Talk to you doctor before adding any new pill to your regimen, especially if it has the potential to lower your blood sugar.

1. Gymnema Sylvestre
Main use: Lowering blood sugar
Typical dosage: 200 to 250 milligrams twice daily.

This plant’s Hindi name translates as “sugar destroyer,” and the plant is said to reduce the ability to detect sweetness. It’s regarded as one of the most powerful herbs for blood-sugar control. It may work by boosting the activity of enzymes that help cells use glucose or by stimulating the production of insulin. Though it hasn’t been studied ­extensively, it’s not known to cause serious side effects.

2. Bitter Melon
Main use: Lowering blood sugar
Typical dosage: 50 to 100 milliliters (approximately 3 to 6 tablespoons) of the juice daily.

The aptly named bitter melon is thought to help cells use glucose more effectively and block sugar absorption in the intestine. When Philippine researchers had men and women take bitter melon in capsule form for three months, they had slight, but consistently, lower blood sugar than those taking a placebo. Gastrointestinal problems are possible side effects.

3. Magnesium
Main use: Lowering blood sugar
Typical dosage: 250 to 350 milligrams once a day.

Magnesium deficiency is not uncommon in people with diabetes, and it can worsen high blood sugar and insulin resistance. Some studies suggest that supplementing with magnesium may improve insulin function and lower blood sugar levels, but other studies have shown no benefit. Have your doctor check you for deficiency before supplementing with magnesium.

4. Prickly Pear Cactus
Main use: Lowering blood sugar
Typical dosage: If you eat it as a food, aim for 1⁄2 cup of cooked cactus fruit a day. Otherwise, follow label directions.

The ripe fruit of this cactus has been shown in some small studies to lower blood sugar ­levels. You may be able to find the fruit in your grocery store, but if not, look for it as a juice or powder at health food stores. Researchers speculate that the fruit may possibly lower blood sugar because it contains components that work similarly to insulin. The fruit is also high in fiber.

5. Gamma-Linolenic Acid
Main use: Easing nerve pain
Typical dosage: 270 to 540 milligrams once a day.

Gamma-linolenic acid, or GLA, is a fatty acid found in evening primrose oil. Some research suggests that people with diabetes have lower than optimal levels of GLA, and studies have found that the supplement can reduce and ­prevent nerve pain associated with diabetes.

6. Chromium
Main use: Lowering blood sugar
Typical dosage: 200 micrograms once daily.

This trace mineral is thought to enhance the action of insulin as well as being involved in carbohydrate, fat, and protein metabolism. Some research shows that it helps normalize blood sugar — but only in people who are deficient in chromium.

7. Bilberry
Main use: Protecting the eyes and nerves
Typical dosage: 80 to 120 milligrams two times per day of standardized bilberry extract.

This relative of the blueberry contains powerful antioxidants in its fruit and leaves. These anti­oxidants, called anthocyanidins, seem to help prevent damage to tiny blood vessels that can result in nerve pain and retinopathy (damage to the eye’s retina). Animal studies have also suggested that bilberry may lower blood sugar.

8. Alpha-Lipoic Acid
Main uses: Easing nerve pain, lowering blood sugar
Typical dosage: 600 to 800 milligrams a day.

Called ALA for short, this vitamin-like substance neutralizes many types of free radicals. A build-up of free radicals, caused in part by high blood sugar, can lead to nerve damage and other problems. ALA may also help muscle cells take up blood sugar. In a German study, a team of scientists had 40 adults take either an ALA supplement or a placebo. At the end of the four-week study, the ALA group had improved their insulin sensitivity 27 percent. The placebo group showed no improvement. Other studies have shown a decrease in nerve pain, numbness, and burning.

9. Fenugreek
Main use: Lowering blood sugar
Typical dosage: 5 to 30 grams with each meal or 15 to 90 grams with one meal per day.

These seeds, used in Indian cooking, have been found to lower blood sugar, increase insulin sensitivity, and reduce high cholesterol, according to several animal and human studies. The effect may be partly due to the seeds’ high fiber content. The seeds also contain an amino acid that appears to boost the release of insulin. In one of the largest studies on fenugreek, 60 people who took 25 grams daily showed significant improvements in blood sugar control and post-meal spikes.

10. Ginseng
Main use: Lowering blood sugar
Typical dosage: 1 to 3 grams a day in capsule or tablet form, or 3 to 5 milliliters of tincture three times a day.

Known for its immune-boosting and disease-fighting benefits, this Chinese herb has several positive diabetes studies behind it. Re­searchers have found that ginseng slows carbohydrate absorption; increases cells’ ability to use glucose; and increases insulin secretion from the pancreas. A team from the University of Toronto has repeatedly demonstrated that ginseng capsules lower blood glucose 15 to 20 percent compared to placebo pills.

Source: http://www.rd.com/

All of this concern is for good reason. Over the past two decades, the number of cases of obesity, defined as more than 30 pounds overweight, in the United States has increased by more than 50%—from 14.5% of the adult population to 22.5%—and another 40% of American adults are overweight, defined as up to 30 pounds overweight. The cost of diseases associated with obesity—including Type 2 diabetes, heart disease, high blood pressure, gallbladder disease, stroke, some types of cancer, and many other conditions—has been estimated at almost $100 billion per year. What’s more, there doesn’t seem to be any indication that this trend toward obesity will slow down or turn around any time soon.

As much time as we spend talking and worrying about how much fat we eat, how much it clogs our arteries, and how the prevalence of obesity in America is skyrocketing, most people know surprisingly little about what fat is, how the human body stores it, or how the body can get rid of it.

What is fat?
First, a bit of chemistry, but nothing you can’t handle. Fat is an oily compound composed of the elements carbon, hydrogen, and oxygen. In the body, the carbon, hydrogen, and oxygen molecules bind together like links to form chains of fatty acids. When chains of fatty acids connect together with a molecule called glycerol, it’s called a glyceride. Triglycerides—three fatty acid chains connected to a glycerol molecule—are the main type of fat in the foods we eat and in our bodies.

