Diabetes -The Medical Perspective
We know that hearing loss occurs more frequently in older
adults than in younger adults. We know that diabetes occurs
more often in older adults than in younger adults. Several
recent studies have suggested that those with diabetes may
suffer hearing loss more often than those of a similar age
who do not have diabetes.
Researchers speculate that the same processes that occur during
diabetes that damage nerve tissue as well as organs like the
eye and kidneys may also damage the ear. At this point, no
one has proof, but scientists and doctors think it sounds
Another study found that certain hearing structures may be
damaged in those who have diabetes, and that this damage is
present even before any problem can be diagnosed by clinical
tests of hearing sensitivity. The nerve impulses going from
the ear to the brain may move more slowly in those who have
diabetes than in others. This suggests that those who have
diabetes may have difficulty understanding speech even if
they have little or no hearing loss.
The best approach is to have your hearing checked during your
regular appointment, or ask your doctor to refer you to an
audiologist. If you’ve never been to an audiologist,
ask your doctor or nurse about what they can do for you. Audiologists
have special training in the prevention, diagnosis and treatment
of hearing disorders. Think of it as your spring tune-up!
If you can’t find an audiologist, try the American Academy
of Audiologist’s website at www.audiology.org.
Diabetes and Food
"Sugar free" doesn't mean "free food." Most sugar-free foods
are desserts and sweets - cookies, jam, jellies, candy. Remember
that the American Diabetes Association says that it is the
total amount of carbohydrate and calories that are eaten that
is important, not just sugar. In fact, people with diabetes
can have foods with sugar in them as long as they eat those
foods with a meal and include those calories or carbohydrates
as part of their meal plan.
Consider these sugar-free oatmeal cookies:
Serving size - four cookies (26g)
Total fat 5g
Total carbohydrates 15g
Dietary fiber 0g, Sugars 0g, Maltitol 6g, Protein 2g.
A regular oatmeal cookie is about 15 grams, but can be as
little as 12 grams but up to 50 grams per cookie! Size will
make the biggest difference in calories or carbohydrates.
What about the total carbohydrates? Fifteen grams equals one
carb unit if you are carbohydrate counting. If you are using
Exchange Lists, this is one starch exchange and one
fat exchange. If you use the Food Guide Pyramid,
these cookies will be a serving from the Breads and Starches
Maltitol is a sugar alcohol, also called a polyol. Can you
subtract those carbohydrates from the total? The rule of thumb
for carbohydrate counting is that if polyols are just one
of the sources of carbohydrates, divide the grams of polyols
in half and subtract that amount from the total carbohydrate.
In this case it would be 6 divided by 2 = 3. Fifteen total
carbohydrates minus 3 = 12.
In cases where polyols are the only carbohydrate, if there
are 10 or more grams of polyols - sorbitol, mannitol, or xylitol
- then divide the grams by 2 and subtract. Also, remember
not to eat more than three servings of polyol-containing foods
each day. If the total carbohydrate in the food comes from
polyols and there is less than 10 grams per serving, the carbohydrates
do not need to be counted if three or fewer servings are eaten
in a day.
Exercise as a Part of Living
Have you heard of T'ai Ch'i (pronounced tie chee)? Many
leisure and sports organizations are adding T'ai Ch'i to their
programs. T'ai Ch'i is a traditional Chinese martial art,
but it is also practiced for exercise benefits. One of the
principles of T'ai Ch'i is an emphasis on relaxation of tension,
both physical and mental, leading to the development of internal
There are different spellings of T'ai Ch'i and different
types of T'ai Ch'i classes. T'ai Chi Chuan is one of the most
famous and widespread of all Chinese health enhancing exercise
systems. It includes 108 movements in the long form or between
20 and 40 movements in the short forms.
As always, search for the right exercise program for you,
and see your doctor before starting anything new.
Recipes to Try
Cauliflower Potato Soup 14 servings (1 cup each)
2 tablespoons margarine
1 teaspoon caraway seeds
1 cup chopped onion
6 cups fat-free chicken broth
4½ cups chopped cauliflower
½ teaspoon salt
4 cups peeled, diced potato
Pepper to taste
¾ cup shredded carrot
- Melt margarine in large saucepan; add onion. Cook until
- Add cauliflower, potato, carrot, and caraway seeds, stirring
constantly for 4-5 minutes.
- Add remaining ingredients and bring to a boil. Reduce
heat, cover and simmer about 15 minutes or until vegetables
are tender. Remove lid, and lightly mash vegetables until
chunky, pureed mixture.
- Replace lid and simmer another 20-30 minutes.
Per serving: 91 calories, 3.5 gram protein, 15 grams
carbohydrate, 2 mg cholesterol, 2.6 grams fat, 24% calories
Peach Raisin Tart (8 servings)
1 cup raisins
1 16-ounce bag frozen, unsweetened peaches, thawed
1/3 cup Splenda®
2 tablespoons flour
½ teaspoon cinnamon
1 tablespoon lemon juice
¼ teaspoon salt
1 9-inch unbaked pie shell
- Preheat oven to 425°.
- Combine raisins, Spenda®, flour, cinnamon, and salt.
- Combine peaches and lemon juice. Toss peaches with raisins/flour
- Put peach mixture in middle of pie shell. Fold edges
toward center of pie and crimp together.
- Bake for 10 minutes. Reduce heat to 350° and bake
20 to 25 minutes more until crust is golden brown.
Per serving: 167 calories, 2 grams protein, 30 grams
carbohydrate, 0 mg cholesterol, 5 grams fat, 29% calories
Metformin (Glucophage) is a biguanide that works by improving
the body’s own insulin action by the liver and decrease
liver glucose production. There are two kinds of metformin,
regular and extended release.
Metformin is also combined with other medications. Glucovance
is a combination of glyburide and metformin. Avandamet is
a combination of rosiglitazone and metformin. Metaclip is
a combination of glupizide and metformin.
These combination drugs for treating diabetes are similar
to cold medication that has more than one drug in it. For
instance, a cold medication might have a decongestant and
an antihistamine. The decongestant and the antihistamine have
different ways of lessening the effects of a cold. The same
is true for the combination diabetes medications. Each part
has a different way of treating high blood glucose levels.
If a single ingredient type of oral hypoglycaemic is not
keeping your blood glucose in your goal range, talk to your
doctor. Ask if a medication that has two approaches to treating
high blood glucose would be helpful for you, or at least worth
a trial. Remember to check your blood glucose often until
you and your doctor are comfortable with a new medication.
A study by the Health and Human Services' Centers
for Disease Control and Prevention shows that deaths
due to poor diet and physical inactivity rose by 33 percent
over the past ten years. The study was published in the Journal
of the American Medical Association and suggests
that interventions to prevent and increase cessation of smoking,
improve diet, and increase physical activity must become much
higher priorities in the public health and health care systems.
The report is titled Actual causes of death in
the United States, 2000 and was published in
the March 10, 2004 issue of JAMA.
Many public libraries carry this journal.
A Nutrition Notes article discusses
pedometers, that have become a favorite way to increase activity
and keep track of how well you’re doing. Pedometers:
Do They Make a Difference? Device Can Bring Benefits if Used
Correctly by Karen Collins, R.D. is available
Nutrition Notes are press releases
by Karen Collins for the American Institute for Cancer Research,
but often apply to those without cancer as well.
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