FW: The Diabetic Newsletter - January 6, 2003 - DiabeticGourmet.com

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The Diabetic Newsletter - January 6, 2003 - DiabeticGourmet.com

THE DIABETIC NEWSLETTER

January 6, 2003 - Volume IV; Issue #23 - http://diabeticnewsletter.com

Published every other Monday by The Diabetic Gourmet Magazine Visit The

Diabetic Gourmet Magazine at http://diabeticgourmet.com

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CONTENTS:

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- In The News

- Announcements

- Feature Recipes

- Mexican Red Rice

- Bean and Cheese Chili Rellenos

- Tomato, Spinach, and Cheese Burritos

- Mexican Hash

- Diabetes 101:

- Diabetes Insipidus

- Food and Cooking:

- Making A Nut Case

- Diabetes Q and A:

- How do I know if I am at risk for getting Diabetes?

- Diabetes Related Explanations & Definitions

- Information About This Newsletter

This week's feature recipes appear courtesy of Surrey Books

and are excerpted from " 1,001 Delicious Recipes For People With

Diabetes. " Book info at:

http://tgcmagazine.com/bin/track/click.cgi?id=24

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IN THE NEWS

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Gelatin Particles Show Promise

for Delivering Therapeutic Genes

Read at: http://thediabeticnews.com/news/438.shtml

Alcohol-Induced Sodium Sensitivity

May Increase Blood Pressure

Read at: http://thediabeticnews.com/news/439.shtml

45-Percent of New Dialysis Patients are

Diabetic; Longer Treatment and Highly Permeable

Artificial Kidney use May Not Improve Survival Rates

Read at: http://thediabeticnews.com/news/441.shtml

Study Finds Traditional Diuretics Work Better Than

Newer Medicines for Treating Hypertension

Read at: http://thediabeticnews.com/news/440.shtml

New Mouse Model Sheds

Light on Lipoatrophic Diabetes

Read at: http://thediabeticnews.com/news/437.shtml

Full Diabetic Gourmet Magazine Newswire and Archive:

http://diabeticgourmet.com/In_The_News/

Get the news delivered as it's reported!

Subscribe to The Diabetic News at http://TheDiabeticNews.com

=========================

ANNOUNCEMENTS

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THIS WEEK'S RECIPES

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More recipes online at http://diabeticgourmet.com/recipes/

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MEXICAN RED RICE

Makes: 6 Servings (about 2/3 cup each)

INGREDIENTS

- Vegetable cooking spray

- 1 large tomato, chopped

- 1/2 cup chopped onion

- 1 clove garlic, minced

- 1/2 teaspoon dried oregano leaves

- 1/4 teaspoon ground cumin

- 1 cup converted rice

- 1 can (14-1/2 ounces) reduced-sodium fat-free chicken broth

- 1/3 cup water

- 1 carrot, cooked, diced

- 1/2 cup frozen, thawed peas

- Salt and pepper, to taste

DIRECTIONS

Spray large saucepan with cooking spray; heat over medium heat until

hot. Saute tomato, onion, garlic, and herbs until onion is tender, 3 to

5 minutes. Add rice; cook over medium heat until rice is lightly

browned, 2 to 3 minutes, stirring frequently.

Add broth and water to saucepan; heat to boiling. Reduce heat and

simmer, covered, until rice is tender, about 25 minutes, adding carrot

and peas during last 5 minutes. Season to taste with salt and pepper.

Nutritional Information Per Serving: (2/3 cup)

Calories: 146, Fat: 0.4 g, Cholesterol: 0 mg,

Sodium: 41 mg, Protein: 4.7 g, Carbohydrate: 30.7 g

Diabetic Exchanges: 2 Bread/Starch

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BEAN AND CHEESE CHILI RELLENOS

Makes: 6 Servings

INGREDIENTS

- 6 large poblano chilies

- 2-3 quarts water

- Vegetable cooking spray

- 1/2 small jalapeno chili, seeds and veins discarded, minced

- 4 cloves garlic, minced

- 1 teaspoon dried oregano leaves

- 2 packages (8-oz each) fat-free cream cheese, room temperature

- 1/2 cup (2 oz) Mexican white cheese (queso blanco)

or farmer's cheese, crumbled

- 1-1/2 cups cooked pinto beans

or 1 can (15 ounces) pinto beans, rinsed, drained

- 1 tablespoon vegetable oil

DIRECTIONS

Cut stems from tops of poblano chilies; remove and discard seeds and

veins. Heat water to boiling in large saucepan; add poblano chilies.

