October/November 2005

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Diabetes -The Medical Perspective

If you have diabetes, remember to care for your eyes.  Diabetes is the leading cause of blindness, but many cases can be prevented.

In diabetic retinopathy (disease of the retina), small blood vessels in the retina of the eye are damaged, resulting in bleeding and fluid leakage. This can also decrease oxygen supply to the eye. The damage to the small blood vessels is worse when blood glucose levels have been high for long periods of time.

The first step in preventing retinopathy is lowering your blood glucose to your target range.  Even if you already have an eye disease, lowering your blood glucose can lessen the progression of the  disease.

Your eyes will also be healthier if you can keep your blood pressure normal.  If you have diabetes, know your blood glucose level and your blood pressure.  High blood pressure increases blood flow to the eye, but the blood flow is usually turbulent and is more likely to clot abnormally.

Make sure you see an eye doctor (ophthalmologist) who has experience and knowledge about diabetes.  You should get a dilated eye exam each year.  Your doctor can tell you what the pressure is within your eye.  He may be able to estimate your risk of eye disease using your intraocular pressure and your blood pressure to calculate the mean arterial pressure (MAP). Some doctors will use this value in a math equation to calculate eye disease risk.  Make an appointment today for your eye exam!

Diabetes and Food

With the fall season, a new crop of fruits and vegetables are waiting to fill our plates.  The fall vegetables colors orange and red are good indicators that the vegetable is a source of carotenoids.

Carotenoids are pigments made by plants.  This group of pigments include beta-carotene, lutein, zeaxanthin, and lycopene.  Although beta-carotene can be split to produce vitamin A, lutein, zeaxanthin, and lycopene have no ability to become vitamin A.  Researchers believe they have their own work to do in the body.

Research with lycopene has been focused on prostate cancer, but the answers aren’t in yet.  Although you can buy lycopene supplements, and no toxic effects have been reported, scientists and nutritionists suggest that the best way to include lycopene in your diet is with red fruits and vegetables.

 Tomatoes are especially rich in lycopene. Lycopene gives tomatoes, pink grapefruit, watermelon, and guava their red color.

Exercise as a Part of Living

Isometric exercises are those that are big muscles contractions.  When you suck in your stomach, that is an isometric contraction.  Isometric exercises are completed without moving a joint.  Another example is pushing into a doorframe while contracting the shoulder and arm muscles.

Isometric exercises are not as good for your heart as running or jogging. Running and jogging are aerobic exercises and increase circulation.  More importantly, isometric exercises can increase blood pressure and should not be performed by those with high blood pressure or heart disease.

The advantage of isometric exercises is that you don’t really need to move – you just “tighten up”.  This is probably not the best exercise for those who have diabetes.  Make sure your doctor is familiar with your exercise routine.  If you belong to a health club or community exercise project, make sure they know your health status.Choose the activities that you enjoy and that are right for you!

Recipes To Try

Easy Salsa   

6 cups; 12 -1/2 cup servings

2 pounds Roma tomatoes, about 14
2 cans chopped green chilies
1/2 teaspoon cumin
2 cloves garlic, minced
1 cup chopped cilantro
2 tablespoons olive oil
Tabasco sauce to taste

1. Combine all ingredients in a bowl. Refrigerate.

Can be served with tortilla chips. Nutrient analysis will vary, but in general,
1 ounce is about 14 chips.

1 ounce plain chips
Calories                 142                                
Fat                        7 grams
Protein                  2 grams                          
Calories from fat    47%
Carbohydrate        18 grams                        
Cholesterol            0 grams
Fiber                     2 grams                          
Sodium                 150 mg

1 ounce 95% fat-free chips
Calories                 120                                
Fat                        2 grams
Protein                  2 grams                          
Calories from fat    11%
Carbohydrate        23 grams                        
Cholesterol            0 grams
Fiber                     1 grams                          
Sodium                 170 mg

1 ounce bite-sized – about 24 chips
Calories                 140                                
Fat                        8 grams
Protein                  2 grams                          
Calories from fat    50%
Carbohydrate        17 grams                        
Cholesterol            0 grams
Fiber                     1 gram                           
Sodium                 110 mg

Medication Update

Over-the-counter medication usually can’t cure you of anything but it may make you feel better.  If you have diabetes, can you safely take over-the counter medications?
    
Generally, if a medication should not be taken be someone who has diabetes, it is on the label or in the instructions. This situation mostly occurs with cough and cold medications.  The only sure way to know is to read the label or talk with your doctor before you have a cough or cold so you know what you can safely take when you need it.  Doctors’ offices become more and more busy as cold and flu season hit. Sometimes a vaporizer can help ease a cough and let you get a good night’s sleep.

For sore throats there are several sugar-free lozenges or throat sprays. If the sore throat persists, be sure to check with your doctor about a throat culture.
    
If with your sore throat you have aches and pains, acetaminophen (like Tylenol) or ibuprofen (like Advil) may help.  To avoid accidental double doses, make sure cough and cold medication does not contain these products.

New Resources

Conquering Diabetes: A Cutting-Edge, Comprehensive Program for Prevention and Treatment by Anne Peters, MD. Published by Hudson Street Press, New York, NY, 2005.  This 349-page hardcover book is $16 to $24.

The Complete Guide to Carb Counting, second edition by Hope S. Warshaw and Karmen Kulkarni. Paperback, 240 pages. American Diabetes Association, 2004. $12 to $17.

Guide to Healthy Restaurant Eating, third edition by Hope S. Warshaw, RD, CDE. 730 pages. American Diabetes Association, 2005. About $18.

The Diabetes Carbohydrate & Fat Gram Guide, third edition by Lea Ann Holzmeister, RD, CDE. 504 pages. American Diabetes Association, 2005. About $15.