Even though body fat would appear to just sit there on our hips, thighs, and abdomens, it actually serves many roles. It insulates us from the cold, pads and supports our vital organs, muscles, and bones, and is part of the structure of every cell membrane. It’s an active organ, too. Scientists have discovered that fat cells behave very much like endocrine glands, secreting many different substances. At last count, more than 27 different enzymes, hormones, and neurotransmitters have been identified that are secreted by fat cells. They are responsible for, among other functions, controlling and regulating appetite, blood pressure, some nervous system and hormonal signals, gene expression, and the formation of testosterone and some forms of estrogen. In short, fat cells are important organs with vital regulatory functions that help our bodies run smoothly.

Humans have anywhere from 25 billion to 275 billion fat cells stored in their bodies. The average person has around 35 billion. For the average man, fat accounts for about 22% of his body weight; for the average woman, 28%. (In comparison, a trained, male athlete has about 10% body fat, and an obese person has between 40% and 50% body fat.) Fat cells are microscopic, 10–20 times smaller than the diameter of a human hair (which is about 100 microns), but they are packed with energy. The average person has more than 100,000 calories stored as fat on his body, theoretically enough fuel to jog from New York City to Chicago.

Fat is stored in special compartments called adipocytes, which are located all over the body and are often referred to as fat cells. Your genes determine where fat accumulates on your body; you don’t have any control over it. Women tend to accumulate it in the adipocytes on the hips, buttocks, and thighs, and men tend to accumulate it in the abdomen. The reason for the different accumulation patterns between sexes has not been identified, but one thing is certain: The fat that accumulates in the abdomen is associated with a high risk for Type 2 diabetes, high blood pressure, cardiovascular disease, and other medical conditions. The fat that accumulates in the lower extremities, although it may not be cosmetically appealing for some, does not present any cardiovascular or metabolic health risk.

Men are generally at higher risk for cardiovascular disease than women, and one of the reasons may be their higher percentage of abdominal fat. The recommendation for a healthy body circumference measured around the belly button is less than 40 inches for men and less than 35 inches for women. If your abdomen is larger than that, your risk for cardiovascular disease and other conditions increases.

Where does fat come from?
Fat comes from foods we eat, particularly animal and dairy products. Every time you eat a food with fat, the fat gets digested by bile and pancreatic enzymes in the small intestine. The resulting fatty acids are then absorbed and transported to the liver, where essential nutrients are removed. Then the rest is wrapped up and packaged together with proteins to form chylomicrons, so that it can travel through the bloodstream to all the organs and cells that need it.

If you eat more fat than your body needs, it either gets stored in the arteries of your heart (which is not a good thing), in your liver (which can give you a fatty liver and is also not a good thing), or in the adipocytes on your hips, thighs, buttocks, or abdomen (another not-so-good thing). Adipocytes love to store fat. They gobble it up like there’s no tomorrow, and with the ample amount of inexpensive, fatty foods available in our society and the copious amounts many of us eat, most adipocytes in the United States are well-fed, happy buckaroos.

When you fill an adipocyte with fat, it gets larger, just as a balloon gets larger when you fill it with air. Contrary to popular belief, however, when adipocytes get too big, they do not divide and multiply to form more adipocytes. Instead, the adipocyte grows like an overinflated balloon until it reaches a maximum diameter of approximately 15–20 microns, then it sends a biochemical signal to adjacent, immature preadipocytes in the body to begin storing the extra fat. These preadipocytes then grow larger, too, and when they become fully mature, plump adipocytes, you gain more body fat. The larger your adipocytes become, the higher your percent body fat will be.

During childhood and into puberty, both the number of mature adipocytes and the size of the adipocytes increases. It is believed by many scientists that the number of adipocytes stays fairly stable after adolescence and that instead of an increase in the number of adipocytes during adulthood, the mature adipocytes enlarge in size, stimulating the preadipocytes to get bigger too. There is some recent evidence to suggest that the number of adipocytes can also increase during adulthood, but whether we increase our body fat through increases in the number or the size of the adipocytes, one thing is certain: Excess fat intake leads to increases in body fat.

It’s not just fatty foods that make us fat, however. Whenever we eat excess calories, we stand a good chance of gaining fat. Excess carbohydrate that isn’t used by the body may be converted to fat, and then it too gets stored in the adipocytes. However, some very interesting research has recently suggested that not as much carbohydrate as was once thought gets converted to fat. Scientists are looking carefully at the role of carbohydrate and its role in making people gain excess fat, but for now, it’s believed that excess calories in any form causes fat gain.

Burning fat
Remember that fat cells are active glands. Not only do they secrete important proteins, enzymes, and hormones, but they also secrete fat. They secrete it because it’s a valuable fuel for muscles. It’s packed with energy, providing nine calories per gram, whereas a gram of glucose contains only four calories. A calorie is a unit of energy contained in our food that provides fuel for our muscles, just like gasoline provides fuel for an automobile. Think of muscle as the engine in your body, and think of fat as high-test fuel, providing more than twice the amount of calories or energy as a gram of glucose. This means that you can go more than twice as far on a gram of fat as you can on a gram of carbohydrate. The catch is learning how to get the fat to the muscle so that it can be burned for energy.

Whenever you move, whether you’re doing an endurance exercise like running or just taking a walk around the block, your muscles need fuel to burn. The fuels that muscles use are glucose and fat. If you’ve ever checked your blood glucose level before and after a bout of exercise or a brisk walk, you know that it usually drops, because the muscles use the glucose in the blood for fuel. Fat is used for fuel by the muscles in much the same way. Here’s how it works, step by step:

1. You take a brisk walk.

2. In response to the movement, certain hormones, including epinephrine (adrenaline) and norepinephrine, get released from the adrenal glands, and the blood levels of these hormones start to rise.

3. The hormones circulate around the body and attach to special hormone receptors on the adipocytes.

4. Once attached to the receptors on the adipocytes, a complex chain of biochemical events takes place in the cell, signaling the adipocyte that the body needs fuel.

