You can keep your blood glucose

levels on target by making wise

food choices, being physically

active, and taking medicines if

needed.

Your Diabetes Medicines

What you eat and when you eat

affects how your diabetes medi-

cines work. For people taking

diabetes medicines, following a

schedule for meals, snacks, and

physical activity is best.

Talk with your doctor about

when to take your diabetes

medicines.

Low Blood Glucose

(Hypoglycemia)

Low blood glucose can make you

feel shaky, weak, confused, irrita-

ble, hungry, or tired. You may

sweat a lot or get a headache.

Continued on pg. 2 . . .

L earning how to eat right

is an important part of

controlling your diabe-

tes. This newsletter will provide

tips on healthy eating, weight

control, recipes and special diets.

Remember, eating healthy is not

just for people with diabetes.

Making wise food choices can

help you feel good every day,

lose weight if you need to, lower

your risk for heart disease,

stroke, and other problems

caused by diabetes.

Healthful eating, along with

physical activity and, if needed,

diabetes medicines, helps keep

your blood glucose in your tar-

get range. The diabetes target

range is the level suggested by

diabetes experts. You can help

prevent health problems by

keeping your blood glucose lev-

els on target.

Target Blood Glucose Levels

for People with Diabetes

Ask your doctor how often you

should check your blood glucose

on your own. Also ask your

doctor for an A1C test at least

twice a year. Your A1C number

gives your average blood glucose

for the past 3 months., telling

you whether your diabetes care

plan is working.

How can I keep my blood glucose

levels on target?

Many people think that having

diabetes means you can't eat

your favorite foods. Well, it's not

true. You can still eat the foods

you love. Food means family,

friends, comfort, and pleasure,

not just vitamins and minerals.

That's why, for most people,

food is the hardest part of caring

for diabetes. Your dietitian will

show you how to include your

favorites and still keep your

blood sugar on track.

Making changes in the way you

eat or the times you eat can be

tough. Remember that it's up to

you to work with your doctor

and tell them what will work for

you. Decide what changes you'd

like to try and work on one.

Whether you'd rather eat noo-

dles or tacos, using a meal plan is

a great way to keep blood sugar

on target.

Talk to your dietitian about your

schedule, how active you are, and

where you go when you eat out.

The two of you will design a plan

that will fit the way you live and

the foods you and your family

like, and help you feel good and

stay healthy.

Information compiled from Ameri-

can Diabetes Association, http://

www.diabetes.org/all-about-

diabetes/chan_eng/i3/i3p1.htm

DIABETES & ME: Eating Right

I N S I D E

TH I S I S SUE :

Diabetes &

Me

1, 2

Favorite

Foods

1

FOCUS:

Teens &

Eating Out

2, 6

How Does

Diabetes

Affect

Women?

4, 5

SPOT-

LIGHT:

Sample Meal

5

Recipes 5

You CAN Enjoy Your Favorite Foods

The Bronx Health LinkThe Bronx Health LinkThe Bronx Health LinkThe Bronx Health Link 198 E. 161st Street Bronx, NY 10451 www.BronxHealthLink.org (718) 590-2648

The Bronx Health Link J A N U A R Y 2 0 0 6 V O L U M E 1 , I S S U E V

SPEC IAL

PO INTS OF

INTEREST :

• Tips on healthy

eating, weight

control, recipes

and special

diets

• What to do

when eating out

• Delicious reci-

pes for you and

your family!

• Diabetes and

Women

P A G E 2

“Watch out for

words like

JUMBO,

SUPERSIZE,

DELUXE, OR

VALUE

when eating at

your favorite fast-

food place.

DIABETES & ME: Eating Right

FOCUS ON: Teens & Eating Out

• 1/2 cup of a regular (not diet) soft drink

• 1 cup (8 ounces) of milk

• 5 -6 pieces of hard candy

• 1 tablespoon of sugar or honey

After 15 minutes, check your

blood glucose again. If it’s still too

low, have another serving. Repeat

until your blood glucose level is

. . . Continued from front pg.

If you have these symptoms, check

your blood glucose. If it is 70 or

lower, have one of the following

right away:

• 3 or 4 glucose tablets

• 1 serving of glucose gel (

• 1/2 cup of any fruit juice

70 or higher. If it will be an

hour or more before your next

meal, have a snack.

Information compiled from

National Diabetes Information

Clearinghouse, http://

diabetes.niddk. nih.gov/dm/

pubs/eating_ez/#eat

T H E B R O N X H E A L T H L I N K

Whether it's the local pizze-

ria, the food court at the mall,

or barbecued ribs on your

best friend's back porch, eat-

ing out is probably a part of

your social scene.