Reduce heat and simmer, uncovered, 2 to 3 minutes, until chilies are

slightly softened. Drain well and cool.

Spray small skillet with cooking spray; heat over medium heat until hot.

Saute jalap chili, garlic, and oregano until chili is tender, 2 to 3

minutes.

Mix cream cheese, white cheese, beans, and jalapeno chili mixture; stuff

poblano chilies with mixture. Heat oil in medium skillet until hot;

saute chilies over medium to medium-high heat until tender and browned

on all sides, 6 to 8 minutes. Serve hot.

Nutritional Information Per Serving: (1/6 of recipe)

Calories: 204, Fat: 5.5 g, Cholesterol: 22.3 mg,

Sodium: 520 mg, Protein: 17.2 g, Carbohydrate: 19.4 g

Diabetic Exchanges: 1 Vegetable, 1 Bread, 1-1/2 Meat, 1/2 Fat

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TOMATO, SPINACH AND CHEESE BURRITOS

Makes: 4 Servings

INGREDIENTS

- 1 cup fat-free ricotta cheese

- 1 cup reduced-fat ricotta cheese

- 1 teaspoon grated Parmesan cheese

- 3/4 teaspoon chili powder

- 1/2 teaspoon crushed red pepper

- 1/2 teaspoon ground cumin

- 8 ounces fresh spinach leaves, divided

- 4 flour tortillas (8-inch)

- 1 large tomato, chopped

- Olive oil cooking spray

- 1/2 cup prepared salsa

- 1/2 cup fat-free sour cream

DIRECTIONS

Process cheeses, chili powder, red pepper, and cumin in food processor,

or beat in large mixing bowl, until smooth. Coarsely shred half the

spinach leaves.

Layer shredded spinach, cheese mixture, and tomato is center

of each tortilla. Fold opposite sides of tortilla over filling, then

roll tortilla. Lay burritos, seam sides down, in lightly greased baking

pan. Spray lightly with cooking spray.

Bake at 400 degrees F. until golden brown, about 25 minutes. Divide

remaining spinach leaves among 4 plates; arrange burritos on spinach.

Serve with salsa and sour cream.

Nutritional Information Per Serving: (1 Burrito)

Calories: 285, Fat: 5.3 g, Cholesterol: 16.9 mg,

Sodium: 712 mg, Protein: 26.6 g, Carbohydrate: 34.7 g

Diabetic Exchanges: 2 Vegetable, 1 Bread, 3 Meat

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MEXICAN HASH

Makes: 4 Servings

INGREDIENTS

- 1 pound boneless beef eye of round, fat trimmed,

cut into 1/2-inch cubes

- 1 quart water

- Vegetable cooking spray

- 1 large tomato, chopped

- 2 large poblano chilies, sliced

- 1 large onion, chopped

- 1 pound Idaho potatoes, unpeeled, cooked,

cut into 1/2-inch cubes

- Chili powder, to taste

- Salt and pepper, to taste

DIRECTIONS

Heat beef cubes and water to boiling in large saucepan; reduce heat and

simmer, covered, until beef is tender, 30 to 45 minutes. Drain; shred

beef.

Spray large skillet with cooking spray; heat over medium heat until hot.

Cook beef over medium-high heat until beginning to brown and crisp,

about 5 minutes. Add tomato; cook over medium heat 5 minutes. Remove

mixture from skillet and reserve.

