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Diabetes - The Medical Perspective
Diabetes management relies to a large extent on what the laboratory values say. High lab values suggest something in the management plan needs to change. That change might be medication, diet, or exercise. High lab values may also suggest something else – infection of some sort. It is important for you to keep track of your lab values. Take them to your doctor’s appointments. For labs completed in your doctor’s office – ask for a printout or for the nurse to write the values and dates in your record book. The following are labs you may need to keep track of:
Fingerstick blood glucose: You will be checking your own blood glucose at home. You should have a schedule for when to check your blood glucose. You may be checking as often as 4-6 times/day, or as infrequently as once a week. Ask your doctor what your pattern is. This glucose check may be fasting or after a meal.
Fasting glucose: This value will be checked in your doctor’s office. You should fast (no food or beverage for 8 to 12 hours) so that the value reflects how your body is handling glucose without food.
Hemoglobin A1C: This value is also checked at your doctor’s office. A hemoglobin A1C value reflects how much glucose has been in your blood over the past 3 months. High blood glucose values in the past 3 months will “stick” to hemoglobin causing the hemoglobin A1C value to be high.
You and your doctor should set target goals for each of these blood glucose monitoring tests.
Diabetes and Food
Cinnamon smells terrific, has no calories, and will probably be added to many holiday recipes.
Can it also lower your blood glucose?
Unfortunately most of the research does not support this claim. A recent study looked at people with type 2 diabetes given 500 mg cinnamon twice a day for 3 months and those given a placebo of wheat flour capsules. No differences were found between the 2 groups for fasting blood glucose or insulin levels.
Some people may have a more favorable result with taking cinnamon. Not all people react the same way to different foods or medications. If you are trying cinnamon to help lower your blood glucose, there are a few things you should do to stay safe.
- Continue your usual diabetes medication – the cinnamon isn’t a replacement
- Check your blood glucose more often – to see if the cinnamon is lowering blood glucose and to make sure your blood glucose isn’t too high or too low
- Let your doctor know you are trying cinnamon
Exercise as a Part of Living
Part of normal daily living is usually classified as “light” activity. This would include walking around the house, shopping, doing laundry, cooking or walking while doing errands. Light activity is important and keeps us moving throughout the day. It doesn’t raise our heart rate or breathing, but all movement is good.
To help make these daily living activities more enjoyable and safe, practice flexibility and balance exercises. Good flexibility will even make driving and showering easier. All muscles need a little stretch to keep them flexible.
Muscle strength and balance are tied together. Keeping muscles strong is important in order to keep them moving as you want them to – whether to climb stairs or stand up from a sitting position. Practice balance exercises every day, keeping a sturdy chair, wall or another person close by to prevent falls.
Remember to always talk to a doctor before initiating any intense exercise plan.
Recipes To Try
Nonfat cooking spray
½ cup fat-free milk
¼ teaspoon salt
½ cup flour
- Heat oven to 425°. Spray a 10” baking pan, pie pan or oven-safe skillet with nonfat cooking spray.
- In a bowl, beat eggs until combined. Add other ingredients.
- Pour into baking pan and bake for 20-25 minutes. Serve with low calorie syrup, yogurt, or fruit. Note: calories or carbohydrate for topping not included in analysis.
Total preparation and cooking time: 35 minutes.
Fat 3 grams
Protein 5 grams
Calories from fat 25%
Carbohydrate 12 grams
Cholesterol 106 grams
Fiber 0 gram
Sodium 179 mg
2 cups flour
1 teaspoon orange peel
½ cup Splenda
3 tablespoons margarine
2 teaspoons baking powder
1 cup fat-free sour cream
½ teaspoon salt
1 cup dried cranberries
- Preheat oven to 375°.
- Combine flour, Splenda, baking powder, salt and orange peel. Cut margarine into mixture.
- Beat egg; add to flour mixture.
- Stir in sour cream until blended. Stir in cranberries.
- Drop rounded tablespoons onto non-stick cookie sheet. With a floured cup or glass, press mixture to flatten slightly. Bake 14-18 minutes until slightly browned.
Total preparation and cooking time: 30 minutes
Fat 2 grams
Protein 2 grams
Calories from fat 19%
Carbohydrate 19 grams
Cholesterol 13 grams
Fiber 1 gram
Sodium 119 mg
Alpha-lipoic acid (ALA) is a sulphur-containing compound that can be made by the body. It is involved with carbohydrate metabolism and is also an antioxidant.
ALA is not a drug or a vitamin. As a nutritional supplement, claims of effectiveness do not need to be supported by research or be approved by the FDA.
Health claims for ALA include prevention or reduction in neuropathy, the pain in legs and feet caused by nerve damage. Several studies have looked at whether the claims have merit or not. While one study of oral ALA found nerve conductivity improved after two years, symptomatic differences compared to placebo were not different. However, a similar study resulted in significant improvements in symptoms. Because potency of supplements varies and the people in the studies have varying severity of neuropathy and diabetes control, it is difficult to draw many conclusions. Research is continuing to see if ALA has any real effects.
Adverse effects of ALA have included nausea, vomiting, vertigo, and skin rashes.
If you are taking ALA, make sure your doctor and pharmacist know you are taking the supplement. Also, be sure they know of any improvement or worsening of your symptoms.
News & Resources
The Big Book of Diabetic Desserts. Jackie Mills, MS, RD. American Diabetes Association, 2007; 248 pages.
The 4-Ingredient Diabetes Cookbook. Nancy Hughes. American Diabetes Association, 2007; 210 pages.
Sex and Diabetes. Janis Roszler, MS, RD, CDE and Donna Rice, DSN, CDE. American Diabetes Association, 2007; 224 pages.
Ten Steps to Better Living with Diabetes. Ginger Kanzer-Lewis, RN, CDE. American Diabetes Association, 2007; 278 pages.
The Diabetes Dictionary. What Every Person with Diabetes Needs to Know. American Diabetes Association, 2007. 160 pages.
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