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Diabetes Health Line
Newsletter 2

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Don't Let Stress Send You Out of Control • Lighten Up Your Holiday Meals • Practice Portion Control to Prevent Holiday Weight Gain • Medicare Benefits for Controlling Diabetes • Light Pumpkin Pie Recipe

Don't Let Stress Send You Out of Control

Everyone has added stress during the holiday season. But you don't have to let stress cause your blood sugar to soar. The way you deal with stress can affect how your blood sugar responds to it. To deal with stress, you need to know two things: how it affects your body and how it affects your behavior.

When your body is stressed, it responds by releasing hormones. These hormones cause your liver to release stored sugar into the blood in case your muscles will need energy for sudden action. When you are under emotional stress, your body will react the same way. This causes your blood sugar to rise. Stress can also affect your blood sugar by causing you to get off of your self-care pattern. Depression or thinking about extra things can cause you to eat more, eat less, forget to take your medicines, forget to exercise or forget to check your blood sugar.

Different things cause stress in different people. One thing that causes stress in everybody is change. Stress doesn't have to be caused by a major event. Small things can affect your body just as much as major things. Stress doesn't have to be caused by a bad thing, either. Stress from preparing for a trip is a good thing, but it can still have bad effects on your blood sugar. Diabetes itself causes stress. An episode of low blood sugar can cause high blood sugar. To combat low blood sugar, your body releases sugar stored in the liver into the blood stream. Just the stress from coping with diabetes, its complications and the lifestyle changes can cause problems.

Physical signs of stress can include back pain, chest pain, cold hands, constipation, diarrhea, headaches, indigestion, muscle tension, racing heart, shortness of breath and changes in blood glucose. Mental signs of stress include anxiety, difficulty thinking clearly, forgetfulness, frustration, indecisiveness, insomnia, irritability and nervousness.

You can do several things to help your body deal with stress. One way is to sit down and get organized. Make a list of what you have to do and set priorities. Get enough sleep. A lack of sleep can make problems seem bigger than they are.

If you know you are under stress, check your blood sugar often to stay ahead of the game. Exercise is a great way to use up the hormones that your body releases in response to stress. The best way to deal with something that is causing you stress is to either change the stressor or change the way you react to it.

Too much stress can turn into depression. If you experience any of the following symptoms for more than two weeks, talk to your doctor about your concerns.

• Changes in sleep patterns
• Changes in appetite
• Changes in energy level
• Withdraw from family and friends
• Decreased sex drive
• Changes in grades or work habits
• Panic attacks
• Fear of going places
• Lack of interest in things you used to enjoy
• Regular outbursts of anger
• Drinking more alcohol
• Using illegal drugs to cope

Stress is a part of life but it doesn't have to rule you or your diabetes. Learning how to beat stress can help you keep control of your diabetes and yourself.

Lighten Up Your Holiday Meals

Traditional holiday meals are often high in fat and calories, but they don't have to be. Here are some simple tips to lighten up your holiday favorites without eliminating the good taste.

• Roasted turkey – Choose a plain bird instead of a self-basting one. Leave the skin on while you roast it to hold in moisture, but remove the skin before eating.
• Gravy – Skim the fat off the pan juices before making gravy. Chilling the juices for a little while will make this easier.
• Dressing – Use less bread and more celery and onions or even fruits for a different twist. Sauté vegetables in fat-free broth instead of butter or margarine.
• Sweet potatoes – Leave out the margarine and marshmallows. Sweeten with apple juice and flavor with cinnamon – it enhances sweetness.
• Green bean casserole – Cook fresh green beans with chunks of potato and chopped onion instead of adding cream soup. Top with almonds instead of fried onion rings.
• Mashed potatoes – Use skim milk instead of whole milk or cream. Season with garlic powder, butter-flavored granules or Parmesan cheese instead of butter or margarine.
• Bread or rolls – Serve smaller pieces or don't serve at all. Use reduced-fat margarine.

Practice Portion Control to Prevent Holiday Weight Gain

Research shows that Americans typically gain one to eight pounds over the holidays. The bad news is that the extra weight is likely to stay with you in the coming year. One way to avoid holiday weight gain is to practice portion control. Here are some helpful ways to picture what a portion should be:

• 1 piece of cornbread is like a small bar of soap
• 1/2 cup cooked cereal, rice, pasta, vegetable or fruit is like a full cupcake wrapper
• 1/2 cup of fresh fruit is like seven cotton balls
• 1 medium size fruit is like a tennis ball
• 1 1/2 ounces of cheese is like a 9-volt battery or three dominoes
• 3 ounces cooked meat, fish or poultry is like a deck of cards or a cassette tape
• 3 ounces grilled/baked fish is like a checkbook
• 1 teaspoon of butter or margarine is like your thumb tip
• 2 tablespoons salad dressing is like a ping-pong ball
• 1 ounce of nuts or small candies is one handful

Medicare Benefits for Controlling Diabetes

Research has clearly shown that measuring blood sugar and keeping it close to normal delays and may prevent the short- and long-term complications of diabetes. If you have problems paying for glucose monitoring equipment and supplies and are eligible for Medicare, you can get help. Medicare benefits can help cover the cost of blood glucose monitors, test strips and lancets. The new policy applies to beneficiaries whether or not they use insulin or have type 1 or type 2 diabetes.

Here's how the benefit works. Once you meet the annual deductible for Medicare medical insurance (part B), you pay only 20 percent of the cost of your diabetes monitoring supplies – Medicare pays the other 80 percent.

How to get your supplies

With your doctor's prescription, you can go to your:

• Local pharmacy
• Hospital or clinic pharmacy
• Medical equipment supplier

How to make sure your Medicare diabetes medical supplies are covered

If you receive glucose monitor supplies from a supplier without asking for them, Medicare will not pay the cost. You should not pay for supplies you did not request.

Medicare requires that you or your caregiver specifically ask for a refill of your supplies (such as strips, lancets or control solution) before they are sent to you. The supplier may not automatically send supplies to you.

Uncontrolled diabetes can lead to blindness, kidney failure, nerve damage and lower-limb amputation. Besides monitoring blood sugar levels, make sure you follow a healthy diet, get regular physical activity and take your prescribed medications.

For more information about controlling diabetes and Medicare's expanded coverage, call the National Diabetes Education Program at 1-800-438-5383 or check out the sits on the World Wide Web. 

Recipe Corner - Light Pumpkin Pie

10 Servings

You'll Need:

2 cups canned pumpkin (can substitute mashed sweet potatoes)

2 eggs or 1/2 cup egg substitute or 4 egg whites, slightly beaten

3 tablespoons brown sugar

12 packets aspartame sweetener (can also use 12 packets of acesulfame K sweetener)

1/4 teaspoon salt (optional)

2 teaspoons pumpkin pie spice

12 ounces of evaporated skim milk

10 inch unbaked pie crust

Preheat oven to 425°F. Combine first 8 ingredients beginning with pumpkin and ending with evaporated milk. Pour into pie shell. Bake at 425°F for 10 minutes. Reduce oven temperature to 325°F and continue baking for another 45 minutes or until knife inserted into center comes out clean. Cool. Store in refrigerator.

Calories: 163 Sodium: 198 mg Carbohydrate: 22 grams
Protein: 6 grams Fat: 7 grams Exchanges:1 starch, 1 vegetable, 1 fat