Readers:

I’ve been keeping clear of fast food for quite a long
time. It really wasn’t too difficult for me, but now I
am facing a rather hard task. I am going to stop drinking
diet soda pop.

Diet soda pop? Who says that anymore? Well, you read
right. I am going to give up consuming one of my favorite
beverages. I’m sure you are curious to why I’m going to
be undertaking this change. Well, I’m doing this for
health reasons.

I don’t think that soda pop is bad for you it’s just that
I could do without the carbonation and the caffeine. I
tried this a few years ago and after a few weeks I felt
great. I was more alert and I felt better physically. But,
that didn’t last too long. I really missed the taste and
nothing goes better with a couple slices of pizza.

So, as of Monday, February 16th, I am off of diet soda
pop. I am looking ahead to looking and feeling health.
It will be a challenge for me so, please, Wish me luck.

Regards,
Steve

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Glucose Levels Affect Cognition in Diabetics

NEW YORK (Reuters Health) – As glucose levels rise,
cognitive function declines in patients who have type 2
diabetes and other cardiovascular risk factors, according
to a report in the current issue of Diabetes Care.

Whether lowering glucose levels can improve cognitive
function will be addressed in future assessments of the
current study group, lead author Dr. Tali Cukierman-Yaffe,
from Tel-Aviv University, Israel, and colleagues note.

This is not the first study to link diabetes with
cognitive decline and dementia, the authors explain,
but the extent to which high blood sugar (hyperglycemia)
impacts cognition was unclear.

The researchers addressed this topic by analyzing data
from the Memory in Diabetes substudy of the Action to
Control Cardiovascular Risk in Diabetes (ACCORD-MIND)
trial. Included were 2,977 subjects with type 2 diabetes
who had their blood sugar levels estimated using fasting
glucose levels and HbA1c.

HbA1c, also known as glycosolated hemoglobin, is a blood
test to determine glycemic control. Glycated hemoglobin
is a substance in red blood cells formed when blood sugar
attaches to hemoglobin. The test also provides a good
estimate of the patient’s average blood glucose level
over the past 2 to 3 months.

The participants also completed four cognitive function
tests: Digit Symbol Substitution Test (DSST); Mini Mental
Status Examination (MMSE); Rey Auditory Verbal Learning
Test; and the Stroop Test.

As glycemic control worsened, so did the scores on all
four tests. An increase of 1 percent in HbA1c levels
was associated with a 1.75-point drop in the DSST score,
0.20-point decline in the MMSE, a 0.11-point decrease in
the memory score, and worse results on the Stroop Test.
All of these declines were statistically significant.

By contrast, fasting plasma glucose levels did not
correlate with performance on any of the tests, the
report shows.

“This cross-sectional analysis illustrates that chronic
hyperglycemia appears to be independently associated with
cognitive function in individuals with diabetes. It also
raises the hypothesis that strategies to lower HbA1c
levels or prevent their rise may favorably affect
cognitive function,” the research team concludes.

SOURCE: Diabetes Care, February 2009.

Copyright Reuters Limited. All rights reserved.

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Doctors use diabetes test as diagnostic tool

A test that doctors have been using for years to monitor
blood sugar in people with diabetes may soon be recommended
as a tool for diagnosing the disease.

Within the next six months, a consensus by several leading
diabetes organizations will lead to the publication of
guidelines recommending the A1C test as a diagnostic tool
for type 2 diabetes, says Matt Petersen, director of
information resources for the American Diabetes Association.

“Right now there are no criteria for A1C use in diagnosing
diabetes, but we know it is being used in practices this
way,” Petersen says.

The ADA guidelines currently recommend doctors use the
fasting blood glucose (FBG) test in patients who are at
risk for type 2 diabetes. A less common practice is for
doctors to require an oral glucose tolerance test (OGTT).

Both are sensitive at measuring real-time glucose levels
in the blood, but results can be easily thrown off, for
example, if a person has a cold or hasn’t eaten properly,
says Daniel Einhorn, medical director of Scripps Whittier
Diabetes Institute in La Jolla, Calif., and vice president
of the American Association of Clinical Endocrinologists.

