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Publication: Diabetes Update
The Older I Get...

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Diabetic Digest - Wednesday, July 30, 2008
News, updates and help from and for the diabetic community.


I'm headed out to see my doctor. I'm due for an A1C blood 
test just to make sure that my blood-sugar is staying 
where it should and making sure that I'm not headed for 
any problems. I get this taken care of every three months. 
I used to hate going to get this taken care of, but now I 
look forward to it. The older I get the more I want to be 
in control of my health and well-being. After all it is my 
health. I do everything I can to keep on the straight and 
narrow. I'll just have to see if it's paying off. Wish me 

Be safe and healthy. 


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Cultural Sensitivity May Improve Diabetes Outcomes

NEW YORK (Reuters Health) - Culturally tailored diabetes 
education may help ethnic minorities with type 2 diabetes 
better control their blood sugar.

"There is some evidence suggesting culturally tailored 
health education can improve some clinical outcomes in 
the short-term," co-author Dr. Yolanda Robles of Cardiff 
University the UK told Reuters Health. However, "further 
research is needed to assess long-term effects," Robles 

Language and cultural barriers may hinder the delivery of 
quality diabetes health education to ethnic minorities, 
yet education is a vital aspect of diabetes care, Robles 
and colleagues report in the Cochrane Database of 
Systematic Reviews from The Cochrane Collaboration. 

To assess the overall efficacy of culturally tailored 
diabetes education versus the "usual" care, the researchers 
combined findings from 11 published research articles that 
compared the two approaches among minority groups living 
in middle- or high-income countries. All of the 1,603 study 
participants were older than 16 years. 

Despite the limited number of studies available for 
analysis, the investigators found "clinically significant 
improvements" in blood sugar control among patients 
educated in their mother tongue using culturally specific 

Patients in culturally tailored educational interventions 
also showed improved knowledge of diabetes and healthy 

These improvements, which were evident after 3 and 
6 months, strengthen the concept "that health education 
should be couched in a learner-centered manner" while 
respecting religion, and social and cultural values, 
Robles and colleagues note. 

However, "there is still need to assess long-term effects 
of interventions," Robles said. 

Well-designed, multi-center trials should examine a range 
of health education interventions in multiple ethnic 
minorities to determine the long-term benefits to overall 
health and quality of life measures, and to assess which 
interventions work best in which context, the investigators 

SOURCE: Cochrane Database of Systematic Reviews, July 2008

Copyright 2006 Reuters Limited. All rights reserved.

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Diabetic Foot Ulcers Often Have Poor Outcomes

NEW YORK (Reuters Health) - Although the majority of 
patients hospitalized because of diabetic foot ulcers 
initially do reasonably well, in the long-term the outcome 
is often poor, French researchers report in the journal 
Diabetes Care. 

"Despite a satisfactory rate of healing," investigator 
Dr. Antoine Avignon told Reuters Health, "the overall 
prognosis of patients with diabetic foot ulcers is not 

Avignon of Universite Montpellier 1 and colleagues came 
to this conclusion after following 89 patients with 
diabetic foot ulcers for an average of more than 6 years. 

Altogether, the ulcer healed in 69 patients, who were able 
to avoid major amputation. However, 42 of the 69 patients 
had a recurrence of the ulcer, and by the end of the 
follow-up period, 25 patients (28.1 percent) were disabled 
and dependent on care. 

In total, only 40 of the original 89 patients studied 
(44.9 percent) achieved complete therapeutic success 
according to the criteria employed. 

Over the course of the study, 46 patients died; 
23 patients died of cardiovascular causes, but 9 died 
from a complication of the foot ulcer. After accounting 
for factors that could influence the outcome, such as 
age, only kidney impairment was an independent predictor 
of mortality. 

"In our opinion," concluded Antoine, "it is essential to 
define internationally recognized success criteria for 
the care of diabetic foot ulcers. Those criteria must go 
beyond just the evaluation of healing rates." 

SOURCE: Diabetes Care, July 2008.

Copyright 2006 Reuters Limited. All rights reserved. 

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                     Diabetic Recipe

                  Grilled Chicken Pizza

                    (makes 8 servings)

1 10-ounce (300 g) tube refrigerated pizza dough
1 teaspoon (5 ml) crushed dried oregano
1/2  teaspoon (2.5 ml) crushed dried basil
8 ounces (240 g) cooked chicken breast, chopped
1/2  cup (124 g) reduced-fat, low-sodium jarred marinara sauce
2 tablespoons (30 ml) finely chopped onion
2 to 3 fresh mushrooms, thinly sliced (optional)
1 tablespoon (15 ml) freshly grated Parmesan cheese
1/4 cup (30 g) shredded part-skim mozzarella cheese

1. Open the dough package and on a lightly floured surface, 
   roll out to roughly form a 10-inch (25 cm) circle. Place 
   the crust on a cookie sheet which has been lightly 
   sprinkled with cornmeal. Using your fingers, pat dough 
   to desired shape and thickness. 

2. Transfer pizza to the prepared grill (see above). Grill 
   for about 3 minutes, until the top of the dough puffs 
   and the underside is crisp and lightly browned. Using 
   a large metal spatula, turn the crust over. Brush the 
   cooked top with olive oil and sprinkle with oregano and 

3. In a medium bowl, combine the cooked chicken, marinara 
   sauce, and onion. Spread mixture over the top side of 
   the crust. Arrange mushrooms on top (if using). Top 
   with Parmesan cheese and sprinkle on the mozzarella, 
   covering the top evenly. 

4. Continue to grill for another 4 to 5 minutes, until the 
   pizza is cooked through, the dough lightly browned, and 
   the cheese melted. To insure even cooking, use tongs to 
   rotate the pizza two or three times during the cooking 
   period, taking care not to knock off the topping. 

Per serving: 142 calories (21% calories from fat), 
             11 g protein, 3 g total fat (1.1 g saturated 
             fat), 17 g carbohydrate, 1 g dietary fiber, 
             21 mg cholesterol, 286 mg sodium 

Diabetic exchanges: 1 lean protein (meat), 1 carbohydrate 

Copyright 1997-2001 Diabetic-Lifestyle.


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