Connie Crawley, MS, RD, LD
Public Service Associate & Extension Nutrition & Health Specialist,
Department of Food and Nutrition

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Are you a black woman with diabetes? If so, you are at greater risk for developing kidney disease. Can you do something about this? Yes.

First, if you have diabetes and high blood pressure, get both under control. High blood pressure is even more likely to cause kidney disease than diabetes. ACE inhibitors, a type of blood pressure medicine, seem to protect the kidney best. They even protect the kidneys of people who don't have high blood pressure. Another type of high blood pressure medicine called calcium channel blockers can also help. One or both of these two types of drugs may benefit you. A low sodium diet and regular exercise will also help control high blood pressure.

Second, have your doctor check your urine regularly for protein. Any protein in your urine may be a sign of kidney disease. Early treatment can slow the disease and delay the need for dialysis or a kidney transplant. Even if you don't have high blood pressure, have your urine checked at least once a year for protein (albumin).

Finally, get your relatives screened for diabetes. Your female relatives who are overweight, hypertensive and have a history of having large babies, stillbirths or gestational diabetes are at highest risk. Only education and treatment will prevent the terrible results of untreated diabetes and kidney disease.

Leon was having problems with his diabetes. His blood glucose readings (when he did them) were unpredictable. He was frustrated and so was his family. He had not seen a doctor recently because he had moved and gotten a new job. His wife, Judy, begged him to see a doctor. She knew he didn't feel well and she was concerned about diabetic complications.

Leon decided he needed a diabetes specialist. He found a new doctor named Dr. Lees. When Dr. Lees saw Leon and did some tests, he realized Leon needed help. Leon had never had much diabetes education and what he knew was out of date.

Dr. Lees adjusted Leon's medication. Then he turned him over to the nurse and dietitian. When Leon noticed the letters "C.D.E." on their nametags, he asked what they meant. Ms. Johnson, the nurse, told Leon that the letters meant "Certified Diabetes Educator." She stated that people with those credentials had special skills and knowledge in diabetes education and extensive patient experience.

Leon was curious why both the nurse and dietitian were certified diabetes educators. Ms. Johnson said that any health professional including doctors, social workers and pharmacists with the right background could take the national exam to get the credentials.

Leon asked what special services he could expect from a certified diabetes educator. Ms. Johnson explained that she and the dietitian would learn all they could about his diabetes and then would individualize his treatment. They would work closely with him in person and would follow up by phone and fax to get his blood glucose in control. They would show him new techniques and tools to control his diabetes. If he had any questions about what they or the doctor said, he could contact them at any time.

Leon was pleased with the special attention the diabetes educators gave him. Soon his diabetes improved and he felt much better. He was glad he chose Dr. Lees, who was also a certified diabetes educator, and his medical staff. While it took some extra time and effort to get in better control, he knew it was worth it. He wanted to do whatever he could to prevent diabetic complications and stay healthy for a long time.

To find the closest certified diabetes educator to your community, call the American Association of Diabetes Educators at 1-800-TEAMUP4.

In June, the American Diabetes Association lowered the blood glucose level used for diagnosing diabetes. Previously when someone was diagnosed with diabetes, his fasting blood plasma level was at least 140. That number has now been lowered to 126. Experts believe that waiting until a blood glucose level is 140 is dangerous. Too much damage to blood vessels and body organs has already occurred. Now with the lower number, more people will be diagnosed and treated earlier. This early diagnosis may delay or prevent the need for expensive diabetes medicine by changing diet and exercise.

The names for the two most common types of diabetes have been simplified. Type I insulin-dependent diabetes is now just called Type 1. Type II non-insulin dependent diabetes is now called Type 2. These changes will prevent confusion because many people with Type 2 also are treated with insulin. The change will also clarify that Type 2 is not Type Eleven (II).

The American Association of Diabetes Educators has published guidelines on how syringes, lancets and blood glucose monitors should be handled to prevent the spread of blood-borne illness like hepatitis and HIV/AIDS. The precautions may seem like common sense but we often get careless after we have a disease for a while:

• Never share syringes, lancets, lancet devices or platforms used on blood glucose monitors to guide blood sample placement.

• Try never to share a blood glucose monitor. If you must share, clean and disinfect it between each test with a bleach solution, hospital disinfectant or hard-surface germicide. The bleach solution should be 1 tablespoon bleach per 1 quart tap water.

• Clean any surface exposed to blood immediately with soap and water. Disinfect it with a hard-surface germicide or the bleach solution.

• Call your health department or sanitation department to find out local regulations for safe disposal of syringes and lancets.

• If there is no special program to handle medical waste, put syringes and lancets in a container that cannot be punctured. Seal it well and mark it with the message "Do Not Recycle." Put it in your household trash. Screw-top containers seem to work best.

While we like ham and turkey during the holidays, pork loin is also a delicious, lean protein choice. Here is a pork recipe with an exotic touch for a cold winter night. Developed by the National Pork Producers Council and the National Pork Board.

1. Trim all visible fat from the pork loin.

2. Blend oil, pepper, nutmeg and cinnamon in a small bowl.

3. Rub the mixture all over the pork surface.

4. Place the pork in a shallow pan.

5. Roast at 350 degrees for 45 minutes to 1 hour or until the internal temperature is 160 degrees.

6. Remove from oven. Let stand 10 minutes before slicing.

4 servings

Nutrition Information:

Exchange: 3 very lean meats