The benefit of the A1C test is that it can be taken at any
time of day and is not thrown off by events of the day,
Einhorn says. It probably would be used along with other
tests.

Also called the HbA1c or glycated hemoglobin test, it
tells what your average blood glucose level was over the
past two or three months by measuring the concentration
of hemoglobin molecules in your red blood cells that have
glucose attached to them. The test also can predict the
chance for future complications, such as nerve, eye and
kidney damage.

Once glycated, or sugar-coated, the hemoglobin stays that
way throughout the red blood cell’s life span, which is
about 120 days. So, if your A1C is an 8, that means 8% of
your hemoglobin molecules are glycated. People who don’t
have diabetes typically have about a 6 or less reading.
Higher results may indicate diabetes.

The only thing that has kept the reliable test from
becoming a standard diagnostic tool is that the major
diabetes groups have not yet agreed on what result
constitutes a diagnosis.

Richard Wender, chairman of the department of family and
community medicine at Thomas Jefferson University Hospital
in Philadelphia, says: “We’ve been using A1C pretty
liberally for screening in primary care and interpreting
it based on our best judgment.” Wender says he looks
forward to a final consensus.

Copyright 2009 USA TODAY, a division of Gannett Co. Inc.

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Diabetic Recipe

Chicken and Corn Tamale Pie

(makes 8 servings)

Crust

olive oil cooking spray

5 1/4 cups (1260 ml) 98% fat free, low sodium canned
chicken broth

2 1/4 cups (310 g) stone-ground yellow corneal

1 teaspoon (5 ml) ground cumin

1/2 teaspoon (2.5 ml) salt (optional)

1/4 teaspoon (1.25 ml) cayenne pepper

Filling

1 1/2 pounds (720 g) boneless, skinless chicken breasts,
trimmed of all fat and cut into 1-inch (2.5 cm) cubes

1 cup (164 g) fresh or thawed frozen corn kernels

1 medium onion, chopped

1 medium fresh tomato, chopped

2 medium tomatillos, husked and chopped

2 jalapeño chile peppers, seeded and minced

2 large cloves garlic, minced

2 tablespoons (18 g) golden raisins, plumped in 2
tablespoons (30 ml) dry white wine or unsweetened apple
juice

1 tablespoon (15 ml) chili powder

1/2 teaspoon (2.5 ml) ground cumin

1 tablespoon (15 ml) chopped fresh oregano or 1 teaspoon
(5 ml) crushed dried

1/4 cup (60 g) shredded reduced fat Monterey jack cheese

1. Preheat oven to 450°F (230°C), Gas Mark 8.

2. Coat a 10-inch (25 cm) round casserole that’s at least
2 inches (5 cm) deep with cooking spray. Set aside.

3. To make crust: In a large saucepan, bring chicken broth
to a boil over medium-high heat. Gradually stir in
cornmeal, cumin, salt (if using), and cayenne. Reduce
heat to medium and cook, stirring constantly, until
thickened, 10 to 12 minutes. Immediately spread mixture
to a depth of about 1/2 inch (1.25 cm) over bottom and
sides of prepared casserole. Set aside.

4. To make filling: Lightly coat a large nonstick skillet
with cooking spray. Place over medium-high heat. Add
chicken and sauté until brown on all sides, about
5 minutes. Add corn, onion, tomato, tomatillos,
jalapeños, garlic, raisins with their liquid, chili
powder, cumin, oregano, and cheese. Stir until well
blended.

5. Spoon mixture into prepared casserole and bake,
uncovered, for 25 to 30 minutes, until crust is golden
brown and filling is bubbly. Remove from oven and let
stand on a wire rack for 10 minutes before cutting into
wedges to serve.

Per serving: 291 calories (11% calories from fat ),
28 g protein, 4 g total fat (0.9 g saturated
fat), 37 g carbohydrates, 4 g dietary fiber,
51 mg cholesterol, 197 mg sodium

Diabetic exchanges: 3 very lean protein, 2 1/2 carbohydrate
(2 bread/starch, 1 vegetable)

Copyright 1997-2001 Diabetic-Lifestyle.

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