Diabetes -The Medical Perspective
Having diabetes does not increase your risk of having arthritis,
and vice versa, although many people have both of these chronic
Achieving or maintaining optimal body weight is very important
for those who have diabetes and arthritis. Being overweight
makes it harder to keep blood glucose levels normal. Being
overweight also puts a strain on joints already affected by
Exercise is a great tool to shed extra pounds, but for those
with arthritis exercise is often painful. If a joint is inflamed,
additional exercise may worsen the inflammation. Swimming
is usually a good choice for those who have arthritis and
Medications used to treat arthritis include pain killers,
anti-inflammatory medications, and steroids. Some of these
can raise blood glucose levels. Be sure to talk to your doctor
about your diabetes and arthritis care at the same time.
Although having diabetes does not increase the risk of having
arthritis “diabetic arthritis” is a term that
is sometimes used for a group of bone and joint conditions
often found in those with diabetes.
Diabetic cheiropathy is a condition affecting the
hands. The skin is tight and waxy and it may be difficult
to extend fingers or press the palms together flat.
Charcot's joint usually affects the foot and ankle.
There are tiny fractures that don’t correctly repair
themselves. Nerve damage is often also present. The joints
can be swollen and painful.
Those with diabetes also often develop carpal tunnel
syndrome. The fingers and hand may become numb and tingly
because the nerve running through the wrist is compressed.
Talk to your doctor about any joint pain you have and available
treatments or therapy.
Diabetes and Food
Those with diabetes know they are at increased risk of developing
heart disease. Very often a lower fat diet is recommended
along with dietary changes to control blood sugar.
Recently the FDA has ruled that the trans fat content of
foods must be on the Nutrition Facts label. While some companies
are complying now with this law, manufacturers have until
the year 2006 implement the new labelling. Trans fat is formed
when liquid oils are made into solid fats like shortening
and hard margarine. The process is called hydrogenation, and
it increases the shelf life and flavor stability of foods
that have these fats.
Trans fat can be found in vegetable shortenings, some margarines,
crackers, candies, cookies, snack foods, fried foods, baked
goods, and other processed foods made with partially hydrogenated
vegetable oils. A small amount of trans fat is found naturally
in some animal-based foods.
Trans fat has been shown to raise low-density lipoprotein
(LDL) cholesterol that increases the risk of heart disease.
To keep the amount of trans fat in your diet low
- Check the Nutrition Facts panel. Choose
foods lower in saturated fat, trans fat, and cholesterol.
- Choose Alternative Fats. Replace saturated
and trans fats in your diet with mono- and polyunsaturated
- Choose vegetable oils (except coconut
and palm kernel oils) and soft margarines (liquid, tub,
or spray) more often because the combined amount of saturated
and trans fats is lower than the amount in solid shortenings,
hard margarines, and animal fats, including butter.
Exercise as a Part of Living
Pedometers can help people set activity goals and give feedback
for good (or bad) behavior. Pedometers measure the up and
down motion of your body while you walk.
Accuracy will be best when:
- You walk at a brisk pace,
- Your feet strike firmly,
- You have an even stride length,
- The pedometer is clipped to a waistband or belt that is
firm around your waist.
Models may vary. Some require stride length input, require
height and weight input, tell you how many steps you’ve
walked or how many calories you’ve burned. Some will
calculate speed, or have alarms or stopwatches in them. Others
may even talk to you!
Before you begin any new exercise, remember to talk to your
health care provider.
Recipes to Try
8 servings (1 cup each)
1 can (20 oz.) pineapple tidbits
l/2 cup chopped walnuts
1 tbsp. lemon juice
1/2 cup raisins
1 medium banana, sliced
1/2 tsp. salt
3 cups shredded cabbage
6 oz. low-fat tropical yogurt
1 can (15 oz.) mandarin oranges, drained
- Drain pineapple, reserving 2 tbsp. juice.
- Stir lemon juice into reserved pineapple juice. Add banana
- In large salad bowl combine cabbage, oranges, walnuts,
raisins, salt, and juice mixture.
- Add yogurt. Toss to coat. Chill until serving.
Per serving: 156 calories, 4 grams protein, 28 grams
4.5 grams total fat, 26% calories from fat, 0 mg cholesterol,
2.8 grams fiber
Pear Pie with Cheddar Cheese Topping
3 lbs. pears, peeled and sliced
1 tbsp. cornstarch
1/3 cup Splenda®
1/8 teas. salt
1 unbaked frozen pie shell, 9”*
1/2 cup shredded, low-fat cheddar cheese
3 tbsp. margarine, melted
1/2 cup flour
1/4 cup Splenda®
1/8 teas. salt
- Combine pears, Splenda®, cornstarch, and salt. Pour
into pastry shell.
- Combine topping ingredients until crumbly. Sprinkle over
- Bake at 425° for 25-35 minutes until crust is light
brown and cheese has melted.
Per serving: 163 calories, 3 grams protein, 28 grams
5 grams total fat, 30% calories from fat, 2 mg cholesterol,
3.5 grams fiber
*The calories in pie shells vary from 80 to 130 per 1/8 of
a pie. The calories calculated in this recipe used the 86
calories per slice value. Read labels to find the pie shell
with the calories you desire.
A new medication has just been approved for treating the
pain associated with diabetic peripheral neuropathy. Diabetic
peripheral neuropathy is nerve damage to the legs and feet
that occurs when blood glucose levels have been too high for
too long. Often this damage leads to pain in the feet and
The new medication is Cymbalta®, manufactured by Eli
Cymbalta® is the only FDA approved medication for treatment
of peripheral neuropathy pain. Cymbalta® is also approved
by the FDA to treat depression.
In the clinical study that led to its approval as treatment
for peripheral neuropathy, participants felt relief from pain
in the first week after taking the medication, and continued
to improve through the 12 weeks of the study.
The most frequently mentioned side effect was nausea. Other
side effects mentioned included sleeplessness, constipation,
and dry mouth. The symptoms were usually not severe enough
to cause the participants to stop taking the medication.
It is possible that Cymbalta® could raise blood pressure
and monitoring blood pressure is suggested. If you have severe
pain in your legs or feet, talk to your doctor about new treatment
Although not new, The I Hate to Exercise Book for People
with Diabetes by Charlotte Hayes, RD, CDE, may help you
start and keep an exercise program going! 117 pgs. American
Diabetes Association, 2001. $14.95-$10.47
Always looking for quick recipes? Last Minute Meals
for People with Diabetes by Nancy S. Hughes may provide
you with some new, easy ideas. 113 pgs. The paperback contains
100 recipes using 6 ingredients or less. American Diabetes
Association, 2002. $16.95-$11.95
If you have more questions about trans fat, visit www.cfsan.fda.gov/
~dms/ qatrans2.html, updated, June, 2004 for more “Questions
and Answers about Trans Fat Nutrition Labeling”.
If you take Avandia, you may want to visit www.fda.gov/cder/
consumerinfo/druginfo/avandia.htm, updated May, 2004.
The FDA has posted new consumer information about the drug.
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