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Publication: Diabetes Update
Cold And Flu More Serious In Diabetics

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Diabetic Digest - Wednesday, January 16, 2008
News, updates and help from and for the diabetic community.


We are going to cover quite a few topics today. 

First, I have two interesting articles covering Diabetics 
facing Cold And Flu Season and Cinnamon's impact of blood 
sugar and fat levels. 

Lastly, there's a great recipe for 5-Way Cincinnati Chili. 
That sounds good, doesn't it? It's a great way to warm up 
this winter. 

Have a great day and enjoy. 


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  Cold And Flu More Serious in People with Diabetes

TORONTO (Reuters Health) - Flu season is unpleasant for
everyone, but if you have diabetes it can be even worse.
If diabetics fail to manage their disease while sick,
the complications can be serious, the American Diabetes
Association warned in a statement this week.

"Your average person (with the flu) will spend three or
four days at home but they'll do okay," said Dr. John
Buse, president of medicine and science at the ADA. "In
patients with diabetes, occasionally they even have to
be hospitalized."

When a person has an infection, the physiologic stress on
the body can cause their blood sugar to rise, Buse said.
This is of particular concern to diabetics, who must
monitor their blood sugar because levels that are either
too high or too low can be dangerous. The body burns
stored fat for energy when there is no food available,
and if insulin is not taken regularly, particularly in
type 1 diabetics, a waste product called ketones can
begin to build up, he said. High ketone levels can lead
to ketoacidosis, which can result in a coma or death.

As well, some drugstore medications, commonly taken to
alleviate cold and flu symptoms, may pose a risk to
diabetics also dealing with blood pressure, Buse said.
Cough syrups containing decongestants can raise blood
sugar and blood pressure, and hypertension is an issue
for about half of diabetics. Though they may relieve
some symptoms, these medications haven't been
demonstrated to actually reduce the duration of colds
or flu, he said.

"It's not that nobody with diabetes can take these
products," Buse said. "As a rule of thumb, if people
don't know that it's okay to take it, it's probably
better to err on the side of not taking it." It is
generally better to put something on the area that is
bothering you instead of ingesting something that has
to work through your entire body, he suggested - for
example, choose a nasal spray to relieve a stuffy nose
instead of an oral decongestant.

Diabetics who become ill this winter can avoid more
serious complications by taking extra care to manage
their condition, Buse said. Unless a doctor advises
otherwise, diabetics should continue to take their
medication as usual, even if they are not eating
normally, he said.

While they are sick, patients should eat as much as is
comfortable for them, Buse said -- the ADA recommends
15 grams of carbohydrates per hour -- but this may be
difficult during some illnesses. Nevertheless, liquids
are key to preventing dehydration, and water, tea and
broth are better choices than sugar-laden juices, which
can raise blood sugar.

In addition to monitoring their blood sugar regularly
for dangerous rises or drops, the ADA also suggests
monitoring urine for ketones, the end-product of
excessive fatty-acid breakdown. Ketones are found in
the urine when the ketones in the blood surpass a
certain level.

If blood sugar levels are too low, drinking juice with
about 15 grams of carbohydrates once an hour, or a
1/2 cup of apple juice or one cup of milk, can help.

The ADA advises diabetics to contact their doctor if
ketones rise or are present in the urine for more than
12 hours; if vomiting or diarrhea lasts for more than
six hours; if a fever increases or lasts longer than a
day; if there is abdominal pain or if blood sugar can't
be controlled.

Because it can be hard to reach a health care professional
quickly, it's helpful for diabetics to have a plan in
place with their doctors, Buse said. "The thing to do is
to know what to do before you get sick."

It is also recommended that diabetics receive the
influenza vaccine every year, Buse said. Pneumonia isn't
a winter-specific illness, he said, but diabetics should
be vaccinated against that as well - once before age 65,
and once after.

Hand-washing is the best known weapon for cold and flu
prevention, Buse said, but if you get sick, taking care
to monitor your diabetes can help you get over it quickly
and without complication.

"The bottom line is there's just more consequences to
colds, potentially, in patients with diabetes than in
the general population."

Copyright 2008 Reuters Limited. All rights reserved


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Cinnamon Does Not Control Blood Sugar Or Fat Levels

NEW YORK (Reuters Health) - Cinnamon does not appear to 
have any impact on blood sugar or cholesterol levels in 
people with diabetes, Connecticut-based researchers report 
in the journal Diabetes Care. 

