Diabetes

---

Diabetes

Easy Ways to Control Blood Sugar

What do actress Mary Tyler Moore and Empty Nest TV actress Park Overall have in common? They both have diabetes, and they both live full, rich lives.

Diabetes is a metabolic problem that affects your body's ability to make or respond to insulin, a hormone. Insulin regulates the delivery of blood glucose (blood sugar) to your body's organs and tissues, where it's used for energy. Type I, or insulin-dependent, diabetes, is an inherited disease that affects the pancreas, destroying that organ's ability to make insulin. Type I diabetes usually occurs during childhood or adolescence.

Nine out of ten people with diabetes have Type II, or non-insulin-dependent, diabetes. For them, the body can't use insulin that's manufactured. Type II diabetes usually occurs after age 30.

SMART SELF-CARE

Women doctors say that if you have been diagnosed with diabetes of either type, you should be under medical supervision (usually a physician, and often a registered dietitian, a nurse practitioner/educator and an ophthalmologist, all working as a team). Changes in diet, exercise and other self-care strategies that follow are important, but should be checked with your doctor or other health care professionals, especially if you plan to have children. With proper blood sugar management, women with diabetes can get pregnant and deliver healthy children, says Kathleen Wishner, M.D., Ph.D., medical director of the Endocrine Global Business Unit of Eli Lilly and Company in Indianapolis and past president of the American Diabetes Association.

"Make sure that your blood sugar is meticulously controlled before you get pregnant," says Marie Gelato, M.D., Ph.D., associate professor of medicine at State University of New York at Stony Brook Health Sciences Center School of Medicine.

Here's what women doctors say you can do to control diabetes.

Lose fat, lose weight. Four out of five women with Type II diabetes are overweight, and they may even control their diabetes or reduce their medication if they lose weight, says Dr. Wishner. Calorically, fat is denser than protein or carbohydrates, so if you reduce the grams of fat that you eat, you automatically reduce calories. "To lose weight, aim for a diet with fat grams comprising 20 to 30 percent of your total calories," she says.

Start with cereal. "Foods high in fiber may help people with diabetes control their blood sugar," says Dr. Wishner. "Fiber slows the absorption of carbohydrates that you ingest. And after eating a high-fiber meal, you feel full. This can also help with weight loss."

Eating a big bowl of high-fiber cereal (like All-Bran) for breakfast and a big bowl of chili for lunch, for example, could help keep your blood sugar levels stable. According to one study, people with Type II diabetes who ate meals with 20 grams of fiber had significantly lower postmeal blood sugar than others who ate meals with only 10 grams of fiber.

Reach for some cornstarch. "We use uncooked cornstarch from the grocery store in people being treated for diabetes who experience episodes of hypoglycemia, or low blood sugar," says Francine Ratner Kaufman, M.D., associate professor of pediatrics at the University of Southern California School of Medicine in Los Angeles, director of the Comprehensive Diabetes Program at Children's Hospital of Los Angeles, and a member of the American Diabetes Association Board of Directors. "Uncooked cornstarch is a very slow release type of sugar--it takes up to six hours for your body to break it down and absorb it.

"Stir one or two teaspoons of uncooked cornstarch into a glass of milk or sprinkle it into pudding," says Dr. Kaufman. She suggests consuming cornstarch with an evening snack to prevent low blood sugar during the night, or before exercise, which affects blood sugar levels.

When To See A Doctor According to the American Diabetes Association, nearly 8.4 million women in the United States have diabetes, but only half know it. See your doctor if you have any of the following symptoms for more than a week. * Increased thirst, urination or appetite * Dry mouth * Vomiting * Diarrhea * Blurred vision * Rapid or irregular heartbeat * Dizziness * Unintentional weight loss * Recurrent yeast or urinary tract infections Also, see your doctor if you have diabetes and you're pregnant or thinking of starting a family. Women with poorly controlled diabetes have higher risk of complicated pregnancies that could affect mother and baby. Women with diabetes are also prone to problems with circulation or loss of feeling in their feet. So inspect your feet for red, dry, cracked skin; infections; calluses or blisters. And see your doctor if you see signs of infection. Untreated, even minor cuts or infections can lead to serious medical problems.

Consider a chromium supplement. Tests show that people with diabetes may have lower blood levels of chromium than people without diabetes. "Chromium may help people with Type II diabetes, because the body needs chromium to be able to respond to insulin," says Dr. Kaufman. "It is sometimes difficult to get beneficial amounts of chromium from food, so look for a multivitamin that supplies the recommended amount for chromium--50 to 200 micrograms daily."

Eat just one. In the past, people with diabetes were told that they could not eat certain foods--namely, refined carbohydrates like cookies or sweets, says Davida F. Kruger, R.N., a nurse practitioner at Henry Ford Hospital in Detroit and senior vice president of the American Diabetes Association. "But research shows that all carbohydrates will elevate blood sugar the same way; a cookie is equal to a piece of bread, which is equal to a piece of fruit.

"If there's a food that you really like, make sure to include it in your diet," says Kruger. "If your favorite snack food is cookies, but you never eat them, it's easy to feel deprived and frustrated, and that can lead to bingeing. Have one cookie and enjoy it. The key here is to treat yourself in moderation--don't eat the entire bag."

Walk, swim, cycle, dance. Exercise burns fat and calories and can help you lose excess pounds. For women with diabetes, exercise offers added bonuses: Exercised muscles are more sensitive to insulin, improving the way your body metabolizes sugar. Plus, studies show that regular exercise lowers the risk of heart disease, a special concern for people with diabetes.

"The current recommendation is to exercise at least three times a week for about 30 to 40 minutes," says Dr. Gelato. "Start out slowly, then work your way up. Walk, swim, cycle, dance--do whatever you enjoy." This should be done under a doctor's supervision, she adds, as your medication and diet may need adjustment to accommodate your increased activity.