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Karen Chapman Novakofski

Professor of Nutrition

Marilyn Csernus

Extension Educator, Nutrition and Wellness

 

April-May 2019

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In This Issue
  • Diabetes - the Medical Perspective
  • Diabetes and Food
  • Recipes to Try
  • Menu Suggestions

Diabetes - the Medical Perspective

Job Change Considerations

Diabetes is a chronic, progressive illness that requires ongoing medical management. Having adequate health insurance coverage is an important factor in receiving proper diabetes care. Since most health insurance is provided through one’s employer, changing jobs can be a little more complicated for individuals with diabetes.

Before accepting a job offer, it is important to inquire about insurance coverage. Attempt to understand the new company’s insurance coverage regarding the following:

  1.  Are your diabetes medications and supplies covered?  In most cases diabetes medication, including insulin and items such as blood glucose meters and test strips are covered.
  2. If you use an insulin pump, inquire about coverage of pump supplies and pump replacement coverage.
  3. Does the coverage only cover a specific brand or generics?  If so, are you willing to make those changes?
  4. Will you be required to use in-network health-care providers?  It is sometimes hard to change health-care providers if you have established care with a trusted team.
  5. Do they offer a flexible spending account where you can use some of your pre-tax earnings on health-care cost?
  6. What about employee assistance programs that can provide counseling or short-term counseling that might be beneficial dealing with the daily challenges of diabetes management.

Whether you share that you have diabetes with your employer is a personal decision. If the job involves a fair amount of physical activity and/or physical labor it is probably wise to make your employer aware of your situation.  Someone needs to know how to recognize and treat hypoglycemia, in the event it occurs. 

The Americans with Disabilities Act allows for accommodations that may be necessary for diabetes self-management care. If you will need accommodations from your employer, it is necessary to disclose that you have diabetes. Clearly state what your needs are while at work. Your employer cannot help if they do not understand your needs.  It might be that you need a set meal and break schedule to eat and monitor your blood glucose. Sometimes a doctor’s note can help support your accommodation request to your employer.

Change can bring about stress, which can raise blood glucose levels. Try to maintain your usual eating and physical activity schedule as much as possible. Planning and being prepared can help reduce stress. Think about whether your commute to work will change and whether you need a little more time to get ready for the day. Change can also be positive and result in easier diabetes management.

It is always best to know what to expect and what your insurance will cover, so you do not have unexpected healthcare cost.


Diabetes and Food

Planning around meals and snacks is of utmost importance to anyone with diabetes. Ask whether there is an employee break room, refrigerator space to store meals and snacks, or an employee cafeteria. If you previously worked in a building with access to a cafeteria or restaurant, it might be an adjustment to start packing lunches. If your work hours are changing, consider how this might affect your meal schedule and your physical activity routine.

In some work environments, co-workers eat lunch together. If this is the case, it is your decision whether to disclose that you have diabetes. It may be best to give yourself a little time to adjust to your new environment and get to know your new co-workers before making that decision.

Your meal and snacking habits will depend on your diabetes management plan. Insulin and certain other medications make it necessary to eat and check your blood glucose on a regular schedule. If you are at risk for hypoglycemia while at work, make sure you keep glucose tablets or other quick acting carbohydrates available.  The following could be stored at your workspace or in a refrigerator or cooler:

  • 3 glucose tablets
  • 4 ounces of fruit juice
  • ½ cup regular soda
  • 7-8 Lifesavers candy ®
  • 1 tablespoon of sugar of jelly

Plan for the unexpected. If possible, keep some foods available in case you forget to pack lunch or need an extra snack. Peanut butter and crackers, granola type bars, fresh fruit or nuts are easy to store.  If you have access to a refrigerator, you might keep some of the following items available.

  • Yogurt
  • Fresh fruit
  • Cheese
  • Raw vegetables
  • Skim or low-fat milk

If a new schedule or environment is making diabetes management more challenging, do not hesitate to contact your health-care team. Your registered dietitian and/or certified diabetes educator can guide you in adjusting your meal plan and self-care behaviors to get back on track.


Recipes to Try

Salmon and Asparagus Salad

Salmon and Asparagus Salad

6 servings per recipe

Ingredients

  • 4 cups water
  • 6 salmon fillets, 4 ounces each
  • 1 tablespoon margarine
  • 2 cups asparagus, cut in 1-inch pieces
  • 3 cups cooked rice
  • 1 cup thawed frozen peas
  • ½ teaspoon salt
  • ¼ teaspoon pepper

Directions

  1. Use 4 cups of water in a skillet to steam or poach salmon until salmon flakes with a fork. Remove salmon and discard water.
  2. Heat margarine in skillet and add asparagus, cooking until tender.
  3. Stir in rice, peas, salmon, salt, and pepper.
  4. Cook about one minute, just to heat, stirring to prevent sticking.
Nutrition Facts per serving
Calories 380
Fat 16 grams
Protein 29 grams
Calories from fat 144
Carbohydrate 28 grams
Cholesterol 71 mg
Fiber  3 grams
Sodium 419 mg
This and other recipes available at http://urbanext.illinois.edu/diabetesrecipes/intro.cfm

Spicy Chicken, Beans and Tomatoes

Spicy Chicken, Beans and Tomato

5-1 cup servings

Ingredients

  • 1 teaspoon canola oil
  • 1 pound skinless, boneless chicken breast, cut into strips
  • 1 package taco seasoning mix, reduced sodium
  • ? cup water
  • 14 ounce can black beans, no added salt, drained and rinsed
  • 14 ounce can unsalted stewed tomatoes with onion, peppers and celery, undrained
  • 1 cup frozen corn, thawed

Directions

  1. Spray large skillet with cooking spray and 1-teaspoon canola oil. Cook chicken for 10 minutes or until browned over medium high heat, stirring occasionally.
  2. Remove chicken from skillet and set aside. Add taco seasoning mix and water to skillet, mixing well.
  3. Add chicken, black beans, corn and tomatoes to skillet and simmer for 15 minutes.
Nutrition Facts per serving
Calories 237
Fat 2 grams
Protein 27 grams
Calories from fat 27
Carbohydrate 27 grams
Cholesterol 52 mg
Fiber 7 grams
Sodium 556 mg
This and other recipes available at http://urbanext.illinois.edu/diabetesrecipes/intro.cfm

Sample Menu

BREAKFAST

Amount/ Portion

Whole Wheat English Muffin

1

Peanut Butter

2 tablespoons

Small Banana

1

Skim Milk

1 cup

472 Calories; 63 Grams Carbohydrate; 4 Carbohydrate Choices

LUNCH

Salmon and Asparagus Salad

1 serving

Vegetable Soup

1 cup

Grapes

16

Skim Milk

1 cup

610 Calories;  70 Grams Carbohydrate;  4 ½ Carbohydrate Choices

DINNER

Spicy Chicken, Bean, and Tomato

1 serving

Tossed Green Salad

1 cup

Balsamic Vinaigrette 

2 tablespoons

Sliced Peaches

1 ½ cup

Skim Milk

1 cup

607 Calories; 63 Grams Carbohydrates; 4 Carbohydrate Choices

Total: 1689 Calories; 196 Grams Carbohydrate; 12 ½ Carbohydrate Choices

This and other recipes available at http://urbanext.illinois.edu/diabetesrecipes/intro.cfm