February/March 2008

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Diabetes - The Medical Perspective

An important part of your medical care plan is checking your blood glucose on a regular basis. The more you check your blood glucose at home, the better you’ll understand how you react to different foods, activities, or stresses.

Checking your blood glucose before a meal tells you how well you (and your medication) are doing in a relative fasting state. A value that is too high may mean that you need more medication, or less food. A value that is too low may mean you need less medication, or more food.

Checking your blood glucose after a meal tells you how your body is responding to that combination of foods and medication if you are taking medication. Some people react with higher blood glucose values to certain foods like pizza or spaghetti than we would expect based on the amount of carbohydrate. Knowing how you react helps to plan you medication schedule, and how much or even what other foods you may eat.

Checking your blood glucose at 2 or 3 am tells you if you are having low blood glucose at night. If you do, this may mean your medication should be reduced or you may need a bedtime snack. Having a very high early morning blood glucose may mean that you didn’t have enough bedtime medication, or that your blood glucose fell and your liver tried to compensate by making more glucose itself.

Because of all these possibilities it is important to keep a record of your blood glucose readings and share them with your health care team. They can help you look at patterns and adjust your diet or medication to help keep your blood glucose at your goal value.

Diabetes and Food

Having an alcoholic drink will not effect your blood glucose if you

• Have your blood glucose in good control normally
• Don’t have complications often associated with diabetes, like high blood pressure or heart disease
• Have the drink close to or with a meal

Drinking alcohol on an empty stomach is not a good idea. Alcohol on an empty stomach can make your blood glucose fall too low (hypoglycemia).

To avoid hypoglycemia if you are having an occasional alcoholic drink,

• Always eat something when you drink alcohol
• Check your blood glucose often, even before, during and after having a drink. Although the effect can be very soon after having alcohol, blood glucose may fall as long as 8 to 12 hours after you’ve had a drink. The Dietary Guidelines for Americans stress that to be healthy, alcohol should be moderate: 2 drinks per day for men and 1 drink per day for women. A drink equals 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor.
• The calories and carbohydrates in alcoholic drinks do count – remember to work them into your meal plan and don’t just “add them on.”

Exercise as a Part of Living

Flexibility is important.  Something we take for granted until we don’t have it anymore.  As we age, developing flexibility will make us more comfortable with all our activities of daily living.

For instance, practicing flexibility exercises for the neck can make it much easier to turn and look over your shoulder when driving.  Flexibility of the leg and back muscles will make it easier to put on shoes and socks.

Staying flexible helps to decrease the likelihood of hurting yourself when you need to move quickly or to move something heavier than normal. Flexibility also helps with everyday movements such as walking, standing up from a sitting position, and reaching for items in cabinets.

Ask you health care provider for flexibility exercises at your next visit!

Recipes To Try

Pecan Crusted Broccoli
6 1-cup servings

¼ cup pecan chips chopped
½ teaspoon marjoram
1 tablespoon olive oil
1 pound frozen
1 tablespoon dry bread crumbs
broccoli, cooked

1. Sauté pecans in olive oil in small skillet for 2-3 minutes. Add bread crumbs and marjoram, stirring frequently. Remove from heat when toasted. Add celery, onion.
2. Toss cooked broccoli with topping mixture.

 Total preparation and cooking time: 20 minutes.

Per serving:
Calories 84                                  
Fat 6 grams
Protein 3 grams                         
Calories from fat 64%
Carbohydrate 4 grams                       
Cholesterol 0 grams
Fiber 2 grams
Sodium 26 mg
Carbohydrate units: 0;
Exchanges: 1 vegetable, 1 fat

Italian Baked Cod
4 servings

1. Preheat oven to 450º.
2. Sauté onions and garlic in oil. Add tomatoes, olives, basil. Simmer until thickened, about 10 minutes.
3. Place in non-stick baking dish. Top with cod fillets. Bake covered about 10 minutes until fish flakes easily.

Total preparation and cooking time: 30 minutes

Per serving:
Calories 153                               
Fat 4 grams
Protein 17 grams                         
Calories from fat 25%
Carbohydrate 12 grams                       
Cholesterol 37 grams
Fiber 4 gram                          
Sodium 144 mg
Carbohydrate units: 1;
Exchanges: 2 vegetable, 2 low-fat meat

Medication Update

When people talk about insulin everyone thinks shots and pain.  Insulin can be your best friend in keeping your blood glucose within your target range – and thereby avoiding or delaying complications like blindness, kidney failure and the need for dialysis, heart disease or stroke, nerve damage and difficulty walking, and possibly the need for amputations.

Try these tips for making the injections more comfortable:

• Use insulin that is at room temperature, not refrigerator temperature
• Make sure the air bubbles are out of the syringe before you inject; flick the syringe gently to get the bubbles to the tip and expel some insulin if necessary
• Try to relax your muscles at the injection site
• Use sharp needles or try a finer gauge
• Don’t start and stop when you are injecting; have a smooth delivery that is quick but not jabbing
• Don’t change the angle of the needle as it enters and leaves the skin; this makes the injection site larger than it needs to be.

Menu Suggestion

*Visit www.urbanext.uiuc.edu/diabetesrecipes/ for recipes in menu above.

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