University of Georgia Family and Consumer Sciences Cooperative Extension

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Diabetes Life Lines

Vol. 12 No. 6

Connie Crawley, MS, RD, LD
Public Service Associate & Extension Nutrition & Health Specialist   ccrawley@uga.edu
An Argument for More Fruits and Vegetables
More fruits and vegetables, along with a low fat diet rich in whole grains and low fat dairy products, may help control high blood pressure. The D.A.S.H (Dietary Approaches to Stop Hypertension) research project found that by increasing vegetable intake of their clients to 4-5 servings a day, along with 4-5 servings of fruit, blood pressures dropped. Meat, poultry and fish were served in small portions of no more than 3 ounces per meal.

To meet these new guidelines, a dietitian may need to adjust your meal plan. Few diabetic meal plans have that many fruit and vegetable servings. To see how it can be done, here is a suggested meal pattern for 2,000 calories:

Breakfast:   Lunch:
1/2 banana 1 fruit     2 ounces sliced turkey 2 lean meats
3/4 cup bran flakes 1 starch   1 whole wheat bun 2 starches
8 ounces skim milk 1 milk   1 tablespoon lite mayonnaise 1 fat
1 slice whole wheat toast 1 starch   cut-up celery and carrots free
1 teaspoon margarine 1 fat   1 peach 1 fruit
coffee free   1 cup skim milk 1 milk

Dinner:   Snack:
1 1/2 cups spaghetti with meat sauce 2 starches, 2 meats, 2 vegetables   1 cup plain low fat yogurt 1 milk
1 cup tossed salad free   3/4 cup blueberries 1 fruit
2 tablespoons salad dressing 2 fats
1/2 cup steamed broccoli 1 vegetable
1/2 cup steamed cauliflower 1 vegetable
1 teaspoon margarine 1 fat
1 slice cantaloupe 1 fruit
12-ounce diet drink free

Another New Diabetes Drug?
Lately the introduction of a new diabetes medicine seems as routine as the rising sun. One of the newest drugs for Type 2 diabetes is Repaglinide (Prandin®). Repaglinide is a unique diabetes pill. You take it before eating to help the body release insulin to cover the meal. Repaglinide is absorbed quickly and eliminated quickly from the blood stream. This reduces the risk for hypoglycemia that can occur with some diabetes drugs taken only once or twice a day. You only take Repaglinide when you eat. It can be taken up to 30 minutes before the meal. If you skip a meal or snack, you skip the Repaglinide. If you add a meal or snack, you take an extra dose. If you miss a dose of Repaglinide, you cannot take it between meals. Instead, you wait until the next meal or snack and then take your usual dose.

You can only take Repaglinide if your pancreas is making some insulin. It is not for anyone with Type 1 diabetes.

Repaglinide can produce side effects including cold or flu-like symptoms, diarrhea and joint or back pain. Although hypoglycemia is rare, it can happen if you don't eat enough. Repaglinide can interact with other drugs, so always be sure your doctor knows you are taking other prescription or over-the-counter drugs.

The main advantage of Repaglinide is its flexibility. Many people on diabetes drugs complain because they have to eat at set times to prevent low blood sugar reactions. With Repaglinide, you can skip a meal or eat an extra meal to fit your schedule. But remember, Repaglinide is not a substitute for healthy eating habits.

If Repaglinide appeals to you, talk to your doctor about it. It may give you the blood glucose control and flexibility you desire.

optometrist
Protecting Your Eyes
Your eyes are one of your most precious possessions. If you take care of them, they should last a lifetime. Here are some tips from the American Optometric Association that may keep your eyes safe and healthy:

  • Wear sun glasses.
    • Everyone of all ages should wear sun glasses when they are outside. Look for brands that protect the most against ultraviolet rays (blocking at least 99 percent of the UV-A and UV-B rays).
  • Eat right. A low fat diet with at least five servings of fruits and vegetables may prevent degeneration of the macula, a leading cause of blindness in the elderly.
  • Have regular eye care. Have a dilated eye exam every year. This will pick up retinopathy (diabetic eye disease) early so it can be treated before it causes serious vision loss. The early symptoms of retinopathy and some other eye conditions are easy to miss.
  • Be alert for symptoms. Between exams, report any vision changes to your eye doctor. Common eye problems include blurred vision, eye redness, headaches, squinting, any kind of eye pain, a foreign object in your eye or eye irritation or fatigue.
  • Practice eye safety habits. Wear proper eye protection if you do any work or play that could hurt your eyes. Many people wear safety glasses on the job or in the field, but forget to wear them at home. Especially protect your eyes when you play sports like tennis or racquetball. Your eye doctor can advise you about the right kind of safety eyewear to buy.
  • Wear contact lens carefully. Always care for and wear your contact lens as your eye doctor prescribes. Never skip follow-up visits with the eye doctor. If you do, you may suffer an eye infection or other eye problems.
  • Watch the drugs you use. Ask your eye doctor, physician and pharmacist about the effects of any drugs on your vision. Some prescription and non-prescription drugs can change how well you see.

