August /September 2001

Diabetes - The Medical Perspective

In 1997, the American Diabetes Association (ADA) recommended low-
dose aspirin therapy to prevent cardiovascular disease among adults with diabetes. A recent study examined the aspirin use among adults with diabetes in the U.S. and found that only 20 percent took aspirin regularly during 1988-1994. According to the authors, "Aspirin use may have increased in recent years, and we hope to see substantial increases as a result of current efforts to educate doctors and patients about the benefits of aspirin therapy in diabetes."

According to ADA, doses of 81-325 mg/day of enteric-coated aspirin are advised. The use of aspirin has not been studied in individuals with diabetes who are less than 30 years of age and aspirin should not be recommended for those less than 21 years of age because of the risk of Reye's syndrome.

"Aspirin has been shown to be effective and relatively safe treatment for people with diabetes. Trials have demonstrated that aspirin therapy can prevent the first heart attack, stroke or other indication of cardiovascular disease." If you are 30 years or older with diabetes and are not using aspirin regularly, talk to your doctor about aspirin use. Diabetes Care: 24:197-201, February 2001.

Diabetes and Food

With summer just around the corner, our days’ become more & more packed with outside activities, sports, yardwork, & vacation plans. It may seem like there is hardly time to eat a meal, let alone eat a balanced meal!

So many times it is just easier and more timely to stop and pick something up at a fast food restaurant. Does this mean we are throwing our diet out the window? It doesn’t have to mean that!

Fast Food Restaurants

There are a few problems to overcome when eating at fast food restaurants:

high-fat food
high-calorie food
few fruits, vegetables

One of the main problems with eating at fast food restaurants is that they tend to be high-fat, high calorie foods. Some restaurants carry more lower fat, lower calorie foods than others. For instance Subways carry lower calorie sandwiches, in general, than do Burger King. Even so, the selections will vary even within a particular restaurant depending on where you are. A Dairy Queen Brazier in the Chicago area might have different selections than one in Vandalia.

When eating at a fast food restaurant, think about the total amount of calories you should be eating for the day. Divide that by three, thinking about your three meals. Although this number of calories will be different for many of us, in general we probably don’t want to eat a sandwich that is more than about 500 calories, especially if we want more than a sandwich to eat!

Fast food restaurants have nutrient charts available, even if they don’t have this information posted. However, it is hard to stand in line and decide on our selections. Try looking ahead and deciding "best choices" at several fast food restaurants before even getting there! Although not all restaurants are listed, information about comparing selections from many fast food restaurants can be found at www.cyberdiet.com on the internet.

To add fruits and vegetables to your diet when eating at fast food restaurants, you can: choose salads or fruit selections at the restaurant; plan ahead and bring your own vegetable or fruit selections; increase your fruit and vegetable servings at another meal to "make up" for not having them at your fast food restaurant meal.

Be careful to keep your calories balanced if tight blood glucose management is important for you.

Exercise as a Part of Living

While enjoying the outdoors this summer, remember to participate – not just watch those fun activities.

If you really are more of a "watcher" than a "doer" get up occasionally and walk- around the baseball field, the soccer field, through the gold course, or just around the block. Walking is a great weight-bearing activity that can be healthful, easy, and fun!

Recipes to Try

Grilled or Broiled Orange Chicken

(4 Servings)

4 skinless boneless chicken breast halves (about 1.5 pounds)
1/2 cup frozen unsweetened orange juice concentrate, thawed
1/2 cup lemon juice
2 Tbls. grated orange peel
1/2 tablespoon garlic powder

1. Place chicken in shallow dish. Mix remaining ingredients. May add salt to taste. Pour over chicken. Turn chicken to coat with marinade. Cover and refrigerate overnight, turning chicken at least once.
2. Grill or broil chicken until the juice of chicken is no longer pink. Actual cooking time will vary depending on heat of the grill, distance from broiler heat and thickness of chicken.

Per serving:

Roasted Vegetable Salsa

(12 1/2 cup servings)

2 cups chopped tomato
2 tablespoon olive oil
1.5 cups chopped summer squash
1/4 tablespoon thyme
1.5 cups chopped zucchini squash
1/8 tablespoon salt
1/2 cup chopped green pepper
1/8 tablespoon black pepper
1/2 cup chopped onion
1/4 tablespoon dried dill weed non-stick spray coating

1. Spray a 7x11" glass pan with non-stick coating. Heat oven to
   400 °F.
2. Toss ingredients lightly in bowl. Pour into pan.
   
3. To shorten roasting time, cover pan with wax paper & microwave on high for 4-5 minutes. Roast for 25-30 minutes, stirring occasionally. If not microwaving, roast for 55-60 minutes.
   
4. Serve warm or cold, as an appetizer with crackers, or as a vegetable.

Per serving:

Medication Update

Ginseng and Diabetes

Ginseng is a perennial herb that is marketed as an "adaptogen" and also as an enhancer of sexual potency. As an adaptogen, ginseng is said to increase the resistance of the body to stress, or help it adapt. One way that ginseng has been tested is concerning its effect on the way the body adapts to carbohydrate intake. Some say it increases the sensitivity of the body to insulin, others say it increases the amount of insulin the body secretes, while others say it has no effect.

Several studies have shown that ginseng can make the natural rise in blood glucose found after carbohydrate ingestion lower - that is, the glucose peak is not as high. Some studies have tested this in people who are not diabetic, other studies were in people who have type 2 diabetes.

There are several different types of ginseng, the two most common being Oriental ginseng and American ginseng. Most commonly available in the United States is Oriental ginseng. In this type of herb there are at least 13 different components that may have some kind of biological effect. Standardizing ginseng has not occurred. Some ginseng may have many active compounds, others will have none. This makes it very difficult to adequately test the effectiveness of ginseng in promoting wellness.

For now, ginseng use in diabetes is only experimental. If you are using ginseng and you have diabetes, make sure you talk with your health care provider. Ginseng may cause your blood sugar to change unexpectantly. This could be very dangerous to your health.

New Resources

What You Need to Know about Diabetes — A Short Guide. Joslin Diabetes Center. This 2000 revision of a Joslin bestseller is easy-to-read and understand, yet is also a comprehensive resource for those with diabetes. 60 pages. Item#: JDC 210 Price: $11.50. Available through http://store.joslin.org/

Controle su Diabetes. Centros para el Control y la Prevención de las Enfermedades, Centro Nacional para la Prevención de las Enfermedades Crónicas y la Promoción de la Salud, División de Traducción para la Diabetes. Disponible en: http://www.cdc.gov/diabetes/pubs/pdf/spanish.pdf

Diabetes Problem Solver. $19.95, ISBN 1-58040-009-4, available through the American Diabetes Association: 1-800-232-6733, through book stores nationwide, or order via Amazon.com for only $17.95. Helps those with diabetes deal with the psychological aspects of having diabetes and the health complications that may also occur.