5. Being the clever devil that it is, the adipocyte receives the signal and processes the stored fat, mobilizes it, and sends it out of storage and into the bloodstream.

6. Once in the bloodstream, the fat gets wrapped up again in chylomicrons so that it can travel in the bloodstream to the muscles that need it.

7. Once the package of fat and protein arrives at the muscle, another complex chain of events occurs, stimulated by an enzyme called lipoprotein lipase and, lo and behold, the fat enters the muscle.

8. Once in the muscle, a truly biochemical magic act occurs. What happens is that fat gets broken down to its smallest elements (carbon, hydrogen, and oxygen), and inside a part of the muscle cell called the mitochondria, known as the power house of the cell, enormous amounts of energy are produced, which allow the muscles to move.

Dozens of complex biochemical reactions have to occur to produce the energy for our muscles to move, but the good news is that you don’t have to remember how to do any of it. All you have to do is move. The body takes care of all the rest.

The physical activity recommendation for improving health is to accumulate 30 minutes of moderate-intensity physical activity on most, if not all, days of the week. The key words in this recommendation are “accumulate,” which means you can do it in three bouts of 10 minutes, two bouts of 15 minutes, or one bout of 30 minutes, and “moderate-intensity,” which means the work should leave you feeling warm and slightly out of breath but not exhausted. Walking, biking, dancing, weight lifting, swimming, climbing stairs, hiking, gardening, housework, and many other activities of daily living such as walking your dog, washing your car by hand, and mowing your lawn with a push mower will all do the trick. In most studies of physical activity, even modest amounts of activity help the body reduce fat, if not all over the body, then certainly in the abdomen and deeper in the visceral fat where it counts most for good health.

Building muscle—through weight lifting or other resistance exercises—will help, too. Muscle burns calories and helps you maintain your metabolic rate. The more muscle you have, the bigger your body’s engine, and the more likely you will be to burn fat.

Once adipocytes get the signal from hormones and release fat into the bloodstream, they shrink just like a balloon that you let air out of. When they shrink, so does your body fat. But if you eat excess fat once you’ve shrunk your adipocytes, chances are it will find its way right back to the adipocyte, and once again you’ll gain fat.

No matter how much physical activity you do, adipocytes never shrink so much that they disappear entirely. Like a balloon that you let all the air out of, you’re always left with some remnant. The only way to totally remove adipocytes from your body is with a surgical procedure such as liposuction or excision. But even with these procedures, if you go back to eating excess fat, you’ll put all the fat back on.

Spot reduction
Many people subscribe to the idea that you can do a specific exercise for a specific body part and the fat will come off that particular area first. For instance, some people think that if they do sit-ups they will lose abdominal fat. However, that’s not the way it works.

Fat on your body belongs to all of your body, and when you start to move, you have no control over which adipocytes release fat first. When you take a brisk walk, for instance, the muscles in your legs may be burning fat that was released from an adipocyte in your gut, or from your face, from your legs or from within the leg muscle itself. And it’s usually a consistent pattern. Everyone who has ever lost and regained weight more than once can tell you that the pattern of their weight loss is almost always the same. Many people lose fat from their face first and from their hips, thighs, and buttocks last. Genetics probably determines the pattern of weight loss and, of course, we have no control over our genes. However, we can shape and tone our physiques by building muscle through exercise.

The other good news is that abdominal fat, particularly the deeper abdominal fat known as visceral fat, which is implicated in heart disease, insulin resistance, and other medical conditions, is known to be very lipolytic. What that means is that abdominal fat is very sensitive to physical activity and readily releases fat in response to movement. That’s good news because it means that a relatively small amount of activity can have a significant impact on your health.

In one study of 24 people with Type 2 diabetes who exercised for 45 minutes three times per week for 8 weeks, visceral fat and subcutaneous abdominal fat—the fat just below the skin—was reduced significantly. Moreover, insulin resistance improved by 46%. Most interesting was that the subjects lost significant amounts of abdominal fat and improved their insulin sensitivity even though they lost very little body weight.

What about cellulite?
The lumpy fat that is often called cellulite is nothing special; it’s just ordinary fat. Its appearance is caused primarily by irregular patterns of connective tissue beneath the skin. What happens is that the adipocytes, which form in compartments in the shape of little honeycombs, get pushed into the skin by the irregular connective tissue, causing the dimpling that is characteristic of cellulite. Studies have shown that people who have cellulite have different patterns of connective tissue than people who don’t, and men tend to have this irregular pattern much less often than women.

Cellulite is not directly a function of excess weight, but rather a genetic difference in the way adipose tissue and connective tissue form. In fact, cellulite occurs in people who are lean as well as in those who are overweight. Skin creams sold to reduce cellulite make the skin swell so that the appearance of the cellulite changes, but the effects are short-lived, and the creams do nothing to change the structure of the connective tissue. There is no health risk to cellulite, and although weight loss and exercise can have some effect on it, in most cases, physical activity does not significantly change its appearance.

The bottom line
The bottom line to losing weight and fat is that you must burn more calories than you consume. If you eat 2,000 calories a day and only burn 1,500, you’re going to gain weight. On the other hand, if you consume 1,500 calories and burn 2,000, you’ll be in caloric deficit by 500 calories. Since it takes 3,500 excess calories to gain a pound, you’d lose one pound per week if you produced a 500-calorie deficit each day of the week. To do that, you could reduce your calorie intake by 250 per day and increase your physical activity by 250 calories per day (for a 150-pound person, a 2.5-mile walk is all it would take). Do that each and every day of the week and you’ll drop a pound per week.

Fat isn’t so bad if we manage it. We need it to survive, but we don’t need lots of it. The average person has more than enough stored fat on his or her body to sustain life for weeks. What we need to do is keep an eye on how much fat we eat (your dietitian can help you with that) and be physically active. No other intervention will do more to burn fat and improve your health than physical activity. Remember that you don’t have to do Herculean amounts of activity. If performed regularly and at a moderate intensity, just about any type of physical activity will help you burn fat, achieve good health, improve your diabetes control, and perhaps most important of all, improve the quality of your life. There’s no time like the present to get started. Results are just around the corner.

