February /March 2003
Diabetes - The Medical Perspective
Many people gain a little weight as they get older. We may
need to get rid of a few clothes that are snug and buy new
clothes a size or two larger. We don’t have to look
like fashion models anyway!
The problem is that if every year we put on a few pounds,
in ten years we have put on many more than a few.
If you have pre-diabetes and are even modestly overweight,
experts recommend that you reduce your weight by 5-10% and
do some kind of modest physical activity for 30 minutes each
day. So if you weigh 170 pounds and were overweight, that
would mean a weight loss of 8.5 to 17 pounds. How much you
should lose depends on the best weight for your height. Talk
to your health care provider to find out what your best weight
may be. (Pre-diabetes is the term used when a person’s
blood glucose is higher than normal, but not high enough to
be called diabetes. It is also called Impaired Glucose Tolerance
(IGT) – the fasting blood glucose level is between 110
and 126 mg/dl.)
If you have diabetes you should work extra hard at preventing
those extra pounds from adding up. If those pounds have already
been put on, pay extra attention to getting them off. But
don’t feel alone; almost 90% of those diagnosed with
type 2 diabetes are overweight.
New diets are published each week and some include a bizarre
combination of foods. Healthful eating should be balanced
and shouldn’t result in drastic loss of weight. Losing
one-half to one pound per week is a good goal. This equals
eating about 250 to 500 calories less each day than you usually
Be sure to talk to you doctor about your weight and any
weight loss plan you may want to pursue. Losing weight is
great! – and it may mean you’ll need less medication
as the pounds come off.
Diabetes and Food
Trying to cut back on your calories and get back on your
usual meal pattern after the holidays? For most people this
is a little hard. We get used to treats and we like them!
Going without feels like we are giving up the fun and excitement
of the holiday season.
Most people don’t pay a lot of attention to why they
are eating, or overeating. Overeating is a habit that is especially
hard to break because you can’t give up on eating altogether.
A habit is automatic. The first step to changing that habit
is to become aware of it. Even if you don’t think you
are overeating, making a check on your eating habits every
once in awhile can help prevent overeating from becoming a
A food diary is a good way to start. It may sound like hard
work, but the payoff is big! Make a late New Year’s
resolution to pick a couple days each month when you write
down everything you eat. And how much! If you find yourself
eating differently than if you had not been writing the food
down, this suggests that you may need to break a bad eating
If you find you have been overeating, think about when you
overeat and why. If there are a lot of excuses for overeating,
find help to be realistic with yourself. Talk to your dietitian
for suggestions to change any bad habits.
Exercise as a Part of Living
Exercise plays an important role in both losing weight and
maintaining a healthy weight. Not only does daily exercise
burn extra calories, in the long run being fit can help you
burn more calories even when resting!
Exercise can also help you develop new interests, and give
you a burst of psychological energy while you are trying to
Once you’ve reached your desired weight, exercise
is still important. Exercise will help maintain flexibility
and balance so that you are less likely to fall and hurt yourself.
It helps keep your heart and circulation running at their
best. It can also give you that healthy glow so you know you
look your best, too.
If you’ve had an exercise routine and given it up
over the holidays, now is the time to get back in the swing
of things. Don’t feel badly because you didn’t
stick to last year’s routine. Start fresh and start
If your exercise routine has become boring, ask a friend
to join you, or join a walking group. Many times your health
care provider can refer you to safe and successful programs
right in your own neighborhood.
Recipes to Try
Chicken Finger Manicotti
1 package manicotti shells (14 shells)
1 jar (30 ounces) spaghetti sauce
1 teaspoon garlic powder
24 ounces (1-1/2 lbs.) chicken tenders
1 1/2 cups light shredded mozzarella
1. Cook manicotti shells according to directions.
2. Heat oven to 350º.
3. Spread a small amount of spaghetti sauce over the bottom
13 x 9 inch baking pan.
4. Sprinkle garlic powder on chicken. Put chicken tender
into manicotti shell. Place stuffed shells in baking pan.
5. Pour remaining sauce over shells. Sprinkle with cheese.
6. Cover baking pan with foil. Bake for 1 hour.
27 grams protein
35 mg cholesterol
66 grams carbohydrate
10 grams total fat
20% calories from fat
1 cup margarine, softened
2 cups flour
1/2 teaspoon baking powder
1 package (8 ounces) fat free cream cheese
1 jar sugar free light preserves, any flavor
1/2 cup chopped pecans
1. Mix first 4 ingredients together. Form a ball and chill
for 3 hours.
2. To make filling, mix jam and nuts together.
3. Roll one-fourth of dough out and cut into 2-inch squares.
(You should have 15 squares per one-fourth of dough to come
up with total of 30 cookies of 2 squares each- if you have
fewer, calories per serving may be higher.)
4. Place a spoonful of filling on square, top with another
square and seal by pinching edges. Repeat until all of dough
5. Bake at 375º for 15 to 20 minutes.
2 grams protein
1 mg cholesterol
10 grams carbohydrate
7 grams fat
60% calories from fat
One of the most expensive parts of diabetes care can be
medications. And when we think of medications and expense,
we think about insurance coverage.
If you are over 65 years of age, usually Medicare is your
insurance coverage. Medicare offers no prescription drug coverage
at this point. Medicare supplement plans H, I and J offer
prescription drug benefits. The basic drug benefit, offered
in plans H and I, has a $250 annual deductible and requires
a 50% co-payment. Plans H and I pay up to a maximum benefit
of $1,250 per year. The extended drug benefit, offered in
plan J, also has a $250 yearly deductible and a 50% co-payment.
However, plan J pays up to a maximum benefit of $3,000 per
Does all this sound confusing? It is!
The Senior Health Insurance Program (SHIP) is a free insurance
counseling service for Medicare beneficiaries and their caregivers.
SHIP is sponsored by the Illinois Department of Insurance.
This service, offered statewide, is available to Medicare
beneficiaries of all ages. They do not sell insurance, but
can help answer your Medicare questions.
Senior Health Insurance Program
Illinois Department of Insurance
320 W. Washington Street
Springfield, IL 62767-0001
1-800-548-9034 or 217-524-4872 (TDD) or visit their website
or e-mail them at SHIP@ins.state.il.us
Want a little humor in your life? Try Confessions of
a couch potato: If I’m so skinny, why do I feel like
flounder?, by Stephen Furst who lost 150 pounds and has
kept it off. Contains lots of tips and anecdotes as well as
recipes. Available from the American Diabetes Association
bookstore at http://store.diabetes.org/adabooks/
or through amazon.com, in paperback, 136 pages.
On a more serious note, there is Counting carbs made
easy for people with diabetes, by Marie McCarren, which
is also available through the ADA webstore. The 60 page, pocket-sized
book has lots of tips for counting carbohydrates in everyday
One book that has been put on tape by ADA is Diabetes
burnout –what to do when you can’t take it anymore!,
by William Polonsky. The book (386 pages) without the audiotape
is available at http://www.diabetesnet.com/burnout.php
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