You don't want to miss out

on these activities just be-

cause you have to watch what

you eat, and the good news is

you don't have to! You can

pretty much eat the same

foods as your friends and

family - you just have to keep

track of what you eat and eat

certain foods in moderation.

Where Should I Eat?

If you're choosing where to

eat, think about the places

that offer you the most op-

tions - even fast-food places

have healthy choices on their

menus. Always look for nutri-

tional facts on the meal you

plan to order - like calorie,

carbohydrate, and fat content.

This information is available in

many chain restaurants (you

may need to ask for it) or ask

your server what's in the food

you're eating.

Don't worry - you're not

limited to places that serve

only soy burgers and carrot

sticks. If you can order a meal

that includes a good balance of

proteins, fats, and carbohy-

drates, you're doing OK. But if

you find that certain restaurants

don't offer many vegetable

choices or that they only serve

fried food that's covered in

cheese, you might want to pick a

place that offers more.

You might find that there are

more healthy breakfast choices -

like yogurt, fresh fruit, and

scrambled eggs - for you at the

diner than at the coffeehouse, so

convincing your friends to chow

down on diner food is one op-

tion. But if your friends prefer

the coffeehouse, one alternative

is to buy something to drink and

bring a snack in your backpack

or purse that's easy to eat dis-

creetly, like pretzels or raisins.

Some people may be embar-

rassed or worried that the man-

ager might give them a hard

time. If you think you may get

caught in a situation like this,

you can talk about what to do

with your doctor and how to

adjust your meal plan or insulin

doses.

What Should I Order?

When it's time to order, follow

the same rules for food content

and portion sizes that you follow

at home. Your meal plan proba-

bly calls for you to eat a good

balance of proteins, fats, and

carbs. Usually, you can get all of

the nutrients you need at a res-

taurant, too. These tips can help:

• Change and rearrange. To

get a well-balanced meal in

a restaurant, feel free to

substitute certain ingredi-

ents or side orders (like

salad for fries). Don't feel

weird about it - people ask

for substitutions all the

time. You can also ask for

a different preparation, like

having chicken broiled in-

stead of fried.

• Watch the sides. Avoid

foods with sauces/gravy, ask

for low-fat dressings.

• Pick your own portion. Try

to eat the same portion of

food that you eat at home.

• Master menu lingo. Watch

out for words like "jumbo,"

"supersize," "deluxe," or

"value".

Continued on page 6 . . .

TBHL Recipes : Delicious and Easy to Make P A G E 3 V O L U M E 1 , I S S U E V

Spanish Omelet

This tasty dish provides a healthy array of vegetables and can be used for breakfast, brunch, or any meal! Serve with fresh fruit salad and a dinner roll.

Ingredients (Serves 5): 5 small potatoes, peeled and sliced 1 tablespoon olive oil or vegetable cooking spray 1/2 medium onion, minced 1 small zucchini, sliced 1 1/2 cup green/red peppers, sliced thin 5 medium mushrooms, sliced 3 whole eggs, beaten 5 egg whites, beaten Pepper and garlic salt with herbs, to taste 3 ounces shredded part-skim mozzarella cheese 1 tablespoon parmesan cheese

Procedure: 1. Preheat oven to 375°F. 2. Cook potatoes in boiling water until tender. 3. In a nonstick pan, add oil or vegetable spray and warm at medium heat. 4. Add the onion and sauté until brown. Add vegetables and sauté until tender but not brown. 5. In a medium mixing bowl, slightly beat the eggs and egg whites, pepper, garlic salt, and mozzarella cheese. Stir egg-cheese mixture into the cooked vegetables. 6. Oil or spray a 10-inch pie pan or ovenproof skillet. Transfer potatoes and eggs mixture to pan. Spread with parmesan cheese and bake omelet until firm and brown on top, about 20-30 minutes.

Nutrition Information: Daily Servings According to Diabetes Food Guide Pyramid:

Rice with Chicken, Spanish Style This is a good way to get vegetables into the meal plan. Serve with a mixed green salad and some whole wheat bread.