Richard Weil is an exercise physiologist and a consultant to St. Luke’s-Roosevelt Hospital Center in New York City.

Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

By Richard Weil, M.Ed., C.D.E.
http://www.diabetesselfmanagement.com/

Rapid spikes or dips in blood glucose level can result in several unpleasant effects: dizziness, disorientation, muscle weakness, nausea and others. For some diabetics, it’s very difficult to prevent this from happening at some time. But there are practices that can improve the odds.

Regular and careful monitoring is a must. It’s no picnic to endure a finger prick three times a day. For those who simply can’t muster the will, it is worthwhile to look into some of the newer glucose monitoring devices that don’t require it.

Some contain tiny, powerful lasers that create a hole through which blood oozes. They produce only a mild tingling sensation. One recent device senses glucose level through the skin using an infrared beam, requiring no blood sample at all.

The goal is to keep the glucose-insulin balance as close to normal levels as possible. Non-diabetics have a fasting glucose level under about 99 mg/dL. Even after a heavy meal, when glucose may rise to over 200 mg/dL, insulin is released which brings it back down within a couple of hours. That means that keeping the glucose level right isn’t so much achieving a static number as maintaining the correct dynamic balance.

Part of a long-term glucose monitoring strategy should encompass regular physician visits with a quarterly A1C test. Several tests exist to measure blood glucose level at a given time. The A1C test provides a picture averaged over a period of months. The name comes from HbA1c, an abbreviation for glycated hemoglobin.

Hemoglobin molecules in the red blood cells carry oxygen to tissues. The extra glucose in the bloodstream of a diabetic causes that hemoglobin to get glycated. That effect persists and allows an A1C test to measure the accumulated result.

Long term the effects will accumulate, good or bad. Over 10-15 years or longer, many diabetes patients of the past would endure blindness, kidney damage, nerve damage and other ill health effects. That no longer has to be the case. With contemporary understanding of the disease and modern technology it’s possible to reduce the odds of those effects nearly to those without the disease.

Exercise and diet are two key elements for the overwhelming majority of diabetes sufferers to help achieve the right glucose-insulin balance.

Keeping body fat low through proper diet and exercise will help. Body fat plays a role in how the body reacts to glucose levels, as well as affecting hormone production and release. While the mechanisms are still being investigated, many studies show there is a clear correlation between body fat and the severity of diabetes effects, as well.

Proper weight and body fat maintenance will also help keep blood pressure at the right level. Chronic high blood pressure is one of the major elements in increasing the risk of common diabetes problems: heart attack and stroke, eye and nerve damage, and others.

With diligence a diabetic can lead a normal life, one very much like those fortunate enough not to have the condition. A little attention a few times a day can lead to not having to pay too much attention at all.

Source: http://battlingforhealth.com/

1. Know that you are not alone. Diabetes can seem like an isolating disease when it strikes, but always remember there are millions of others going through the same struggles you are. According to the American Diabetes Association’s website (http://www.diabetes.org), there are “20.8 million children and adults in the United States, or 7% of the population, who have diabetes.”

2. Get as much information as you can. New techniques for treating diabetes are being developed all the time, so make sure you see an endocrinologist every year for a diagnosis. Know what your A1C levels are. Even if you’ve had diabetes for many years, there is always something new that can be learned. The more information you have, the better you’ll feel about managing your disease.

3. Think “healthy life” rather than restrictions. Once upon a time having diabetes meant no sweets, limited diet, and no fun. That isn’t the case anymore. Diabetics eat a healthy diet that can include occasional sugar or treats from time to time. Think long-term health when making choices. Exercise to stay fit and remain healthy. Strive for a healthy, balanced life.

4. Don’t let one bad day overshadow all the work you’ve put in to maintain a healthy body. Too often diabetics look at their blood sugar readings as a judgment for their lives. Remember that your A1C is the real indicator for how well your blood sugar is being controlled. Aim for good control, but if you find yourself have a bad sugar day, get back on track but don’t freak out.

5.Take part in activities that you enjoy and relax you. Sometimes diabetics focus on exercise but forget about other hobbies they could also enjoy. Take up painting, crochet, knit, or read. Find a hobby that will take the focus off of food, stress, and exercise.

6. Allow yourself the feelings of frustration from time to time. At times diabetics feel sad and angry about having to deal with the disease. That’s okay. Don’t beat yourself up further because you feel frustrated. Even the healthiest of individuals won’t feel happy 100% of the time. Acknowledge your negative feelings, but don’t wallow in them for long. Seek out some of the more positive alternatives to blow off some steam and get back to a healthy mindset.

7. Think “manage,” not “fix.” Diabetes is a manageable disease, but there will be ups and downs. There has never been a better time to have the disease, as research and technology is growing fast every year. So take it moment by moment.

8. Get connected. Join a local or online support group. While your friends and family will do their best to understand, sometimes there’s nothing like talking with someone who has actually experienced the same things you have.

Source: http://www.ehow.com/

The Diabetes Food Pyramid differs from the standard Food Guide Pyramid in the way that it groups different foods together. Because blood glucose is of primary concern to people with diabetes, the Diabetes Food Pyramid focuses on the way in which certain foods affect blood glucose levels. For example, in the standard pyramid, beans and legumes are grouped with meats, due to their protein content. In the diabetes pyramid, however, beans are grouped with starches, because they affect blood glucose in the same way that starchy foods do.