Eating the Mexican Way
Many of us enjoy Mexican food. Often traditional Mexican recipes are very healthy. Unfortunately as these recipes are adapted to American tastes, good nutrition is often lost.

Here are a few suggestions to help you prepare Mexican food so that it fits the diabetic meal plan:

  1. Use fat-free flour or corn tortillas instead of regular flour tortillas. Flour tortillas are made with lard and can have as much fat as a pat of butter.
  2. Heat tortillas and taco shells in the oven or microwave instead of frying them.
  3. Use chicken, fish or very lean beef or pork for fillings. Bake, grill or boil instead of frying.
  4. Use beans seasoned with fat-free broth. Avoid refried beans made with lard.
  5. Add other vegetables to Mexican dishes. Good additions are shredded cabbage, chopped tomato, steamed broccoli, shredded carrots, sliced mushrooms and peppers.
  6. Top dishes with fat-free sour cream or plain non-fat yogurt instead of regular sour cream.
  7. Use less cheese. Substitute reduced-fat or fat-free cheese for regular cheese.
  8. Season lightly with salsa and taco sauce. Both can be high in sodium.
  9. Use brown rice instead of white rice to add fiber.
  10. If you must fry something, use a small amount of vegetable oil in a non-stick skillet instead of lard or other solid fat.

When you eat out, ask how the food is prepared before you order. See if the food can be made with low fat or non-fat ingredients. Many dishes are made from scratch, so you can often "customize" your menu choice. Remember, you are the customer so the restaurant wants to please you so you'll come back.

If low fat ingredients are not available at the restaurant, you can still make some changes:

  1. Ask for the high fat tortilla chips on the table to be removed.
  2. If your order has cheese, ask that the amount be cut in half or left off completely.
  3. Order ala carte so you can control the amount of food served. Platters or combination dinners have very large portions and too much fat.
  4. Skip the "deluxe" items. They often have a lot of sour cream and extra cheese.
  5. If portions are big, share with someone else or ask for a take-home carton. Put the extra amount in the carton before you start eating.
  6. Don't drink alcohol without your doctor's permission. Plan how much you are going to drink before you enter the restaurant. Mexican food can be spicy so you are likely to drink a lot. The best low-calorie beverage is water. If you must drink alcohol, keep to one 12-ounce lite beer, 4 ounces of wine or 1 1/2 ounces of hard liquor. Many mixed drinks are high in sugar or sodium, so know what you are getting. Many of us enjoy Mexican food. Often traditional Mexican recipes are very healthy. Unfortunately as these recipes are adapted to American tastes, good nutrition is often lost.

Recipe Corner
Here is an easy macaroni and cheese dish that is perfect for a holiday buffet.

Low-Fat Macaroni and Cheese
1 16-ounce box uncooked macaroni 3 cups shredded reduced-fat cheddar cheese
1 12-ounce can evaporated skim milk 1/4 cup minced onion
1 1/2 cups skim milk

  1. Cook macaroni according to package directions until still slightly firm to the bite. (al dente).
  2. Drain and rinse in cold water.
  3. Pour into crock pot.
  4. Add remaining ingredients, stirring well.
  5. Cover and cook on low setting for 3-4 hours. Stir occasionally.
  6. Freezes well.

Serves 25

Nutrition information per 1/2 cup serving:

Calories 127 Carbohydrate 16 grams Protein 8 grams
Fat 3 grams Sodium 131 milligrams Cholesterol 10 milligrams
Exchanges 1 starch 1 lean meat
This recipe was contributed by Alissa Reinhart, Dietetic Intern

Suggested Menu
Menu Item Exchanges
3 ounces ham 3 medium lean meats
1/2 cup macaroni and cheese* 1 starch,1 lean meat
1/2 cup broccoli 1 vegetable
1 small dinner roll 1 starch
1 teaspoon margarine 1 fat
1 apple 1 fruit
Ice tea with artificial sweetener free

* This month's featured recipe.

Note: Portion sizes may need to be adjusted for your personal meal plan.