Add poblano chilies and onion to skillet; cook until tender,

5 to 8 minutes. Add potatoes and cook until browned, about

5 minutes. Add reserved meat mixture to skillet; cook until hot, 3

minutes. Add reserved meat mixture to skillet; cook until hot, 3 to 4

minutes. Season to taste with chili powder, salt, and pepper.

Nutritional Information Per Serving: (1/4 of recipe)

Calories: 242, Fat: 4 g, Cholesterol: 54.7 mg,

Sodium: 55 mg, Protein: 23.4 g, Carbohydrate: 27.9 g

Diabetic Exchanges: 1-1/2 Vegetable, 1 Bread, 2-1/2 Meat

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DIABETES 101: DIABETES INSIPIDUS

=========================

DIABETES INSIPIDUS

Diabetes insipidus (DI) is characterized by excretion of large amounts

of dilute urine, which disrupts your body's water regulation. To make up

for lost water, you may feel the need to drink large amounts of water.

You are likely to urinate frequently, even at night, which can disrupt

sleep or, on occasion, cause bedwetting. Because of the excretion of

abnormally large volumes of dilute urine, you may quickly become

dehydrated if you do not drink enough water. Children with DI may be

irritable or listless and, in some cases, may have fever, vomiting, or

diarrhea.

Normal Fluid Regulation in the Body Your body has a complex system for

balancing the volume and composition of body fluids. Your kidneys remove

extra body fluids from your bloodstream. This fluid waste is stored in

the bladder as urine. If your fluid regulation system is working

properly, your kidneys make less urine to conserve fluid when the body

is losing water. Your kidneys also make less urine at night when the

body's metabolic processes are slower.

The hypothalamus makes antidiuretic hormone (ADH), which directs the

kidneys to make less urine.

In order to keep the volume and composition of body fluids balanced, the

rate of fluid intake is governed by thirst, and the rate of excretion is

governed by the production of antidiuretic hormone (ADH), also called

vasopressin. This hormone is made in the hypothalamus, a small gland

located in the base of the brain. ADH is stored in the nearby pituitary

gland and released from it into the bloodstream when necessary. When ADH

reaches the kidneys, it directs the kidneys to concentrate the urine by

returning excess water to the bloodstream and therefore make less urine.

DI occurs when this precise system for regulating the kidneys' handling

of fluids is disrupted. The most common form of DI, central DI, results

from damage to the pituitary gland, which disrupts the normal storage

and release of ADH. Another form, nephrogenic DI, results when the

kidneys are unable to respond to ADH. Rarer forms occur because of a

defect in the thirst mechanism (dipsogenic DI) or during pregnancy

(gestational DI).

Diabetes Insipidus versus Diabetes Mellitus DI should not be confused

with diabetes mellitus, which results from insulin deficiency or

resistance. Diabetes insipidus and diabetes mellitus are unrelated,

although they can have similar signs and symptoms, like excessive thirst

and excessive urination.

Diabetes mellitus (DM) is far more common than DI and receives more news

coverage. DM has two forms, referred to as type 1 diabetes (formerly

called juvenile diabetes, or insulin-dependent diabetes mellitus, or

IDDM) and type 2 diabetes (formerly called adult-onset diabetes, or

non-insulin-dependent diabetes mellitus, or NIDDM). DI is a different

form of illness altogether.

Central DI Damage to the pituitary gland can be caused by different

diseases as well as by head injuries, neurosurgery, or genetic

disorders. To treat the resulting ADH deficiency, a synthetic hormone

called desmopressin can be taken by an injection, a nasal spray, or a

pill. While taking desmopressin, you should drink fluids or water only

when you are thirsty and not at other times. This is because the drug

prevents water excretion and water can build up now that your kidneys

are making less urine and are less responsive to changes in body fluids.

Nephrogenic DI The kidneys' ability to respond to ADH can be impaired by

drugs (like lithium, for example) and by chronic disorders including

polycystic kidney disease, sickle cell disease, kidney failure, partial

blockage of the ureters, and inherited genetic disorders. Sometimes the

cause of nephrogenic DI is never discovered.