Under this plan, 60 to 70 percent of your total daily calories should come from grains, beans, and starchy vegetables, with the rest being meat, cheese, fish and other proteins. Fats, oils, and sweets should be used sparingly. The Diabetes Food Pyramid suggests the following daily servings of food for people with diabetes:

Daily Servings Per Food Group		Suggested Serving Size
3-4 servings of fruit		1 small fresh fruit, ½ cup canned or dry fruit, ½ cup cup fruit juice
3-5 servings of vegetables		1 cup raw vegetables, ½ cup cooked vegetables, ½ cup tomato or vegetable juice
6 or more servings of grains, beans, and starchy vegetables		1 slice bread, ½ small bagel or English muffin, 1 6-inch tortilla, ½ cup cooked cereal or pasta
2-3 servings of milk and yogurt		1 cup milk or yogurt
2-3 servings of meat, cheese, fish, and other proteins		2-3 oz. Cooked lean meat, fish or poultry, 2-3 oz. cheese, 1 egg
Sparing use of fats, oils, and sweets		A serving of fats and oils can be 1 Tsp. Butter, margarine, oil or mayonnaise. A serving of sweets can be ½ cup ice cream or 2 small cookies.

Registered dietitians (RDs) have training and expertise in how the body uses food. RDs who understand diabetes can teach you how the food you eat changes your blood glucose level and how to coordinate your diabetes medications and eating. Do you know how many calories you should eat each day? How to cut down on the fat in your meals? How to make eating time more interesting? An RD can help you learn the answers to these, and lots of other questions. Your dietitian will work with you to create a healthy eating plan that includes your favorite foods.

2. Can I eat foods with sugar in them?

For almost every person with diabetes, the answer is yes! Eating a piece of cake made with sugar will raise your blood glucose level. So will eating corn on the cob, a tomato sandwich, or lima beans. The truth is that sugar has gotten a bad reputation. People with diabetes can and do eat sugar. In your body, it becomes glucose, but so do the other foods mentioned above. With sugary foods, the rule is moderation. Eat too much, and 1) you’ll send your blood glucose level up higher than you expected; 2) you’ll fill up but without the nutrients that come with vegetables and grains; and 3) you’ll gain weight. So, don’t pass up a slice of birthday cake. Instead, eat a little less bread or potato, and replace it with the cake. Taking a brisk walk to burn some calories is also always helpful.

3. Why does losing weight help my diabetes?

Weight loss helps people with diabetes in two important ways. First, it lowers insulin resistance. This allows your natural insulin (in people with type 2 diabetes) to do a better job lowering blood glucose levels. If you take a diabetes medicine, losing weight lowers blood glucose and may allow you to reduce the amount you’re taking, or quit taking it altogether. Second, it improves blood fat and blood pressure levels. People with diabetes are about twice as likely to get cardiovascular disease as most people. Lowering blood fats and blood pressure is a way to reduce that risk.

4. How can I cut the fat in my diet?

Here are some beginning hints. See a dietitian for more advice. Stir-fry foods in tiny amounts of oil and lots of seasonings. Choose nonfat or low-fat selections, such as nonfat or 1% milk or low-fat cheese. Keep portion sizes on target. Avoid fried foods — bake, grill, broil, or roast vegetables and meat instead.

5. Are some fats better than others?

Yes. Unsaturated fats are the healthiest for your body. This includes both monounsaturated and polyunsaturated fats. You can find these “healthy fats” in foods like nuts, vegetable oils, olives and avocados.

The fats to cut back on are the saturated and trans fats. Saturated fats are found in full-fat dairy products like ice cream, half and half, sour cream, cheese, and meats, chicken skin, bacon and lard. Trans fats are found in margarines and shortening as well as many processed packaged foods and sweets. Trying to cut back on how much saturated and trans fat you eat is important to help reduce your risk of heart attack and stroke.

6. What foods can I eat a lot of?

Forget about eating with abandon. The key to healthy living is moderation. Air-popped popcorn may be low in fat, but it still has calories. And calories count. If you can control the portion sizes of the food you eat, you will be able to eat a wider variety of foods, including your favorites, and still keep your blood sugar in your target range.

7. What can I do if I overeat over the holidays?

Put on your walking shoes and head for the pavement. Being more active helps lower your blood sugar, blood pressure and cholesterol. Physical activity uses up extra sugar in your blood and helps your insulin work better.

8. Can I use low calorie sweeteners?

Low calorie sweeteners are safe for everyone except people with phenylketonuria, who should not use aspartame. Calorie-free sweeteners like aspartame, saccharin, sucralose and acesulfame-K won’t increase your blood glucose level. The sugar alcohols — xylitol, mannitol, and sorbitol — have some calories and do slightly increase your blood glucose level. Eating too much of any of these can cause gas and diarrhea.

9. How much weight should I lose each week?

Limiting your weight loss to 1/2 to 1 pound a week will keep you healthy, and let you enjoy the foods you love in small amounts. A slow steady weight loss is the key to keeping lost weight off.

10. Can I drink alcohol?

Yes, in moderation. Moderation is defined as two drinks a day for men and one drink a day for women. A drink is a 5-ounce glass of wine, a 12-ounce light beer, or 1-1/2 ounces of 80-proof distilled spirits. Make sure that your medications don’t require avoiding alcohol, and get your doctor’s okay.

11. Isn’t glucose control easier if I eat the same things every day?

Probably, but this method of blood glucose control isn’t very nutritious, not to mention boring. One of the keys to nutrition is eating a variety of foods each day. By checking your blood glucose two hours after starting to eat a meal, you can learn how different foods affect you. Over time, you will be able to predict how foods, and combinations of foods, affect your blood glucose level.

12. What vitamins will help my diabetes?

If you have a vitamin or mineral deficiency, it could be causing problems with your glucose control. For instance, one study found that taking the trace element chromium improved glucose control in subjects who had a chromium deficiency. More studies need to be done. If you choose a variety of fruits, vegetables, grains, and meat each day, and keep your blood sugar close to your target range, you probably don’t need to take vitamin supplements because of diabetes.

13. Are there herbs that will help my diabetes?

Many herbs supposedly have glucose-lowering effects, but there are not enough data on any herb to recommend it for use in people with diabetes. Herbs are not considered food by the Food and Drug Administration and are not tested for quality or content. Therefore, products can be promoted as helping health conditions without having to show evidence of this. Discuss the herbal dietary supplements with your doctor or dietitian before trying them. They may interact poorly with your diabetes medication.

