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Wake-up call: Dealing with diabetes

Newly diagnosed patients might feel overwhelmed, but diabetics
can take control of their health so the disease does not control them.

JOEL HAWKSLEY | The Roanoke Times

Dan Wooldridge walks along the Katie George Memorial Track at Mountain View Elementary School in Roanoke County. Wooldridge, who has been a diabetic for about five years, has managed it by exercising, keeping his meal portion sizes down and by eating sugar and carbohydrates in moderation.

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Diabetes dictionary

Glucose: A simple form of sugar used by the body for energy.

Insulin: A powerful hormone made by the pancreas that helps glucose enter cells and keeps blood glucose from rising too high. When insulin is released, it circulates in the blood, binds to the surface of body cells and allows glucose to enter the cells to be used for energy or stored for later use.

Type 1 diabetes: An autoimmune disease where beta cells in the pancreas are attacked and destroyed to the point where insulin is not produced at all. In these cases, insulin must be taken via syringe, insulin pen or insulin pump. Sometimes referred to as “juvenile diabetes,” although adults can also be diagnosed with it.

Type 2 diabetes: In Type 2 diabetes, the most prevalent type, the body may not produce enough insulin. There may also be insulin resistance, which means glucose cannot enter the cells efficiently and high blood glucose (hyperglycemia) results. In addition, there may be excess insulin production and release of glucose by the liver, further contributing to high blood glucose.

Pre-diabetes: When a person’s blood glucose level is higher than normal but not high enough to warrant a diabetes diagnosis.

Gestational diabetes: A type of diabetes developed by many women during pregnancy. Often goes away after birth.

A1C: The average blood glucose over the past three months; expressed as a percentage. As the A1C rises above 7 percent, the likelihood of complications increase with diabetes. The United Kingdom Prospective Diabetes Study showed that in Type 2 diabetes, every 1 percent drop in A1C translated to a 37 percent drop in kidney disease and blindness, a 14 percent drop in heart attack, and a 43 percent drop in amputations.

Source: Martie Slaughter, certified diabetes educator for Carilion Clinic

Scalloped Cabbage with Tomatoes

Nancy Wooldridge got this recipe from a good friend. It has become a family favorite. The vegetables are supposed to retain some of their texture, not be mushy. Leftovers freeze well.

1 lb. cabbage (4 cups) shredded
3 Tbsp. margarine or olive oil
1⁄2 cup chopped onion
3 Tbsp. flour
Salt and pepper
2 1⁄2 cups (large can) chopped tomatoes
1⁄3 cup chopped green pepper
1 cup shredded cheddar cheese

1. Preheat oven to 375 degrees.

2. Place cabbage in a large pot with about 1⁄4 cup water over medium heat. Bring water to a boil, then cover, reduce heat and simmer for 7 minutes. Drain well and set cabbage aside.

3. In a large skillet, melt margarine over medium heat. Add onion and saute onions briefly. Blend in flour, season with salt and pepper and cook until the mixture bubbles. Remove from heat.

4. Gradually stir in tomatoes and green pepper. Return to heat and cook rapidly, stirring, until thickened. Green pepper will still be crisp.

5. To assemble, pour 1⁄3 of tomato mixture in a 13-by-9-inch casserole dish. Top with 1⁄2 of the cabbage. Repeat with another 1⁄3 of tomato mixture, the rest of the cabbage, and the last of the tomato mixture. Sprinkle evenly with cheese.

6. Bake in preheated oven for 25 minutes.

Light Key Lime Pie

Julie Manley of Bedford discovered this easy, adaptable low-sugar pie while seeking recipes for her husband Lynch, who is diabetic. This is their favorite flavor, but it can be customized in numerous ways. All you have to do is find a Jell-O flavor and a complementary yogurt flavor. For example, you could make this in lemon, strawberry, orange or peach.

1⁄4 cup hot water
1 box sugar-free lime Jell-O
2 (6 oz.) containers Yoplait key lime yogurt
1 container sugar-free whipped cream
1 graham cracker crust

1. Place hot water in a large mixing bowl. Sprinkle Jell-O over water and allow it to dissolve.

2. Mix in the yogurt, then the whipped cream.

3. Pour mixture into the pie crust and refrigerate until set up, about 3 hours or overnight

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Lindsey Nair | 981-3343

Wednesday, June 19, 2013

Dan Wooldridge has always been an athletic man.

The retired referee, former ODAC commissioner and supervisor of the Big East conference had spent much of his career running up and down basketball courts and football fields. So when he was diagnosed with Type 2 diabetes about five years ago, he was stunned.

“I had never been a sickly person,” said Wooldridge, 79. “ I was in shock when I was told ‘Hey, you’d better really change the way you’re doing things.’”

According to the 2011 National Diabetes Fact Sheet, the most recent comprehensive set of data about the disease, about 26 million Americans (more than 8 percent of the population) have diabetes and 79 million have pre-diabetes (see the infobox for definitions).

Martie Slaughter, a certified diabetes educator with Carilion Clinic’s Diabetes Management Program, said many newly diagnosed patients feel overwhelmed. She and her colleague, Kate Jones, work to help diabetics take control of their health so the disease does not control them.

I asked them to introduce me to some patients who have earned gold stars for the lifestyle changes they’ve made — such as to their eating habits — to manage the disease.

While talking to these folks, I learned that no two diabetes patients have an identical situation, which is why individualized counseling is so important. I also learned that people with pre-diabetes or diabetes aren’t the only ones who can learn from success stories — a healthy lifestyle for a diabetic doesn’t look much different from the kinds of choices we all should
be making.

