February /March 2002
Diabetes -The Medical Perspective
Ketosis is the condition of having too many ketones in the
blood. Ketones are waste products made when your body is forced
to burn body fat, instead of glucose, for energy. Your body
gets rid of ketones by emptying them into your urine.
Your body will use body fat instead of glucose when any
of the following situations occur:
- You have a high blood glucose (hyperglycemia) caused
by too much food and/or too little insulin. Without the
right amount of insulin, your body burns fat for energy.
- You have a low blood glucose (hypoglycemia) caused by
too much insulin and/or too little food. When your body
does not have enough glucose to be used for energy, it uses
- Using a lot of energy as in exercise, stress, or illness.
How do I know if I have ketones in my urine? If you have
high blood glucose and/or have some symptoms from the list
below you may have a high level of ketones. If you have high
blood glucose levels, and your ketones are high for long periods
of time, you could develop ketoacidosis. Signs of ketoacidosis
or ketones in your urine, include...
- dry mouth/great thirst
- fruity breath
- loss of appetite
- dry, flushed skin/fever
- frequent urination
- labored breathing.
If you have these symptoms, or have a blood glucose level
over 240 mg/dL, you should test your urine using a ketone
test kit. If you have large amounts of ketones in your urine,
you should call your diabetes team or health care provider
immediately. If you have a "trace" or "small"
amount of ketones in your urine you should drink a glass of
water every hour and test your blood glucose every three hours.
If blood glucose and ketone levels are not going down after
two tests, call your diabetes team.
Diabetes and Food
Fruits and vegetables are low in calories, high in fiber,
and packed with vitamins and minerals! They are low in fat,
low in sodium, and may have other beneficial components -
Unfortunately these wonderful foods are often thought to
be boring, hard to fix, or expensive. While they could be
all three of these, they can also be exciting, easy to prepare,
and low cost.
How many servings of fruits and vegetables you should eat
each day depends on your diabetic diet plan. If you are searching
for some new ideas to plan your fruit and vegetable servings,
- Waking up to fruit. Drinking juice or adding fruit to
cereal is a light touch to breakfast!
- Thinking "grate"! Add grated or shredded vegetables
such as zucchini, carrots, or cabbage to mixed meat or pasta
dishes, or even top a sandwich with some "grate"
- Just "stuffing it"! Stuff pitas, omelette,
tortillas with chopped or grated vegetables. Keep a handy
supply of grated vegetables to make additions easy.
- Being saucy! Puree berries, apples, pears, or peaches
to be added to grilled or broiled chicken, pork, or seafood.
- Turning smooth. Many recipes for fruit smoothies are
low calorie and delicious!
Exercise as a Part of Living
Forget something? Maybe you should take a walk! A study of
older adults conducted at the University of Illinois found
that those who walked about 45 minutes, three times per week
for six months performed substantially better on several mental
tasks than those who did stretching or strengthening exercises.
All of the 124 study subjects had been previously sedentary.
That is one of the nice results of the study: a person who
has not been physically active during his or her younger years
still can benefit from walking.
However, remember to walk safely - wear correct shoes, use
an uncluttered path or walkway, make sure the lighting is
This may be especially important to those who do not have
their blood glucose in good control. A study of 379 Finnish
men and women reported that the proportion of female subjects
with good balance tended to decrease along with those who
had poor glucose control. There was also a trend that disturbances
in gait (such as walking speed and step length among the women)
increased along with the deterioration of glucose control.
Remember - talk to your doctor before beginning any exercise
Recipes to Try
Pineapple Whipped Salad
1 pkg. (3 oz.) sugar-free lime gelatin
1/2 cup low-fat cottage cheese
1 cup boiling water
1 cup no-fat whipped topping
1 can (20 oz.) crushed pineapple in its own juice
- Dissolve gelatin in boiling water.
- Drain pineapple, reserving 1/2 cup. Add this 1/2 cup of
pineapple juice to gelatin.
- Chill until very thick.
- Fold in pineapple, cottage cheese, and whipped topping.
Chill until firm.
Per serving (1/2 cup serving):
||3 grams protein
|2 mg cholesterol
||13 grams carbohydrate
|1 grams total fat
||13 % calories from fat
(1 - 8 oz. serving)
4 oz fat-free, no sugar added strawberry yogurt, frozen
6 oz. Crystal Light lemonade
- Combine all ingredients in blender.
- Blend until smooth.
||6 grams protein
|13 grams carbohydrate
||0 grams total fat
|2 mg cholesterol
||4 % calories from fat
Taking medication all the time AND at the right time may
be hard to remember, especially if you have many activities
in your life, or different routines from time to time.
There are many innovative devices on the market to help
you remember when to take your oral medication or your insulin.
One device is vibrating watches. There are many types, but
most have up to six alarm times for up to six times in a day
to take medication. There is even a talking watch for the
A little less technical are the various medication organizers,
with divisions for each day, and slots for each time. Some
of these organizers are sophisticated and also have alarms
and clocks built into them. One even provides a choice of
light, sound, or vibration as a reminder!
If you are using insulin, you can adapt these by putting
"marker" pills or pebbles that you take out whenever
you give yourself insulin. The drawback is if you give yourself
insulin and forget to remove the "marker!"
For those who are taking insulin, a fanny pack-type organizer
will keep insulin cold for up to 12 hours, and also has room
for two vials of insulin and syringes.
For information about medication alert watches or containers
or call 800-549-0095 or (781) 239-8255 or write to e-pill,
LLC 70 Walnut Street, Wellesley, MA 02481-2175, USA.
Other similar products are available
or write to Health Accessories at Bluff City, 5991 Daybreak
Drive , Bartlett, TN 38135-5134.
The Diabetes Food and Nutrition Bible by Hope S.
Warshaw, Robyn Webb, Graham Kerr.
Included in the book are meal planning approaches; portion
control; how to buy, store, and handle foods; two weeks of
menus using the recipes; and how to find a dietitian. Paperback,
320 pages, about $13 to $19 depending on where you purchase.
Available from amazon.com at $13 and the American Diabetes
Association at ADABookOrders@pbd.com;
or call the Order Fulfillment Department at 1-800-232-6733
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