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Publication: Diabetes Update
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Diabetic Digest - Wednesday, August 16, 2006
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 better get going. I'll let you know how it went in the 
next issue. 

Be safe and healthy. 


Diabetic Update Newsletter
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p.s. Visit the Diabetic Update Forum and post your comments.
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Poor Diabetes Control Tied To Cognitive Difficulty

NEW YORK (Reuters Health) - Elderly diabetics with poor 
blood sugar control have a high prevalence of undiagnosed 
cognitive dysfunction, depression and functional 
disabilities, according to a study by researchers in 

Dr. Medha Munshi, of the Joslin Diabetes Center, and 
colleagues examined the association between cognitive 
dysfunction and blood sugar control in 60 diabetics older 
than age 70. These individuals had diabetes for an average 
of about 14 years and elevated hemoglobin A1C levels -- an 
indicator of poor blood sugar control. 

The mean HbA1C level was 7.9 percent. The American Diabetes 
Association recommends a target A1C level of 7.0 or lower. 

Several common tests were used to screen for cognitive 
dysfunction such as the Mini Mental State Examination and 
standard drawing tests. The subjects were also screened 
for depression and functional disability. 

Overall, the Mini Mental State Examination scores 
correlated with drawing test scores. 

More than a third had low scores on the drawing tests and 
these scores were inversely correlated with cognitive 
function. This suggests an association between cognitive 
dysfunction and poor blood sugar control, the researchers 
report in Diabetes Care. 

The 33 percent of subjects with depressive symptoms also 
had greater difficulty completing tasks of daily living. 

This population of older diabetics had a high incidence of 
functional disabilities. Overall, 48 percent had hearing 
impairments, 53 percent had vision impairments, 33 percent 
had recently fallen, and 44 percent were afraid of falling. 

No association was observed between depression scores and 
blood sugar control. 

In an interview with Reuters Health, Munshi said: "Elderly 
patients with diabetes require special and specific treat-
ment plans. Elderly patients with diabetes should be 
screened for the presence of co-existing medical conditions 
like cognitive dysfunction, depression, and physical 
disabilities as these conditions may act as barriers to 
their ability to self-manage." 

Elderly diabetics, she added, may benefit from 
"modification of treatment modalities, focused education, 
nutrition counseling, and care coordination with the help 
of a multidisciplinary team." 

SOURCE: Diabetes Care August 2006. 

Copyright 2005 Reuters. 

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                      Diabetic Recipe

                      Animal Crackers

                 (makes about 59 crackers)

3/4 cup (94 g) whole wheat flour
1/4 cup (35 g) cornmeal
1/4 cup (30 g) grated Parmesan cheese
2 tablespoons (30 ml) dehydrated vegetable flakes
1 teaspoon (5 ml) baking powder
1/4 teaspoon (1.25 ml) salt (optional)
4 tablespoons (60 ml) cold reduced-fat margarine
1/4 cup (59 ml) skim milk
dash cayenne pepper (optional)

1. In a bowl, combine flour, cornmeal, Parmesan cheese, 
   dehydrated vegetable flakes, baking powder, and salt 
   (if using).

2. Using a pastry blender or two knives, cut margarine 
   into flour mixture until it resembles fine crumbs. 
   Make a well in the center and stir in the milk to 
   form a stiff dough. Gather the dough into a ball and 
   chill, wrapped in plastic wrap, for 15 minutes. 

3. Preheat oven to 375°F (190° C). Roll out dough on a 
   lightly floured work surface to 1/8-inch (1/2 cm) 
   thickness. Cut out with small cookie cutters into 
   animal shapes. Transfer cut out crackers to a nonstick 
   cookie sheet. Prick surface with tines of a fork. 

4. Bake 4 to 5 minutes, until crackers are lightly browned 
   on the bottom. Using a wide spatula, turn cracker over 
   and bake for another 3 to 5 minutes, until browned on 
   the bottom. Cool on a wire rack. 

5. Store in an airtight container. 

Per 7-cracker serving: 122 calories (40% calories from 
fat), 6 g total fat (1.4 g saturated fat), 15 g 
carbohydrate, 2 g dietary fiber, 3 mg cholesterol, 
182 g sodium 

Exchanges: 1 carbohydrate (1 bread/starch), 1 fat 

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Copyright 2006 by NextEra Media. All rights reserved.

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