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Diabetes - The Medical Perspective
The Centers for Disease Control and Prevention (CDC) reported that 3.4 million Americans are legally blind or have visual impairment. This is expected to double over the next 30 years. One reason for this increase is that more adults are becoming older. Another reason is that more people have diabetes. A major complication of uncontrolled diabetes is diabetic retinopathy (disease of eye). This can progress to blindness.
Diabetic retinopathy occurs when long-term uncontrolled blood glucose damages the blood vessels in the eye. Eventually the damage leads to vision impairment and could continue to blindness.
Those at risk of diabetic retinopathy include individuals with Type 1 or Type 2, as well as gestational diabetes. It is recommended that any person with diabetes have a dilated eye exam each year.
The National Eye Institute urges everyone with diabetes to have a dilated eye exam at least once a year. For this test, the doctor will place drops in the eyes to dilate the pupils. This lets the doctor look inside the eyes more easily. There should be no pain, but sometimes the drops sting slightly. After having your eyes dilated, you must be careful to avoid bright sun until your eyes are not dilated any longer. Often your doctor will give you disposable sunglasses if you don’t have your own.
The major keys in delaying and reducing vision impairment are to keep your blood glucose, cholesterol levels, and blood pressure as normal as possible. According to the American Academy of Ophthalmology detecting diabetic retinopathy at an early stage will help the doctors slow the progression of the disease by as much as 95 percent.
Diabetes and Food
We want to provide clarification about the February/March 2008 issue concerning alcohol. The article is about having an occasional drink. A reader was correct to send concern that diabetes medications carry the warning to avoid alcohol if taking oral medications. That is true. Oral medications may not mix well with alcohol. Both can work to lower blood glucose - sometimes too low. Very low blood glucose (hypoglycemia) is also dangerous.
Check with your doctor if you are taking oral medications and want to have an occasional alcoholic drink. Certain medications are more likely to cause hypoglycemia than others.
An occasional alcoholic drink, like a beer or a glass of wine, is often a social behavior. The American Diabetes Association suggests that if you want to have an occasional drink ask yourself three questions:
- Is my diabetes under control? Meaning - are my blood glucose levels stable and within my target range?
- Does my doctor agree that I don't have conditions that an occasional drink may worsen? These conditions include nerve damage and high blood pressure.
- Do I know how alcohol can affect me and my diabetes?
The American Diabetes Association states that if you answered "yes" to these questions then having an occasional drink might be okay. Visit http://www.diabetes.org/type-1-diabetes/alcohol.jsp for more information, or talk to your health care provider.
Exercise as a Part of Living
The Diabetes Prevention Program reports that 30 minutes of physical activity for five days a week can help reduce your risk of diabetes by half. If you already have diabetes, engaging in physical activity can also help you control your blood glucose, cholesterol, and blood pressure.
A light walking program is a good way to start exercising. Before you start, have comfortable shoes and wear appropriate walking clothes. Start out easy, and walk from your house for 10 minutes and then walk back. Add more distance and time as your energy increases.
Be sure to check with your doctor for advice before you begin a routine.
Recipes To Try
8 1-cup servings
2 pounds chicken, boneless, skinless
2 tablespoons olive oil
2 teaspoons ground cumin
2 small zucchini, sliced
1 teaspoons ground allspice
1 can (14.5 oz) drained chickpeas
1 teaspoons ground nutmeg
1 can (14.5 oz) diced tomatoes
- Trim fat from chicken. Mix spices. Rub mixture into chicken.
- Add oil to skillet. Brown chicken, turning pieces as needed.
- Add zucchini, stirring occasionally for 10 minutes.
- Add chickpeas and tomatoes. Cover, bring to a boil, then lower heat to simmer for 20 minutes.
Preparation time: 10 minutes; cooking time about 45 minutes.
Fat 7 grams
Protein 26 grams
Calories from fat 31%
Carbohydrate 9 grams
Cholesterol 79 grams
Fiber 2 grams
Sodium 342 mg
6 1/2-cup servings
1 package (10 oz.) shredded carrots
1 cup water
1/2 medium onion, sliced, shredded
- In a medium saucepan add carrots and onion. Add water.
- Bring to a boil. Cover and simmer 15 minutes.
- Sprinkle with dill before serving.
Preparation time: 5 minutes; cooking time about 15 minutes.
Fat 0 grams
Protein 1 gram
Calories from fat 0%
Carbohydrate 5 grams
Cholesterol 0 grams
Fiber 1 gram
Sodium 38 mg
Fenofibrate is intended to lower several types of fats and cholesterol in our blood when taken along with a low fat low cholesterol diet. Reducing fat and cholesterol can reduce your risk for cardiovascular disease.
Fenofibrate is sold under the brand name Tricor, Triglide, and Lofibra. Recent research suggests that Fenofibrate may reduce the need for laser eye treatments for individuals suffering from diabetic retinopathy. This study was published in the Lancet medical journal. A five-year follow up of 9800 subjects between the ages of 50 – 74 with type 2 diabetes showed a reduction of diabetic retinopathy laser treatments compared to subjects taking a placebo. This suggested an extra benefit of the medication. The Australian researchers suggested that Fenofibrate coupled with self- management of blood glucose levels can be beneficial to a diabetic patient.
There are many possible side effects of Fenofibrate. These include gas and constipation, with upset stomachs or gastric pain; headaches and dizziness. Longer term studies suggest that Fenofibrate may be associated with an increased risk of cancer, pancreatitis, or problems with the gallbladder.
There are positives and negatives with most medications. Talk to your doctor and pharmacist if you have more questions about Fenofibrate.
News and Resources
American Association of Diabetes Educators toll-free at 1–800–TEAMUP4 (1–800–832–6874), www.diabeteseducator.org
To find a dietitian near you, call the American Dietetic Association toll-free at 1–800–877–1600, or look on the Internet at www.eatright.org and click on "Find a Nutrition Professional."
The National Eye Institute (NEI) is part of the National Institutes of Health. To learn more about eye problems, see www.nei.nih.gov.
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