October/ November 2003

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Diabetes -the Medical Perspective

For people with diabetes, the flu can be more than aches and pains. It can mean longer illness, hospitalization, even death! Diabetes can make the immune system more vulnerable to severe cases of flu. In fact, people with diabetes are almost three times more likely to die with influenza, “the flu”, or pneumonia.

So take control!
When you live with diabetes you are careful about the food and meals you eat, you try to exercise each day, and you see your doctor regularly. Now add an annual flu vaccine to your routine. Call your doctor’s office to make sure a flu shot is okay for you.
Check the schedule for flu shots in your local paper or clinic.

You might also ask your doctor about a pneumonia vaccine. This vaccine protects against pneumococcal disease, which is the most common form of pneumonia. This vaccine is safe to take at the same time as the flu shot, and for most people one dose one time provides years of protection.Both the flu shot and pneumococcal vaccines are covered by Medicare, Part B. Be sure to take your Medicare card.

Can a Flu Shot Give Me the Flu?
No. Flu vaccines do not contain a live virus, so they cannot infect you. Some people coincidentally have a cold a week or two following immunization. This is not a result of their flu vaccine.
The flu is not a cold.

Do I Need a Flu Shot Every Year?
Yes. Flu viruses vary from year to year, so it is important to get a shot every year to be sure.

Do I Need To Get a Pneumonia Vaccine Every Year?
No. Usually one vaccine will last years and years.

Diabetes and Food

The Nutrition Facts on food labels are packed with information, whether you have diabetes or not. Right at the top is one of the most important pieces of information – serving size! Although you may know how much you want to eat, knowing the serving size is the first step towards using your meal plan and managing your diabetes.

For example, look at several Nutrition Facts labels on bread. Some have a serving size of one slice, while others have a serving size of 2 slices. In this case, the serving size information can help you choose a product that will fit both your food preferences and your meal plan.

The next important piece of information is the calories per serving. It would be logical to assume that if one slice of bread was 70 calories that two slices of bread would be 140 calories. However, the manufacturers would try to keep the calories per serving roughly equal. The only way to do that is to make the slices thinner, and perhaps smaller. Two slices of bread may not equal the 70 calories of one slice – it may be closer to 90 calories.

How you adjust your meal plan to account for these few extra calories depends on the meal plan you are using – the plate method, the Food Guide Pyramid, the exchange lists, or carbohydrate counting. Talk to your dietitian and start reading food labels from the top!

Exercise as a Part of Living

Researchers at the Centers for Disease Control in Atlanta, Georgia, recently published the results of a study they conducted with adults who have diabetes. They interviewed 2,896 people, asking them how often they had walked for exercise during the previous 2 weeks, the average number of minutes they spent walking each time, and how much their heart and breathing rates increased while walking.

The average age of the participants was 59 years old and the average length of time that they had diabetes was 11 years. About one-third used insulin.

Compared with participants who reported no walking, those who walked at least 2 hours per week had a much lower mortality rate from any disease (39%) and a much lower risk of dying from a heart disease (34% lower). Those who walked longer had an even lower mortality rate. Those who perceived the intensity of their walking to be fairly high also had a lower mortality rate than those who didn’t feel they were really working at it.

At your next visit, talk to your doctor about your walking program.

Recipes to Try

Banana Walnut Muffins

12 muffins

1-½ cups flour
½ teas. salt
¾ cup chopped walnuts
¼ teas. nutmeg
½ cup toasted wheat germ
2 ripe bananas, mashed
¼ cup brown sugar, not packed
¾ cup milk, non-fat
¼ cup Splenda®
4 tbsp. margarine, softened
1 tbsp. baking powder 1 egg
1 teas. cinnamon

1. Preheat oven to 400º. Fit muffin pan with 12 paper liners.
2. Mix flour, walnuts, wheat germ, brown sugar, Splenda®, baking powder, cinnamon, salt, and nutmeg in a large bowl. Stir in remaining ingredients. Mix until just blended.
3. Fill muffin liners with mix.
4. Bake until a toothpick comes out clean, about 20 minutes.

Per serving: 200 calories 6 grams protein
24 grams carbohydrate 18 mg cholesterol
9 grams total fat 42 % calories from fat

Salmon and Asparagus Salad

6 servings

4 cups water 3 cups cooked rice
4 6-ounce salmon fillets 1 cup thawed frozen baby peas
1 tbsp. margarine ½ teas. salt
2 cups asparagus, cut in 1” pieces ¼ teas. pepper

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. Cook about 1 minute, just to heat, stirring to prevent sticking.

Per serving: 380 calories 29 grams protein
28 grams carbohydrate 71 mg cholesterol
16 grams total fat 38% calories from fat

Medication Update

It is very important to remember the exact name of your medications. If remembering is a problem, write the name of your medications on a card, and keep that card in your wallet.

Recently there has been confusion reported between Lantus® (insulin glargine) and Lente® (zinc insulin suspension) insulins. Their names look-a-like and sound-a-like in some respects. Does it make a big difference? Yes, it can.

Lente® is quicker acting but does not last as long as Lantus®. Lantus® is usually given at bedtime while Lente® is often given in the morning.

The company who makes one type of lente insulin called Novolin® L (Lente®, human insulin zinc suspension [rDNA origin]) is discontinuing this product. While insulin glargine (Lantus®) is an option, there is a difference in absorption rate, when the drug is most active, and how long the effects of the insulin lasts.

If your pharmacist or doctor changes the name of your insulin, make sure you understand how the drugs are similar and how they differ. A change in insulin may be changing one brand for another, resulting in little or no effect for you. However, it may also be changing the insulin type. Although this may also result in little or no effect on you, there is a likelihood that some effects will be different.

New Resources

Although the primary audience is for parents of children with diabetes, the website Children with Diabetes at http://www.childrenwithdiabetes.com/index_cwd.htm has information for everyone. The homepage is fairly crowded, but if you take time to read through it, there will be some new information just for you.

Diabetes123.com has a new section for readers favorite recipes. Each recipe is posted on a separate page to make printing easier. The recipes have a nutritional analysis for calories, carbohydrates, protein, and fat, as well as listing exchanges.

The American Association of Diabetes Educators has joined with Merck & Co., Inc. to spread the word about heart disease risk to those with diabetes. Visit the webpage http://www.aadenet.org/EducationalCampaigns/HeartPart/page1.html or to receive a free Diabetes: Know the Heart Part brochure mailed directly to you, call 1-800-224-4089.