First, know what your cholesterol and triglyceride levels are. Since you have diabetes, you may have to work to keep your LDL-cholesterol down. LDL-cholesterol is the most harmful to your arteries. While a level below 130 might be good enough for someone without diabetes, doctors now recommend that people with diabetes keep their LDL level below 100. Likewise you want your HDL cholesterol (the kind that reduces risk) to be above 45 and triglycerides to be below 200. To do this, you may need medication along with diet and exercise changes. (To remember which kind is the good cholesterol and which is bad, let the “L” in LDL-cholesterol stand for “lousy” and the “H” in HDL-cholesterol stand for “healthy.”)

Next have your blood pressure checked at least once a year. High blood pressure is common with diabetes. If you see your blood pressure creeping up, start making lifestyle changes. These include losing weight if you are overweight, eating fewer salty foods, limiting alcohol and getting more exercise. If your blood pressure is still too high, you may need blood pressure medicine.

Diabetes is a demanding disease. Fortunately the things you do to maintain your diabetic control will go a long way to reducing your risk for heart disease.

If you really work out, you are going to sweat. Sweat helps you stay cool, but it can provide moisture for growing bacteria and fungi. To control the danger, wear clean, loose clothing made from cotton or other fabrics that allow moisture to dry. Also use a good antiperspirant under your arms and a light dusting of talcum powder in those areas where you sweat the most.

Don’t sit around in sweaty clothing after you exercise. Take a shower or bath as soon possible or at least change the clothing closest to your skin, including socks, shirt and underwear. When you bathe, use warm, but not hot, water and a non-drying soap. Very hot water dries out the skin. Dry skin is damaged easily when you scratch or rub it. Small breaks in the skin allow bacteria, fungi and viruses to invade.

Pat your skin dry. Then use a moisturizer recommended by your health care provider. Do not put lotion between your toes. This could allow bacteria or fungi to grow.

Protect yourself from blisters or other skin injuries when using exercise equipment. Use leather gloves when lifting weights and during batting practice. Have your bike at the right height and use a padded seat or padded bike pants when riding. Purchase shoes and ski boots that fit well and break them in before you exercise. Cover your feet during water sports (and showers) with water shoes.

Closely inspect your skin and feet every day, especially after exercise. Treat any red spots, blisters, calluses or wounds right away. Learn how to handle minor problems yourself but never hesitate to call your doctor if an injury looks suspicious. It’s always better to seek medical treatment and not need it, than to wait and wish you had called.

They also found that any improvement in blood sugar or blood pressure control lowered risk for complications. For each percentage point drop in the Hemoglobin A1c test, there was a 35 percent reduction in damage to the kidneys, eyes and nerves and a 25 percent reduction in risk of death caused by diabetes. (The Hemoglobin A1c test shows blood sugar control over a three month period.)

How does this apply to you? Ask your doctor what changes you need to make to improve your diabetes control. Are most of your blood sugars in the range your medical team recommends? Can you follow your meal plan better or exercise more often? Is there a new diabetes medication or way to take your current medicine that will give you better control? Have you had your blood pressure checked lately and treated it if it’s high?

These are hard questions, but dealing with diabetic complications is even harder if you don’t take care of yourself. Take these study results to heart and make a New Year’s resolution to improve your diabetes and blood pressure control in 1999.

Some people report that tomato sauce seems to raise their blood sugar. This may be due to added sugar in the sauce or something else unique to tomato sauce. Of course one big reason may be that we tend to eat large portions of Italian food.

Cooking at Home. You have more control when you prepare Italian food at home. First, make the sauce from scratch using unsalted canned tomatoes, tomato paste and lots of fresh vegetables like mushrooms, onions, garlic, zucchini and bell peppers. Some people even add shredded carrots, peas or yellow squash. Watch out for canned sauces. Many are high in sodium, so read the label carefully before you buy.

To add flavor and not fat, season the sauce with plenty of Italian spices like oregano and basil. If you must saute the vegetables, use non-stick spray in a non-stick pan or a small amount of olive or canola oil. Use half the meat, fish or poultry a recipe calls for and double the low-calorie vegetables.

