Karen Chapman Novakovski - Associate Professor of Nutrition

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August/September 2009

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In This Issue

Diabetes - The Medical Perspective

People with diabetes are at a greater risk for kidney disease than the general population. The kidneys filter toxins out of your body though the blood vessels.  You might think of the kidneys like a car filter or vacuum cleaner filter.  High blood glucose can injure blood vessels and then the filtering is not as good as it should be. 

This can lead to weight gain, retention of salt and water, protein in your urine and waste materials building up in your blood.  About 30% of people living with Type 1 diabetes and around 10-40% of people with Type 2 diabetes will
eventually suffer from kidney failure.

There are tests to evaluate your kidney function. One is called a BUN (blood urea nitrogen) to creatinine ratio.  The normal level for your BUN should be between 10-20 mg/dL and your creatinine should be between 0.6-1.4 mg/dL. 

High numbers for your BUN and creatinine may cause your health care team to do things differently because the kidneys aren’t working well.  One change may be how they order x-rays or other imaging testing.  Imaging testing is done using dye to make certain organs, certain tissues, & certain blood vessels become visible on X-rays. It may also be used for a CT scan, ultrasound, or magnetic resonance imaging (MRI). However, the dye might cause more problems with your kidneys.

This is why it is important to tell the nurse, doctor, and technician that you have diabetes. If your BUN levels are high, your doctor may not give you the dye as part of your x-ray.

Diabetes and Food

Several different tests in the x-ray department will require you to do different things related to eating and drinking prior to, during and after your test.

When you are having a barium swallow or x-rays of your upper stomach and intestines, you might be asked to stop eating and drinking 12 hours before the test. A barium swallow looks at the upper and middle sections of your gastrointestinal tract.  During the test you will also be asked to drink barium contrast material.  The barium will light up on the screen allowing the radiologist to watch it as it travels through your esophagus, stomach and the beginning of your small intestine.  When the contrast is in your body, the radiologist will take “pictures” or X-rays needed to diagnose your symptoms.  After the test is over and for the next few days, you need to drink a lot of fluids.  This helps get the barium out of your body quicker. 

Remind your doctor you have diabetes if an x-ray is ordered. Ask if the tests require you to change your diet or medications for your diabetes.

Medication Update

Always tell your nurse, technician, and doctor what your medications are. They probably have a list already, but it is better to be sure they know.  Also tell them all the over-the-counter drugs you take, as well as any supplements.

Metformin (Glucophage) is taken by many people with diabetes. Sometimes they need an x-ray and sometimes those x-rays work better with a dye to help the x-ray take a better picture.  One type of dye is called iodated contrast material. When people who take metformin need to have iodinated contrast material for a test, certain precautions need to be taken.  This is because when metformin and iodinated contrast are taken together your kidneys may not be able to remove the metformin from the blood.

Before having surgery or an x-ray, tell your doctor and technician that you are taking metformin. You will need to temporarily stop this medication before your exam or procedure.  Your doctor will also tell you when it is okay to start taking it after the exam so there are no complications.  Remember do not stop, start or change the dose of your medication until you have first talked to a healthcare professional.

Recipes To Try

Two Potato Bake
8 serving

  • 1 cup instant potato flakes
  • 1/3 cup Parmesan cheese
  • 1 1/4 cup water
  • 1 tablespoon chopped garlic
  • 2/3 cup skim milk
  • 16 frozen potato wedges, (24-ounce package)
  • 1 cup no fat sour cream
  • Cooking spray
  1. Heat oven to 400°F. Spray 2-quart baking dish with non-fat cooking spray. Bring water to boil in sauce pan.  Add potato flakes and skim milk. Fluff flakes to make mashed potatoes.
  2. Add sour cream, Parmesan cheese, and garlic. Mix well. Place in the baking dish. Arrange potato wedges in a spiral on top of mashed potato mixture. Bake 30-35 minutes until hot.

Per serving:
Calories 121
Fat 3 gram
Protein 5 grams    
Calories from fat 20
Carbohydrate 20 grams     
Cholesterol 6 mg
Fiber 1 grams
Sodium 227 mg

Chocolate Banana Bread
14 servings

  • 1/2 cup margarine, softened
  • 1/2 cup Splenda®
  • 1/2 cup sugar
  • 2 eggs
  • 1 cup mashed ripe bananas (about two medium)
  • 1/4 cup skim milk
  • 1 teaspoon vanilla
  • 2 cups flour
  • 1/4 cup cocoa
  • 1 teaspoon baking soda
  • 1/2 teaspoon salt
  • 1/4 cup finely chopped nuts
  1. Preheat oven to 350°F.  Mix together margarine and sugars very thoroughly. Add eggs, bananas, milk, and vanilla; stir well.
  2. Add the rest of ingredients and mix until just barely combined. Pour batter into a greased 8 1/2 x 4 1/2 inch loaf pan. Bake for 55 minutes or until toothpick inserted near center comes out clean. Cool for 10 minutes before removing from pan; cool completely before wrapping for storage.

Per serving:
1 serving = 1 slice
Calories 198
Fat 8 g
Protein 4 gram
Calories from fat 36
Carbohydrate 27 grams
Cholesterol 27 mg
Fiber 1 grams      
Sodium 247 mg

Menu Suggestions

Breakfast

Amount/Portion

Scrambled egg beaters

1/2 cup

Whole grain waffles

2 waffles

Trans fat free margarine 1 tablespoon
Orange 1 medium
295 calories, 63 g carbohydrates, 4 carbohydrate choices
   
Snack  
2% cheese slice 1 slice
Saltine crackers 8 crackers
154 calories, 18 g carbohydrates, 1 carbohydrate choice
   

Lunch

 

Whole wheat spaghetti

2 ounces (1/8 of package)

Jar spaghetti sauce with meat

1/2 cup

Garlic Texas toast 1 slice

Steamed broccoli

1 cup

500 calories, 62 g carbohydrates, 4 carbohydrate choices
   
Snack  
Apple 1 medium
Peanut butter 2  tablespoons
270 calories, 20 grams carbohydrates, 1.5 carbohydrate choices
   

Dinner

 

Grilled pork chop

3 ounces

Baked potato

1 medium

Reduced fat sour cream 2  tablespoons
Green beans 1 cup
Trans fat free margarine 1  tablespoon
Diced peaches in light syrup 1 - 4 ounce can
Skim milk 1 cup
507 calories, 62 g carbohydrates, 4 carbohydrate choices
   

Total: 1726 calories, 225 g carbohydrates, 14.5 carbohydrate choices
Meals may also include a calorie-free beverage (diet soda, tea, coffee, etc.)


 

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


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

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