Karen Chapman Novakovski - Associate Professor of Nutrition

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February/March 2007

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In This Issue

Diabetes - The Medical Perspective

Getting a cold or the flu during the winter months can be annoying, inconvenient, and for those with diabetes, can cause higher blood glucose levels.  The infection itself may cause blood glucose fluctuations, but over-the-counter medications can cause rises in blood glucose, too.

Check the ingredients part of the label for dextrose, sucrose or dextrin.  Even if they don’t contain sugar, decongestants and cough syrups can raise blood glucose levels.  Check with your pharmacist or health care provider for cold and flu remedies that are more appropriate for you. 

To help avoid a cold or the flu wash your hands frequently. Telephones, door handles and stair rails may have cold germs on them, and help transmit the germs to you when you touch your nose, mouth or face. Of course, it is hard to avoid the air-borne germ droplets after someone else coughs or sneezes!  If you have a cough or the sniffles, remember to cover your mouth to avoid spreading the germs.

Make sure you have a sick day plan for your food and medications just in case you are unlucky and get the flu.  Skipping medications because you aren’t eating much is usually not the recommended practice.  Your body releases stress hormones in response to infection that can raise blood glucose even if you aren’t eating!  Check your blood glucose to see if this is happening to you, especially if you are nauseous.

An upset stomach maybe part of the flu, or may be a symptom of high ketones. If your blood glucose rises to above 240 mg/dl, check your urine or blood for ketones and call your health care provider.

This is a reminder to get a flu shot for this year to help keep your diabetes well managed.

Diabetes and Food

Extra vitamin C to prevent colds may not be a science-based practice but almost everyone drinks some extra juice to ward off the sneezes. If you have diabetes, remember to include the carbohydrate in the fruit juice as part of your meal plan.  Although a healthy choice, juices are not calorie or carbohydrate-free!

Because of their liquid form, the carbohydrates in juices may also be absorbed more quickly than fruit.  That’s why people who are having low blood glucose may be given orange juice - it is rapidly absorbed.  If you have diabetes and are not experiencing low blood glucose, drinking juice with a meal will help to slow the rise in blood glucose, especially if the meal has fiber, protein, or fat.

For high vitamin C choices in addition to juice try:

  • cantaloupe
  • kiwi
  • oranges
  • papaya
  • strawberries

Exercise as a Part of Living

For every reason you can think of that you should start exercising there will be at least that many reasons why you shouldn’t.  The “Big 3” are:

  • It’s too cold/windy/rainy/snowy
  • I don’t have time
  • I’m too tired

The counter-arguments for these are well known:

  • Do something inside
  • Make time for yourself
  • Exercising will give you more energy

So think harder. Think about why you really haven’t started your New Year’s resolution yet.  Need motivation? Try making a rash decision and calling the YMCA for ballroom dance classes or low impact aerobics.  Sign up today as a gift to yourself.

Embarrassed that you’re too out of shape to go to a class?  Go observe first.  Most people are not models – just ordinary people trying to improve their health.

If you want a moderate to strenuous program, always check with your doctor first.  Call today before the weather gets worse, you fall asleep, or you don’t have time.

Recipes To Try

Orange Asparagus Chicken Stir Fry
8  1-cup servings

2 tablespoons oil                                              
1 tablespoon ginger
1 medium hot pepper                                       
2 lbs. asparagus
1 3/4 lbs. boneless, skinless chicken                 
1 cup water
2 tablespoons orange peel        
1 teaspoon cornstarch

  1. Add oil to large skillet. Finely chop pepper, add to oil; cook on medium heat.
  2. Chop chicken into 1/2 x 1-inch pieces and add to oil.
  3. Cover, cooking a few minutes, stirring occasionally.
  4. Add orange peel and ginger; cover, cook a few minutes, stirring occasionally.
  5. Wash asparagus, trim, and cut into 1-inch pieces.
  6. Remove chicken from pan; place in bowl and cover to keep warm.
  7. Add asparagus to pan with 1/2 cup water. Cook 6 to 7 minutes on high heat or until tender.
  8. Mix cornstarch into 1/2 cup cold water; add to pan, stirring constantly. When mixture begins to boil, add chicken. Cook on medium heat, stirring for 2-3 minutes.

Per serving:
Calories: 180                                
Fat: 7 grams
Protein: 24 grams
Calories from fat: 36%
Carbohydrate: 3 grams                          
Cholesterol: 69 grams
Fiber: 1 gram
Sodium: 92 mg

Pesto Tortellini
8  1-cup servings

1 package frozen tricolor tortellini
2 medium summer squash        
1/4 cup pesto                                                   
1/4 cup shredded Parmesan and Romano cheese         
2 medium zucchini                                                 
  1. Preheat oven to 350º.
  2. Cook tortellini according to package directions.
  3. Wash and slice zucchini and other squash.
  4. Toss vegetables, tortellini, and pesto together.
  5. Place mixture in (greased?) baking dish. Sprinkle with cheese. Bake 20 minutes until cheese is melted.

Per serving (3 strawberries):
Calories: 185                                
Fat: 5 grams
Protein: 7 grams
Calories from fat: 26%
Carbohydrate: 26 grams                        
Cholesterol: 8 grams
Fiber: 2 grams
Sodium: 390 mg

Medication Update

Januvia (sitagliptin) is a new drug recently approved by the Food and Drug Administration. Januvia works by blocking an enzyme that breaks down proteins needed for insulin release.  By blocking this enzyme, the proteins aren’t broken down and insulin release is promoted when it is needed.

This new drug is oral so it doesn’t need to be injected.  It also only works when blood glucose levels are high so there is no risk of hypoglycemia.

Unlike many other medications, Januvia doesn’t have a side effect of weight gain.  The other big plus is that it can be taken just once a day.  Januvia can be used by itself or with other medications.

Side effects that might occur are stuffy or runny nose, headache, sore throat, or head cold.

Because Januvia works to enhance insulin secretion, it is not appropriate for those with type 1 diabetes because they have no insulin to secrete.

News & Resources

For those with diabetes who have low vision or who are blind, finding information can be difficult. However, the Diabetes Action Network of the National Federation of the Blind publishes a quarterly newsletter called Voice of the Diabetic available at http://www.nfb.org /nfb/ Voice_of_the_Diabetic.asp or by calling 573-875-8911.

The Braille Group of Buffalo, New York has many books on diabetes available in Braille, including cookbooks.  Call Braille Group of Buffalo at 800-561-8253 or email brlgrp@adelphia.net.

The Hadley School for the Blind has a 10-lesson course on diabetes that is offered in Braille, in large print, online, or audiotaped.  Call Hadley School for the Blind at 800-323-4238 or email visit www.hadley-school.org

About Diabetes | Food & Diabetes | Medications & Diabetes | Current Issue | Archive | En Español

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