Stay away from the heavy cream sauces like alfredo sauce or the recipes that add bacon or other high-fat sausage or meat.

If possible, use whole wheat pasta. It is higher in fiber, but eat small portions. One starch exchange of any pasta is 1/2 cup. Most people eat more than three times that amount at one time.

Fill up on salad. Use fat-free Italian dressing and enjoy low calorie vegetables like lettuce, radishes, carrots, celery, bean sprouts, raw chopped turnip, bell pepper and shredded red cabbage. Limit your intake of croutons and cheese.

If you must have cheese on top of the pasta, sprinkle it on lightly. Fresh parmesan or romano cheese is stronger than canned versions, so grate your own and you’ll use less.

If you enjoy garlic bread or rolls, look for whole grain Italian or French bread and make your own. Spread each slice lightly with reduced fat margarine and add minced garlic or garlic powder or spray the slices with garlic-flavored non-stick vegetable spray.

A great dessert after a pasta is fruit. It cuts the intense flavor of the sauce.

Eating Out. It is much harder to control what you are getting when you eat out. If portions are big, see if you can order a side or appetizer version of a pasta dish or share with someone else.

A big favorite is pizza. Choose vegetable toppings instead of fatty meat toppings. If you must have meat, consider Canadian bacon or lean ham. Order the thin crust and the smallest size pizza that will feed your table. Add a side salad with low-calorie Italian dressing so you won’t fill up on pizza alone. Check to see how pizza affects your blood sugar. A few studies have found that the ingredients in pizza raise the blood sugar higher when they are made into a pizza than when they are served separately. No one is sure why.

Some restaurants offer soup and salad. Look for soups with plenty of vegetables like minestrone or pasta e fagioli. Watch how much you eat of bread sticks or rolls. You may need to have the bread removed from the table so you won’t overeat.

If wine or light beer is a must, have only one drink with your doctor’s permission. Drink with the meal instead of before so your blood sugar won’t go too low.

Italian food is great, but it can really raise your blood sugar. Test your blood sugar after your next Italian dinner and learn to adjust your portions, menu choices or your cooking methods so you can enjoy it in good health.

The FAA requires detailed records to document a pilot’s diabetes control. These records include:

• copies of all medical records and accident or incident reports that may reflect diabetes control;
• documents from a doctor to verify the absence of diabetic eye disease, heart disease, nerve disease and disease of the blood vessels to the brain, arms or legs;
• electrocardiogram readings done during a stress test at a doctor’s office if the person is over age 40;
• results of two hemoglobin A1c tests done no more than 90 days before the application.

Within the last year, the applicant must not have any history of recurrent hypoglycemia that occurred without warning or resulted in unconsciousness, seizure, impaired ability to think, or that required help from someone else for treatment. Recurrent is defined as two or more times.

The doctor treating the applicant or another knowledgeable person like an aviation medical examiner also has to submit a statement documenting the applicant’s ability to read and interpret blood glucose tests done with a blood glucose meter.

Obviously the FAA is very concerned about the safety of the pilot and anyone else who might be hurt by an airplane accident if the pilot’s diabetes is poorly controlled. These rules are tough, but they are well worth it if they prevent the loss of even one life.

1. In a Dutch oven over medium heat, saute the onion and garlic in the oil for about 3-5 minutes or until slightly limp. Add the green pepper and cook another 3 minutes.
2. Add the bouillon cubes and the hot water. Stir to dissolve the cubes. Add the tomatoes.
3. In a colander, rinse the beans well with tap water for 1 minute. Drain and add to the soup mixture.
4. Bring ingredients to a boil, then reduce heat to low. Simmer, stirring occasionally for 1/2 hour.
5. Add the thyme and spinach. Cook 5-8 minutes or until spinach is thawed and cooked. Add the pasta and gently heat for 1-2 minutes. Sprinkle with pepper and serve.

Servings: 6 - 1 cup servings

Exchanges: 1 Starch, 1 Vegetable

Nutrition Information:

* This month’s featured recipe.

Note: Portions may need to be adjusted to fit your meal plan.