Source: http://www.diabetes.org/

6 tablespoons stick butter
1 cup Equal® Spoonful*
1 large egg
2 tablespoons 2% milk
1 teaspoon vanilla extract
1 1/4 cups all-purpose flour
1/4 teaspoon baking powder
1/4 teaspoon baking soda
1/4 teaspoon salt
3/4 cup spreadable fruit of choice

1. Beat butter and Equal® until well combined. Mix in egg, milk and vanilla until blended. Gradually beat in combined flour, baking powder, baking soda and salt.
2. Shape dough by teaspoonfuls into balls. Place on sprayed baking sheets. Press thumb deeply into dough to form a “thumbprint” indentation. Bake in preheated 350°F oven 11 to 13 minutes or until firm to the touch. Remove from baking sheet and cool completely on wire rack. Store in airtight containers at room temperature.
3. Fill each cookie with about 1/2 teaspoon spreadable fruit just before serving.

Makes about 2 dozen.

* May substitute 24 packets Equal sweetener

Nutrition Information Per Serving:
calories 58, protein 1 g, carbohydrate 8 g, fat 3 g, cholesterol 16 mg, sodium 46 mg.

Food Exchanges: 1/2 starch, 1/2 fat.

Recipe provided courtesy of Merisant Corporation ® and the NutraSweet Company, makers of Equal®.

3 cups crispy rice cereal squares
2 cups toasted O-shaped cereal
2 cups small reduced-fat pretzels
1 cup oyster crackers
1 cup dry roasted peanuts
1 egg white
1/2 cup SPLENDA® No Calorie Sweetener, Granular
1 tablespoon Worcestershire sauce
1/2 teaspoon ground red pepper

1. Preheat oven to 300°F (150°C).
2. Combine first 5 ingredients in a large bowl.
3. Beat egg white until foamy; stir in SPLENDA® Granular, Worcestershire sauce and red pepper. Pour over cereal mixture, tossing to coat.
4. Spray a 15- X 10-inch jellyroll pan with cooking spray; spread cereal mixture in a single layer in pan.
5. Bake for 20 to 25 minutes, stirring every 10 minutes. Cool.

Makes 16 (1/2 cup) servings.

Note: Store mix in an airtight container

Nutrition Information per serving Serving Size: 1/2 cup; Total Calories 140; Calories from fat 50; Total Fat 5g; Saturated Fat 1g; Cholesterol 0mg; Sodium 290mg; Total Carbohydrate 19g; Dietary Fiber 2g; Sugars 1g; Protein 4g

Exchanges per Serving: 1 Starch, 1 Fat

Recipe and photograph courtesy of Splenda, Inc. Splenda® is a no-calorie sweetener made from sugar that is suitable for diabetics. For more information regarding this product, please call 1-800-777-5363 or visit their website at www.splenda.com.

Adrenal a gland of the endocrine system that produces essential hormones including adrenaline (epinephrine) and cortisol

Adult-Onset Diabetes another term sometimes used for type 2 diabetes

Albuminuria occurs when a protein called albumin is found in the urine above a specified level – indicates potential kidney damage

Alpha Cells cells in the pancreas (the area called the islets of the Langherans), that produce the hormone glucagon which in turn raises blood glucose(sugar)levels

Angiopathy a disease of the blood vessels (arteries, veins, and capillaries) that occurs as a long-term complication of diabetes. Two types macroangiopathy and microangiopathy

Antibodies substances occurring naturally in the body that help fight infection

Arteriosclerosis thickening, hardening and narrowing of the arteries

Artheriosclerosis see Arteriosclerosis

Artery a blood vessel that carries blood away from the heart

Aspartame a low calorie synthetic sweetener

Asymptomatic no symptoms or sign of disease present

Background Retinopathy an early stage of diabetic retinopathy that usually does not impair vision - also referred to as “nonproliferative retinopathy”

Beta Cells the insulin producing cells of the pancreas

Blood Pressure is the force of the blood on the walls of arteries. Two levels of blood pressure are measured – the higher, or systolic, pressure, occurs each time the heart pushes blood into the vessels, and the lower, or diastolic, pressure, occurs when the heart rests. In a blood pressure reading of 120/80, 120 is the systolic pressure and 80 is the diastolic pressure. High blood pressure can lead to health problems such as heart attacks and strokes

Brittle Diabetes phrase used when a person’s blood glucose (sugar) level often swings quickly from high to low and from low to high – also called labile and unstable diabetes

Callus a hardened or thickened part of the skin caused by pressing or rubbing

Calorie a measure of the energy value of foods (now replaced by kilojoule: 1 calorie = 4.2 kilojoules)

Candida a yeast like fungus infection often affecting the female genital area

Capillary smallest of the body’s blood vessels

Carbohydrate foods which contain sugars and starches

Cardiovascular relating to the heart and blood vessels (arteries, veins, and capillaries) - the circulatory system

Cataract clouding of the lens of the eye

Cell the microscopic unit that forms the basis of all living things

Chemical Diabetes a term no longer used – see impaired glucose tolerance

Cholesterol a steroid produced by the human body, which acts as the precursor for all steroid hormones.Too much cholesterol, however, may cause fat to build up in the artery walls and cause a disease that slows or stops the flow of blood

Claudication pain in the calf muscles occurring on exercise and disappearing with rest. Caused by decreased blood supply

Coma loss of consciousness from any cause. In diabetes may result from either very high or very low blood glucose levels

Creatinine a waste product normally removed by the kidneys. The amount in blood and urine can show whether the kidney is functioning properly

Cyclamate a low calorie artificial sweetener

Cystitis an inflammation of the urinary bladder

Dawn Phenomenon a sudden rise in blood glucose levels in the early morning hours. This sometimes occurs in people with type 1 diabetes and rarely in people with type 2 diabetes