"The preponderance of evidence currently available does 
not suggest that cinnamon has the ability to decrease a 
person's risk of heart disease by helping them control 
their diabetes or lower their cholesterol," Dr. Craig I. 
Coleman, of Hartford Hospital, who was the principal 
investigator, told Reuters Health. 

Several studies have looked at the impact of cinnamon on 
blood sugar and lipids (fats) in patients with diabetes 
but had only modest sample sizes and yielded mixed results, 
Coleman and colleagues note in their report. 

This led them to perform a large review, or "meta-
analysis," of five studies in which a total of 282 
type 1 or type 2 diabetic patients were randomly assigned 
to receive cinnamon or a placebo and were followed for 
up to 16 weeks. 

All five studies used cinnamon cassia, "the same cinnamon 
most people have in their spice racks at home," Coleman 
noted. Doses ranged from 1 to 6 grams daily. 

As mentioned, the use of cinnamon did not significantly 
alter hemoglobin A1C -- a marker of blood sugar control. 
It also had no effect on fasting blood sugar levels or 
lipid parameters. Analyses by subgroup and sensitivity 
did not appreciably alter these results. 

Coleman told Reuters Health that the inspiration for 
conducting this specific analysis came from one of his 
research fellows, Dr. William Baker. "He works in a 
chain pharmacy as a pharmacist, now and then, and he 
was asked by a patient whether cinnamon was useful in 
treating diabetes." 

"As pharmacists, we want to be able to provide patients... 
with the best information about these over-the-counter 
treatments, which are often readily available but under 
researched," Coleman said. Based on the current study, 
"we would not recommend its use to patients," he said. 

SOURCE: Diabetes Care, January 2008.

Copyright 2008 Reuters Limited. All rights reserved.

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                     Diabetic Recipe

                 5-Way Cincinnati Chili

                   (makes 8 servings)

1 1/2 pounds ground sirloin
2 medium onions, chopped
1 celery ribs, chopped
4 large cloves; garlic, minced
2 tablespoons good-quality chili powder
1 tablespoon paprika
1/2 teaspoon crushed dried basil
1/2 teaspoon crushed dried oregano
1/2 teaspoon crushed dried thyme
1 teaspoon ground cinnamon
1/2 teaspoon cayenne pepper
1/2 teaspoon ground cumin
1/2 teaspoon crushed red pepper flakes
1/4 teaspoon ground allspice
salt (optional)
freshly ground pepper
2 14 1/2--ounce cans no-salt-added diced tomatoes with 
their juice
1 8-ounce can no-salt-added tomato sauce
1/2 to 1 cup water
12 ounces dried thin spaghetti
1 cup chopped onion
1/2 cup low fat shredded cheddar cheese
1 cup drained dark red kidney beans

1. In a large nonstick pot, brown ground sirloin, onion, 
   celery, and garlic over medium heat, stirring occasion-
   ally, until beef is browned and vegetables are limp, 
   about 10 minutes. Drain off and discard all fat. 

2. Stir in chili powder, paprika, basil, oregano, thyme, 
   cinnamon, cayenne pepper, ground cumin, red pepper 
   flakes, and allspice. Season with salt (if using) and 
   pepper to taste. 

3. Stir in tomatoes and tomato sauce. Add 1/2 cup water, 
   adding additional water as needed to reach desired 
   consistency. Partially cover and simmer for 30 minutes. 
   Transfer chili mixture to a freezer container and freeze 
   until firm or cover and refrigerate overnight. 

4. When ready to serve, defrost chili and reheat on the 
   stove for at least 15 minutes while you cook the 
   spaghetti, following package directions, to al dente. 
   Drain the spaghetti and keep warm. Place the chopped 
   onion, shredded cheese, and kidney beans in small 
   serving bowls. 

5. To serve, divide the hot spaghetti between 8 shallow 
   soup bowls. Ladle hot chili over each serving and pass 
   the condiments separately to spoon onto each serving. 

Per serving: 401 calories (22% calories from fat), 
             29 g protein, 10 g total fat (3.6 g 
             saturated fat), 50 g carbohydrates, 
             6 g dietary fiber, 32 mg cholesterol, 
             376 mg sodium 

Diabetic exchanges: 2 1/2 lean protein, 3 1/2 carbohydrate 
                   (2 1/2 bread/starch), 3 vegetable) 

Copyright 1997-2001 Diabetic-Lifestyle. 


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