Desmopressin will not work for this form of DI. Instead, you may be

given a drug called hydrochlorothiazide (also called

HCTZ) or indomethacin. HCTZ is sometimes combined with amiloride. Again,

you should drink fluids only when you are thirsty and not at other

times.

Dipsogenic DI A third type of DI is caused by a defect in or damage to

the thirst mechanism, which is located in the hypothalamus. This defect

results in an abnormal increase in thirst and fluid intake that

suppresses ADH secretion and increases urine output. Desmopressin or

other drugs should not be used to treat dipsogenic DI because they may

decrease urine output but not thirst and fluid intake. This fluid

" overload " can lead to water intoxication, a condition that lowers the

concentration of sodium in the blood and can seriously damage the brain.

Gestational DI A fourth type of DI occurs only during pregnancy.

Gestational DI occurs when an enzyme made by the placenta destroys ADH

in the mother. The placenta is the system of blood vessels and other

tissue that develops with the fetus. The placenta allows exchange of

nutrients and waste products between mother and fetus.

Most cases of gestational DI can be treated with desmopressin. In rare

cases, however, an abnormality in the thirst mechanism causes

gestational DI, and desmopressin should not be used.

A specialist should determine which form of DI is present before

starting any treatment.

Diagnosis Because DM is more common and because DM and DI have similar

symptoms, a health care provider may suspect that a patient with DI has

DM. But testing should make the diagnosis clear.

Your physician must determine which type of DI is involved before proper

treatment can begin. Diagnosis is based on a series of tests, including

urinalysis and a fluid deprivation test.

Urinalysis is the physical and chemical examination of urine. The urine

of a person with DI will be less concentrated. Therefore, the salt and

waste concentrations are low, and the amount of water excreted is high.

A physician evaluates the concentration of urine by testing its specific

gravity or osmolality.

A fluid deprivation test helps determine whether DI is caused by (1)

excessive intake of fluid, (2) a defect in ADH production, or (3) a

defect in the kidneys' response to ADH. This test measures changes in

body weight, urine output, and urine composition when fluids are

withheld. Sometimes measuring blood levels of ADH during this test is

also necessary.

In some patients, an MRI (magnetic resonance imaging) of the brain may

be necessary as well.

Source: NIDDK

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FOOD AND COOKING

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MAKING A NUT CASE

Scientists and health experts have started to go nuts. Researchers have

determined that nuts - used in moderation - can make beneficial

contributions to a healthful diet. Nuts provide many of the same

nutrients as other protein sources, like meat and poultry, but without

the saturated fat.

There is new evidence that unsaturated fats - found in foods such as

nuts, vegetable oils and fish - can lower the risk of several chronic

diseases. Studies have shown significant drops in cholesterol when

people add walnuts, almonds, pistachios, peanuts, or other nuts to their

diets. (Peanuts are technically legumes but are eaten like nuts and have

similar nutrition.) In addition to mono- and polyunsaturated fats, nuts

contain vitamin E, protein, magnesium, potassium and dietary fiber - all

potential cancer-fighting substances.

The key to including nuts in your diet is moderation. Nuts

are concentrated in calories, so be sure you cut back on other foods and

watch portions. A serving of nuts is a scant handful. The cholesterol

drops in the new research studies usually involved substituting three

servings of nuts for other foods each day.

Nuts should be exchanged for foods with a similar number of calories.

For example, instead of serving broccoli with 2 teaspoons of butter,

saute cooked broccoli in 1 teaspoon of olive oil and sprinkle it with a

tablespoon of chopped nuts.

You get a lot of bang for your buck with a nut. A handful of nuts, which

can be quite satisfying, is a better snack than chips or high-fat

crackers made with hydrogenated oils. And nuts can replace some of the

meat or cheese as the protein in salads and stir-fries. Spiced nuts are

a good, filling snack. The flavor of most nuts benefits from a light

toasting, as in the following recipe.

