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Diabetes Life Lines
Vol 12. No. 2
Connie Crawley, MS, RD, LDPublic Service Associate & Extension Nutrition & Health Specialist ccrawley@uga.edu
More information is available about troglitazone (brand name Rezulin), a new oral drug to control Type 2 diabetes. It decreases the amount of glucose the liver produces and helps the body's cells use insulin better.
While troglitazone lowers triglycerides and blood glucose levels, it is not perfect. First, it is much more expensive than some other diabetes pills. Second, it cannot be used in Type 1 diabetes because it is only effective if insulin is produced by the body. Third, it may take several weeks before it lowers glucose levels. Finally, no one with liver problems should use it.
Risk of hypoglycemia may go up when troglitazone is combined with insulin or other diabetes pills. It also increases the risk for unwanted pregnancy. It increases fertility in some woman who could not get pregnant before due to high blood glucose levels, and by reducing the effectiveness of birth control pills.
Troglitazone can be used in combination with insulin injections and some kinds of diabetes pills. It can also be used alone. Many people with Type 2 diabetes who were taking more than 30 units of insulin per day have seen dramatic drops in their insulin needs. Some have even gotten off insulin completely.
Your medical team can help you deal with some of these concerns. To prevent hypoglycemia, test your blood glucose more often and work with your medical team to adjust your other diabetes medications. To prevent unwanted pregnancy, use a barrier method of birth control like a diaphram or condom with spermicide.
Choices for diabetes care are increasing every year. Troglitazone is just one more weapon in the war against the complications of high blood glucose levels.
Diabetes is a life-long disease. It requires daily self-care and attention. Anyone with a chronic disease gets tired of dealing with it sometimes. We just want a break. This feeling can lead to stress and even depression for some people. Many of the symptoms for stress and depression are similar. Some may even resemble symptoms of poor blood glucose control. Unfortunately stress and depression can make blood glucose control more difficult.
What are some common signs of stress?
- frequent feelings of frustration
- frequent boredom
- being highly critical of oneself
- uncontrollable crying
- nervous laughter
- getting discouraged easily
- feeling that one's life is empty
- not caring about anything
- not enough energy
- little pleasure in life
- sleeping too little or too much
- eating too little or too much
- poor concentration
- feeling anxious and nervous
- poor sex drive
- feeling guilty or worthless
- desire to hurt or kill oneself
- feeling especially down in the morning
- waking up in the middle of the night for no apparent reason
There are things that you can do to control these symptoms. First, ask for help. Confide in a friend, family member, counselor or support group. Talk about and write down possible ways to deal with these feelings. Don't limit your thinking. Sometimes the wildest ideas lead to the best solutions.
Second, distract yourself. Plan at least one fun activity a day. Sometimes this literally has to be a "prescription" that you write down like taking a medication. If this is difficult, ask for suggestions from others. You can take up a new hobby, go to a ball game, have your hair styled or even get a baby sitter to care for your kids so you can lay on a blanket in the park for one hour and read. Sometimes we get so caught up in what we "should" do that we forget how to enjoy ourselves.
If these ideas don't help, consider professional help. Even talking to a counselor may not be enough. Some medications can help. Many do have side effects, including affecting your blood glucose control. Be sure the doctor who prescribes them knows that you have diabetes in case you need changes in your diabetes management. Sometimes just using antidepressants for a short time gets you on the road to recovery much faster.
Stress and depression are only hopeless if you do nothing. Giving up is the only way they will defeat you.
Since diabetes increases the risk for heart disease, controlling a child's cholesterol level is important. Even children without diabetes can have arteries narrowed with plaques made of fat and cholesterol. Part of this problem is due to the high saturated fat diet we eat.
Children under the age of two should never have their fat intake restricted. However, after the age of two, parents should gradually reduce fat intake to 30 percent of the child's total calories. What fat the child does eat should be low in saturated fat. That means more liquid oils and less solid fat should be in the child's diet.
To achieve this goal, keep meat, fish and poultry portions to less than 2-3 ounces per serving. Use soft or liquid margarine in small amounts instead of stick margarine. Snack on fruit or low-fat, low-sugar snack foods. Encourage plenty of vegetables seasoned without fat. Use non-fat and reduced fat dairy products and whole grain breads and cereals. If you fry at all, use only liquid oils. Limit convenience foods and fast foods.
Diabetes experts recommend that a child with diabetes have a cholesterol test once a year. Ideally total cholesterol should be under 170 milligrams per deciliter and LDL-cholesterol (the bad kind) should be under 110 milligrams per deciliter. If cholesterol levels are high, saturated fat and cholesterol intake will need to be reduced more.
These burritos are an excellent source of high fiber vegetables. This recipe is definitely lower in fat than other burrito recipes, which can be high in fat. Submitted by Marilyn Wright, Dietetic Intern.
| 1 pound fresh, sliced mushrooms | 1/2 teaspoon ground cumin |
| 1 medium onion, chopped | black pepper to taste |
| 1 bell pepper, chopped | 8 (8-inch) flour tortillas |
| 1 cup thinly sliced zucchini | 1/2 cup non-fat sour cream |
| 2 cloves minced garlic | 1 cup salsa |
| 2 teaspoons olive oil | 1/2 cup shredded, reduced-fat Cheddar cheese |
| 1-15 ounce can kidney beans, drained and rinsed | non-stick vegetable oil spray |
1. Cook mushrooms, onion, bell pepper, zucchini and garlic in oil in large, non-stick skillet over medium-high heat until tender. Remove from heat and drain.
2. Add beans, cumin and black pepper.
3. Spoon around " cup of the vegetable mixture down the middle of each tortilla. Top with 1 tablespoon of sour cream, salsa and cheese. Fold sides of tortilla over filling.
4. Coat non-stick skillet with non-stick vegetable oil spray. Place over medium-high heat until hot. Add filled tortillas and cook seam side down, until heated through - approximately 1-2 minutes.
5. Serve with additional salsa if desired.
8 servings
Note: This recipe may be too high in sodium for some individuals.
Nutrition Information:
| Calories: 274 | Carbohydrate: 37 grams | Protein: 15 grams |
| Fat: 7 grams | Sodium: 630 milligrams | |
| Cholesterol: 16 grams | Exchanges: 2 starches, 1 vegetable, 1 high fat meat |
| Menu Item | Exchanges |
| 1 vegetable burrito* | 2 starches, 1 vegetable, 1 high fat meat |
| tossed salad | free food |
| 2 tablespoons reduced-fat dressing | 1 fat |
| 1/3 cup rice | 1 starch |
| 1/2 cup canned peaches packed in juice | 1 fruit |
| iced tea sweetened with artificial sweetener | Free |
Note: Portions may need to be modified to fit your meal pattern.
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Contributers Connie Crawley, M.S., R.D., Extension Nutrition and Health Specialist, Principal Writer and Editor
Editorial Board |
Print copies of Diabetes Life Lines are available 6 times per year free to Georgia residents by calling the local county extension office.