Find support

Marion and Bobbie Hargrove were founding members of the Diabetes Support Group of Bedford County.

Marion, now 76, was diagnosed 25 years ago. Their group meets the second Thursday of every month, and even though the Hargroves have learned a great deal about diabetes, they still find it useful.

“We are so lucky to have that,” Bobbie said.

They are also lucky to have each other. Bobbie, who is pre-diabetic, suspects she would have developed diabetes by now if she hadn’t learned to cook healthier for her husband. Wooldridge credits his wife, Nancy, for making sure he doesn’t stray from a healthy diet.

“I sympathize with people who do not have a supportive partner,” he said.

With diabetes, it is also extremely important that patients monitor blood sugar regularly. For a non-diabetic, normal fasting blood sugar should be under 100. Someone with a fasting blood sugar of 100 to 126 is considered pre-diabetic while a 126 or above in a clinical lab test is diagnostic of diabetes, Slaughter said.

Diabetics must know what a healthy blood sugar should be at certain times of day and manage their diet to maintain healthy numbers. People who don’t know they are diabetic or who ignore the disease can have blood sugar levels in the 200 to 400 range or more, which becomes incredibly dangerous.

“Consistency in management of any chronic disease is very important,” Slaughter said, “but particularly diabetes.”

When it comes to food, Bobbie Hargrove uses what is called “plate visualization” to plan their meals. The method involves mentally dividing a dinner plate in half and filling one half with non-starchy vegetables. One quarter of the plate is for lean meat and the final quarter is for a healthy carbohydrate, such as a baked potato or whole grains.

The garden that Marion Hargrove tends to at least one hour a day fulfills the vegetable quotient — and the one for exercise.

Carve out active time

Staying active is important not only because it reduces weight and prevents weight gain, Slaughter said. It also builds muscle, which results in a higher metabolic rate and helps to regulate blood sugar levels.

Bonnie Moncada, 64, of Bedford, has had diabetes for 15 years. She has carved out time from her daily babysitting schedule to take a 2-mile walk three to five times per week. Marion Hargrove plays golf three to four times per week, walking the course. Wooldridge also plays golf and walks.

The key is finding exercise you enjoy and making it a priority in your life, not just something you’ll do if you have time left over after everything else is done.

Even a little bit helps. Slaughter said a study found that walking 10 to 15 minutes after meals caused a reduction in A1C, or an average blood glucose level (see infobox).

Shop and eat smart

Some diabetics are able to maintain self-control around sweets. Moncada still bakes a pound cake every week for her husband (“He’s all skinny,” she said. “It makes you mad.”), but it took her a long time to be able to avoid digging in herself.

“My mom used to make cakes and pies and everything,” she said. “That’s what I grew up on. It has been hard [to avoid desserts]. I even went to a hypnotherapist who taught me to stop dead and think, ‘Now, do I need that?’ That little tip has helped me a lot.”

But the best bet is to keep them out of the house, Nancy Wooldridge said. She never buys cookies, candy and other sweets. She also avoids purchasing processed foods, preferring to cook as much from scratch as possible.

“The key is if you bring it in, you’re going to eat it,” she said.

So instead, buy other things.

The Wooldridges buy a lot of vegetables and do not eat meat every night. On a recent evening, Nancy Wooldridge planned to serve leftover cabbage casserole (see recipe), green beans, a potato and some cucumber.

Moncada fixes herself boiled eggs, salads, cooked vegetables and lean chicken.

Nancy Wooldridge also freezes food in serving sizes so she and her husband don’t feel the need to overindulge in order to avoid wasting food. For example, the Easter ham gets frozen in small portions, as does ground beef.

Live a little

One of the worst things a diabetic can do (or anyone, for that matter) is try to cut out treats entirely. The idea that diabetics could never eat sugar is outdated; sugar is OK in moderation and when paired with blood sugar monitoring.

“You can’t deprive yourself of everything,” Dan Wooldridge said. “You can have a glass of wine, but not three.”

Instead of an entire package of M&Ms, he might eat only a few to satisfy a sweet tooth. If he wants some peanuts or baked chips, he brings a small dish from the kitchen rather than sitting down in front of the television with an entire can or bag.

Marion Hargrove counts his carbs, and if he had a dinner that was particularly light, he can have a cookie or a small piece of cake.

Moncada allows herself a “cheat day” every Saturday, when she and her daughter go to CiCi’s pizza. She orders a pizza with a “cracker-thin crust” and has four small pieces along with a salad.

“When they see me come in,” she said, “they fix my pizza.”

Pictures of success

None of the people I talked to seemed unhappy or deprived. In fact, they were quite upbeat.

The diagnosis of diabetes may have been a blow, but it was also a wake-up call that helped them to make their health a priority.

“It scared me enough that with Nancy’s help, I was willing to do whatever it took to avoid having to go on insulin,” Wooldridge said.

As a result, folks like the Wooldridges, the Hargroves and Moncada are now taking much better care of themselves , and that attitude is rubbing off on the people around them.

“We work to establish smart goals,” Slaughter said, “and we found what the research supports: If you can work with individuals at their level to make small changes that they can sustain, that builds self-efficacy — the belief in themselves that they can succeed.”

On the blog

Has your battle with diabetes taught you lessons you can share with fellow diabetics? If so, visit my blog and share your story and recipes at blogs.roanoke.com/fridgemagnet.

Saturday, September 14, 2013