple and easy tool for people with
diabetes. When eating out, Nutrition Facts might not be readily
available. The plating method can be used as a meal planning
guide for people with diabetes. For lunch and dinner:
- Start with a 9–inch plate.
- Draw an imaginary line
through the middle of the plate.
- Divide one of the halves
in half, so it becomes two quarters.
- Fill one quarter
of the plate with carbohydrates/starch such as rice, pasta,
potatoes, corn, or peas.
- Fill another quarter of the plate
with protein such as meat, fish, poultry, or tofu.
the last half of the plate with non-starchy vegetables
such as broccoli, carrots, cucumbers, salad, tomatoes,
- Then, add a glass of milk or a piece of fruit, and you
have a variety of healthful foods.
Exercise as a Part of Living
Should you test your blood glucose before exercising? Your
doctor may advise you to test your blood glucose if you:
- have type 1 diabetes
- take insulin
oral hypoglycemic agents that increase insulin secretion
such as sulphonylureas or meglititindes
- have a history
of hypoglycemia (low blood glucose)
- sometimes have
very high blood glucose levels.
Testing your blood glucose
gives you and your health care team more information about
how your body reacts to exercising. This information makes
it easier to recommend certain types of exercises, how
long you should exercise, and how intensely you should
Your doctor might recommend that you test your
30 minutes before exercising,
- right before exercising,
30 minutes of exercising,
- and when you finish exercising.
If your blood glucose level is <70 mg/dl, a snack of 15
grams carbohydrate should raise the blood glucose level.
Test your level again in about 15 minutes. If it is still
low, eat again and test until the blood glucose level is
close to 100 mg/dl. Then talk to your doctor about adjusting
your medications so that additional food isn’t needed
in the future.
Recipes To Try
Spinach and Seafood Soup
10 1-cup servings
6 cups fat-free chicken broth
12 ounces skinless fish fillet
(sole or flounder)
1 cup water
1 tablespoon soy sauce
tiny cooked shrimp
½ tablespoon minced ginger
peeled, sliced cucumber
½ tablespoon minced garlic
8 ounces sliced mushrooms
1-1/2 ounce spaghetti
chopped green onions
4 cups chopped spinach leaves
- Heat broth, water, soy sauce, ginger, and garlic to
boiling in large pan.
- Break pasta into 1-inch pieces
and add to broth mixture; reduce heat and simmer until
pasta is done, about 4 minutes.
- Slice fish into ½ inch
cubes. Add shrimp, fish, cucumber, mushrooms, and green
onions to broth; simmer until fish flakes with a fork,
about 2 minutes.
- Stir in spinach. Serve hot.
Fat 1 grams
Protein 11 grams
from fat 13%
Carbohydrate 6 grams
Cholesterol 42 grams
Fiber 1 gram
Sodium 796 mg
Microwave English Muffin Bread
2 loaves, 13 slices each-26 servings
¼ teaspoon baking soda
5 cups flour
2 ¼-ounce packages yeast
2 teaspoons sugar
1 teaspoon salt
½ cup water
- Spray 2 microwave-safe loaf pans with non-fat cooking
spray; sprinkle with cornmeal.
- Combine 4 cups flour,
sugar, salt, baking soda and yeast in large bowl.
water and milk, heating until very warm, but not boiling.
Add to dry mixture and beat well. Add remaining flour.
- Divide dough in two, putting each half in loaf pan.
Sprinkle with cornmeal. Cover and microwave on 50% power
for 1 minute. Let dough rest 15 minutes. Repeat heating
- Microwave on high for 6 ½ minutes.
Allow to cool; slice; serve toasted
Per serving (1 slice):
Fat 0 grams
Protein 3 gram
from fat 0%
Carbohydrate 20 grams
Cholesterol 0 grams
Sodium 112 mg
Diabetes often causes damage to small blood vessels leading
to eye disease (retinopathy), nerve damage (neuropathy),
and kidney disease (nephropathy). A new drug being tested
initially for positive effects on preventing or treating
nervous tissue damage is also being tested to see the effects
on eyes and kidneys. The drug, Ruboxistaurin, is the type
that inhibits a certain enzyme that is believed to be involved
in much of the small blood vessel damage.
A small pilot study
with people who had diabetes and increased amounts of albumin
in their urine showed favorable results. The increased albumin
the urine is associated with later kidney disease. Those
who were taking Ruboxistaurin had less albumin in their urine
after 1 month of taking the drug.
There were side effects,
though, the most common one being hypertension (high blood
pressure). Because this was a small study, the drug will
be tested again several times before it is available for
treatment or prevention of kidney disease in those with diabetes.
News & Resources
If you have diabetes, your doctor should check your eyes
or refer you to an eye doctor, an ophthalmologist, regularly.
This advice may be especially true for those taking Avandia
or Avandamet as an oral hypoglycemic agent to help control
blood glucose. These drugs may increase swelling. Although
rare, this swelling may occur in the back of the eye. If
you are taking either of these drugs and notice changes in
your vision or you have not had your eyes checked recently,
contact your doctor.
The CDC has compiled many hurricane
health and safety resources in English, Spanish, and several
other languages. For instance, Safety of Drugs Exposed to
Hurricane Conditions can be viewed at www.fda.gov/cder/
This resource discusses how drug products should be discarded
if they came in contact with flood or contaminated water.
In the case of urgently needed life-saving drugs, if the
container is contaminated but the contents appear unaffected
(pills are dry), the pills may be used until a replacement
can be obtained.
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