Dehydrated great loss of water or fluid from the body. A very high level of glucose (sugar) in the urine causes loss of a great deal of water, and the person becomes very thirsty

Dextrose see glucose

Diabetes Insipidus a disease of the pituitary gland or kidney, but not diabetes mellitus. So-called because most people who have it show most of the same signs as someone with diabetes mellitus-they have to urinate often, get very thirsty and hungry, and feel weak. However, they do not have glucose (sugar)in their urine

Diabetic Coma a severe emergency in which a person is not conscious because the blood glucose(sugar)is too low or too high. If the glucose level is too low, the person has hypoglycemia; if the level is too high, the person has hyperglycemia and may develop ketoacidosis

Diabetic Ketoacidosis severe, out-of-control diabetes (high blood sugar) that needs emergency treatment. DKA happens when blood sugar levels get too high. This may happen because of illness, taking too little insulin, or getting too little exercise. The body starts using stored fat for energy, and ketone bodies (acids) build up in the blood.

Diabetic Retinopathy a disease of the small blood vessels of the retina of the eye. When retinopathy first starts, the tiny blood vessels in the retina become swollen, and they leak a little fluid into the center of the retina. The person’s sight may be blurred. This condition is called background retinopathy. About 80 percent of people with background retinopathy never have serious vision problems, and the disease never goes beyond this first stage. However, if retinopathy progresses, the harm to sight can be more serious. Many new, tiny blood vessels grow out and across the eye. This is called neovascularization. The vessels may break and bleed into the clear gel that fills the center of the eye, blocking vision. Scar tissue may also form near the retina, pulling it away from the back of the eye. This stage is called proliferative retinopathy, and it can lead to impaired vision and even blindness

Dialysis artificial removal of waste products from the blood when the kidneys fail

Digestion breaking down food in the stomach and intestines

Electrocardiograph (ECG) the recording of the electrical activity of the heart

Endocrine Glands glands that produce chemicals (hormones) which affect other body cells

Enzyme special type of protein. Enzymes help the body’s chemistry work better and more quickly

Epinephrine one of the secretions of the adrenal glands. It helps the liver release glucose (sugar) and limit the release of insulin. It also makes the heart beat faster and can raise blood pressure; also called adrenalin

Exchanges A grouping of foods by type to help people on special diets stay on the diet. Each group lists food in serving sizes. A person can exchange, trade, or substitute a food serving in one group for another food serving in the same group. The lists put foods in six groups: (1) starch/bread, (2) meat, (3)vegetables, (4) fruit, (5) milk, and (6) fats. Within a food group, each serving has about the same amount of carbohydrate, protein, fat, and calories

Fats one of the three main classes of foods and a source of energy in the body. Fats help the body use some vitamins and keep the skin healthy. They also serve as energy stores for the body. In food, there are two types of fats: saturated and unsaturated

Fat Atrophy hollows (atrophy) or lumps (hypertrophy) that occur at sites of repeated insulin injection

Fibre food substances found in cereals, fruits and vegetables that are not digested but help the function of the intestines

Fluorescein a harmless yellow coloured dye that is used to outline the vessels of the eye

Fructosamine a glycated protein like glycated haemoglobin that measures glucose control over the preceding 2-3 weeks

Fructose a sugar found in fruits

Gangrene death of body tissue usually caused by lack of blood supply

Gestational referring to the period of pregnancy from conception to birth

Glomerulus a tiny tuft of blood vessels that is part of the functional unit of the kidney

Glucagon a hormone produced in the pancreas that increases blood glucose

Glucose a simple sugar found in the blood. It is the body’s main source of energy; also known as dextrose

Glucose Tolerance Test a diagnostic test for diabetes involving a drink of glucose (after an overnight fast) followed by a series of blood glucose estimations over 2 hours

Glycated Haemoglobin haemoglobin with glucose and other sugars chemically bound to it – also referred to as glycosylated haemoglobin. Haemoglobin A_1c is a specific component of glycated haemoglobin

Glycosuria the presence of glucose in the urine

Haemoglobin the red coloured iron protein that carries oxygen in red cells

HLA human leucocyte antigens which are natural markers on white cells much the same as blood groups on red cells

Hormone a chemical substance produced by endocrine glands which causes specific effects on other cells

Hyperglycaemia blood glucose higher than normal

Hyperosmolar Coma A coma (loss of consciousness) related to high levels of glucose (sugar) in the blood and requiring emergency treatment. A person with this condition is usually older and weak from loss of body fluids and weight. The person may or may not have a previous history of diabetes. Ketones (acids) are not present in the urine

Hypertension high blood pressure

Hypoglycaemia too low a level of glucose (sugar) in the blood. This occurs when a person with diabetes has injected too much insulin, eaten too little food, or has exercised without extra food. A person with hypoglycemia may feel nervous, shaky, weak, or sweaty, and have a headache, blurred vision, and hunger. Taking small amounts of sugar, sweet juice, or food with sugar will usually help the person feel better within 10-15 minutes

Hypertrophy see Fat Atrophy

Impaired Glucose Tolerance (IGT) blood glucose (sugar) levels higher than normal but not high enough to be called diabetes. People with IGT may or may not develop diabetes. Other names (no longer used) for IGT are “borderline,” “subclinical,” “chemical,” or “latent” diabetes

Impotence the inability in males to start,sustain or complete the act of sexual intercourse

Insulin a hormone produced by the pancreas that lowers blood glucose

Insulin-Dependent Diabetes see type 1 diabetes

IDDM see type 1 diabetes

Insulin Resistance many people with noninsulin-dependent diabetes produce enough insulin, but their bodies do not respond to the action of insulin. This may happen because the person is overweight and has too many fat cells, which do not respond well to insulin. Also, as people age, their body cells lose some of the ability to respond to insulin

Intramuscular administration of a medication through a needle into the muscles

Intravenous administration of a medication through a needle into a vein

Islet Cells (of Langerhans) clusters of cells in the pancreas which include the beta (insulin producing) and alpha (glucagon producing) cells