SPICED TOASTED ALMONDS

Ingredients

- 1 Tbsp. dried thyme leaves

- 1 tsp. kosher or sea salt

- 1/4 tsp. red (cayenne) pepper, or to taste

- 2 tsp. canola oil

- 2 cups whole, unblanched almonds

- Canola oil spray

Directions

Preheat oven to 400 degrees.

In large, shallow bowl, combine thyme, salt, pepper and oil. Set aside.

Place nuts in medium bowl. While tossing with fork, lightly spray with

canola oil so all surfaces are coated.

Lightly coat baking sheet with canola oil spray. Turn nuts

onto sheet and spread evenly across surface. Place baking

sheet in center of the oven.

Toast until nuts are lightly browned and fragrant - about

8 minutes. Occasionally, shake pan to shift nuts and prevent scorching.

(Be careful not to let nuts get too dark or they'll taste burned.)

Remove from oven and immediately add hot nuts to spice mixture. Stir for

a few minutes to coat the nuts thoroughly. Taste and adjust the

seasonings.

Serve warm or at room temperature. Nuts can be sealed and stored for up

to two weeks. Reheat in a hot oven.

Makes 2 cups or 8 servings.

Nutritional Information Per Serving:

223 calories, 19 g total fat (1 g saturated fat),

7 g carbohydrate, 7 g protein, 4 g dietary fiber, 235 mg sodium

Source: AICR

=========================

DIABETES RELATED DEFINITIONS

AND EXPLANATIONS

=========================

- ENDOGENOUS

Grown or made inside the body. Insulin made by a person's own

pancreas is endogenous insulin. Insulin that is made from beef

or pork pancreas or derived from bacteria is exogenous because

it comes from outside the body and must be injected.

- LIPODYSTROPHY

Lumps or small dents in the skin that form when a person

keeps injecting the needle in the same spot. Lipodystrophies

are harmless. People who want to avoid them can do so by

changing (rotating) the places where they inject their

insulin. Using purified insulins may also help.

- RISK FACTOR

Anything that raises the chance that a person will get a

disease. With non-insulin-dependent diabetes, people have

a greater risk of getting the disease if they weigh a lot

more (20 percent or more) than they should.

- NONKETOTIC COMA

A type of coma caused by a lack of insulin. A nonketotic

crisis means: (1) very high levels of glucose (sugar) in

the blood; (2) absence of ketoacidosis; (3) great loss of

body fluid; and (4) a sleepy, confused, or comatose state.

Nonketotic coma often results from some other problem such

as a severe infection or kidney failure.

- PANCREATITIS

Inflammation (pain, tenderness) of the pancreas; it can make

the pancreas stop working. It is caused by drinking too much

alcohol, by disease in the gallbladder, or by a virus.

=========================

DIABETES Q AND A:

=========================

QUESTION:

How do I know if I am at risk for getting Diabetes?

ANSWER:

Experts suggest that adults age 45 years and older be tested for

diabetes. If their blood glucose is normal at the first test, they

should be tested at 3-year intervals. People under age 45 should be

tested if they are at high risk for diabetes. Please check with your

doctor if you think you may be at risk for diabetes.

High-risk factors include:

Being more than 20 percent above ideal body weight or having

a body mass index (BMI) of greater than or equal to 27. BMI

is the ratio of weight in kilograms to height in meters

squared (kg/m2 ). (Your doctor or dietitian can provide information on

your BMI)

Having a mother, father, brother, or sister with diabetes.

Being African American, Alaska Native, American Indian, Asian American,

Hispanic American, or Pacific Islander American.

Giving birth to a baby weighing more than 9 pounds or having diabetes

during pregnancy.

Having blood pressure at or above 140/90 millimeters of

mercury (mmHg).

Having abnormal blood lipid levels, such as high density lipoprotein

(HDL) cholesterol less than 35 mg/dL or triglycerides greater than 250

mg/dL.

Having abnormal glucose tolerance when previously tested for diabetes.

Source: NIDDK

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