Juvenile Onset Diabetes see type 1 diabetes

Ketones chemical substances from the breakdown of fat which can be dangerous in large amounts

Ketonuria warns of ketoacidosis

Ketoacidosis uncontrolled blood glucose and ketone levels that cause dehydration, concentration of body fluids, build up of acids (acidosis) and coma (see diabetic ketoacidosis)

Lactic Acidosis a serious condition caused by the build up of lactic acid which is produced from glucose when there is not enough oxygen. Similar effects as ketoacidosis

Lactose a sugar found in milk

Laser an intense narrow beam of light which can be used to heal damaged areas in the body (e.g. blood vessels in the eye)

Macrovascular referring to the large blood vessels

Maturity Onset Diabetes see Type 2 diabetes

Metabolism the physical and chemical changes occurring in the body

Microalbuminuria leakage of small amounts of protein (albumin) into the urine. An early warning of kidney damage

Microvascular referring to the small blood vessels

Millimole (mmol) a measurement of the concentration of chemicals in the body

Monila see Candida

Nephropathy disease of the kidneys

Neuropathy disease of the nerves

Non-Insulin Dependent Diabetes see type 2 diabetes

NIDDM see type 2 diabetes

Obesity the condition of severe overweight

Oral Hypoglycaemic Drug medications taken by mouth that stimulate the release or improve the action of insulin

Pancreas an organ behind the lower part of the stomach that is about the size of a hand. It makes insulin so that the body can use glucose (sugar) for energy. It also makes enzymes that help the body digest food. Spread all over the pancreas are areas called the islets of Langerhans. The cells in these areas each have a special purpose. The alpha cells make glucagon, which raises the level of glucose in the blood; the beta cells make insulin; the delta cells make somatostatin

Photocoagulation using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy

Polydipsia a great thirst that lasts for long periods of time; a sign of diabetes

Polyphagia great hunger; a sign of diabetes. People with this great hunger often lose weight

Polyuria the passage of large amounts of urine

Portions see exchanges

Prandial referring to meals e.g. pre-prandial: before meals; post-prandial: after meals

Proteinuria too much protein in the urine. This may be a sign of kidney damage

Pruritus itching

Renal a term that means having something to do with the kidneys

Renal Threshold the blood glucose level above which glucose spills into the urine

Retinopathy damage to the retina of the eye

Saccharin a low calorie artificial sweetener

Somogyi Effect a rebound effect of low followed by high blood glucose caused by too much insulin

Sorbitol a sugar used to sweeten foods

Subcutaneous underneath the skin

Sucrose a form of sugar that the body must break down into a more simple form before the blood can absorb it and take it to the cells

Sugars simple carbohydrates which are sweet and occur widely in nature e.g. fructose, glucose,lactose, sucrose

Thrush see Candida

Thyroid an endocrine gland in the base of the neck producing hormones controlling the body’s metabolism

Triglyceride a type of fat found in the blood and other parts of the body

Type 1 Diabetes where little or no insulin is made, usually occurring under the age of 30 and requiring insulin injections for life. Also known as insulin dependent and juvenile onset diabetes

Type 2 Diabetes insulin is present but doesn’t work adequately. Usually occurs over the age of 30 and is controlled by diet and medication or diet and insulin. Also known as non insulin dependent and maturity onset diabetes

Ulcer a break in the skin; a deep sore. People with diabetes may get ulcers from minor scrapes on the feet or legs, from cuts that heal slowly, or from the rubbing of shoes that do not fit well. Ulcers can become infected

Ultralente Insulin a type of insulin that is long acting

Unit the basic measure of insulin. U-100 insulin means 100 units of insulin per milliliter (mL) or cubic centimeter (cc) of solution

Uraemia build up of poisons because of kidney failure

Urine Testing checking urine to see if it contains glucose (sugar) and ketones. Special strips of paper or tablets (called reagents) are put into a small amount of urine or urine plus water. Changes in the color of the strip show the amount of glucose or ketones in the urine. Urine testing is the only way to check for the presence of ketones, a sign of serious illness

Vein a blood vessel that carries blood to the heart

Xylitol a sweetener found in plants and used as a substitute for sugar

Source: http://www.diabetes.org.au

Researchers writing in BioMed Central’s open access journal Critical Care studied 930 million hospitalisations over a 25-year period to investigate the protective effect, adding to our knowledge of both diabetes and sepsis.

Drs. Annette Esper and Greg Martin from Emory University in Atlanta, Georgia worked with a team of researchers to investigate suspected links between diabetes mellitus (DM) and the likelihood of experiencing different kinds of organ dysfunction during sepsis.

He said, “We’ve found that people with DM and sepsis were more likely to develop acute renal failure than people without DM, while being less likely to develop acute respiratory failure. Findings like these are important, as accurate identification of populations at risk for different acute organ dysfunctions is crucial to the development of novel therapies for these patients.”

According to the Surviving Sepsis Campaign, it is estimated that 1,400 people die each day from sepsis. DM is an increasingly common illness, believed to afflict as much as 7% of the population of the US.

The authors found that among patients with a respiratory source of sepsis, 16% of those with DM developed acute respiratory failure compared with 23% in people without DM. Among patients with a non-pulmonary source of sepsis, those with DM were still less likely to develop acute respiratory failure when compared with those without DM (6% vs. 10%).

Speculating upon possible reasons for the discrepancy, Martin said, “Possible mechanisms of protection in patients with DM may be impaired neutrophil function or altered neutrophil-endothelial interactions. Alternatively, patients with DM may be hospitalised earlier in the course of their illness than those with no DM because they learn to be aware of specific signs of infection.

Finally, pharmacological aspects of DM care may also influence the development of organ dysfunction, because many medications administered to patients with DM, including insulin and thiazolidinediones, are known to have anti-inflammatory effects in addition to lowering blood glucose.”

The effect of diabetes mellitus on organ dysfunction with sepsis: an epidemiological study. Annette Esper, Marc Moss and Greg S Martin. Critical Care

Source: BioMed Central