Ingredients (Serves 8): 2 tablespoons olive oil 4 cups water of Sazón, for color 2 medium onions, chopped 3 medium tomatoes, chopped 4 garlic cloves, minced 1 cup frozen peas 1 cup frozen corn 1 cup frozen green beans 2 stalks celery, diced 3 1/2 cups chicken broth, fat removed 1 cup chopped mushrooms 2 cups uncooked rice 1 teaspoon salt (optional) Olives or capers for garnish, if desired 2 medium red/green peppers, cut into strips 1 3-lb chicken, cut into 8 pieces, skin removed Procedure: 1. Heat the oil over medium heat in a nonstick pot. 2. Add onion, garlic, celery, green pepper, and mushrooms. Cook over medium heat, stirring often, for about 3 minutes or until tender. 3. Add the rice and sauté for 2-3 minutes, stirring constantly until it begins to brown. 4. Add the chicken, salt, chicken broth, water, Sazón, and tomatoes. Bring water to a boil, then reduce heat to medium-low and simmer. 5. Cover the pot and let the casserole simmer until the water is absorbed and rice is tender, about 20 minutes. 6. Stir in peas, corn, and beans, and cook for 10 minutes. When everything is hot the casserole is ready to serve. Add garnish, if desired.

Nutrition Information: Daily Servings According to Diabetes Food Guide Pyramid:

Serving from Grains/Beans/Starchy Vegetable group

1

Serving from Meat group 1

Serving from Fat 1/2

Serving size 1 cup

Calories 330

Carbohydrate 24 grams

Protein 17 grams

Fat 14 grams

Serving from Grains/Beans/Starchy Vegetable group

1

Serving from Meat group 1

Serving from Fat 1

Serving size 1 cup

Calories 330 Carbohydrate 24 grams

Protein 17 grams

Fat 14 grams

Both recipes taken from National Diabetes Education Program, http://ndep.nih.gov/diabetes/MealPlanner/en_recipes.htm

How Does Diabetes Affect Women? P A G E 4 V O L U M E 1 , I S S U E V

Approximately 9.1 million or 8.9% of all women

in the United States have diabetes, however,

about a third of them do not know it. The preva-

lence of diabetes is at least 2-4 times higher

among African American, Hispanic/Latino,

American Indian, and Asian/Pacific Islander

women than among white women. Because

women are living longer and the rapid growth of

minority populations, the number of women in

the U.S. at high risk for diabetes and its compli-

cations is increasing.

Diabetes is the

fifth-deadliest

disease in the

U.S. , and it has

no cure. Women

with diabetes

have an increased

risk of vaginal

infections and

complications

during pregnancy.

For women who

do not have dia-

betes presently, pregnancy

brings the risk of gesta-

tional diabetes. Gesta-

tional diabetes develops in

2-5% of all pregnancies

but disappears when a

pregnancy is over.

Women who have had

gestational diabetes are at

more of a risk for devel-

oping type 2 diabetes later

in life.

Diabetic Complications

The risk for cardiovascular disease, the most

common complication associated with diabetes,

is more serious among women than men. Deaths

from heart disease in women with diabetes have

increased 23% over the past 30 years, compared

to a 27% decrease in women without diabetes.

The risk of diabetic ketoacidosis (DKA) is 50%

higher among women than men.

DKA, often called diabetic coma, is

a condition brought on by poorly

controlled diabetes and marked by

high blood glucose levels and ke-

tones (by-products of fat metabo-

lism in the blood). Although it is

accompanied by high blood glucose

levels, DKA is not caused by high

blood sugar but by lack of insulin.

Before insulin therapy was available,

DKA was the #1

cause of death from

diabetes.

Women with diabe-

tes are 7.6 times as

likely to suffer pe-

ripheral vascular

disease (PVD) than

women without

diabetes. PVD is a

disorder resulting in

reduced flow of

blood and oxygen to

tissues in the feet and legs. The prin-

cipal symptom of PVD is intermit-

tent claudication, or pain in the

thigh, calf, buttocks during exercise.

Pregnancy and Diabetes

Pregnancy demands

more insulin in the

body than normal

because of the in-

creased production of

hormones that can

lead to insulin resis-

tance. For women

with diabetes, excel-

lent blood glucose

control before con-

ception and then

throughout pregnancy

is vital to the health of

the baby and mother.

Major congenital mal-

formations in babies born to

women with preexisting diabetes

varies from 0-5% among women

who receive preconception care to

10% among women who do not

receive preconception care.

Macrosomia, or large birth weight,

occurs 2 to 3 times more often in

diabetic pregnancies as in the gen-

eral population. Because of the

increased risk of fetal macrosomia,

women with diabetes are 3 to 4

times more likely to have a cesar-

ean section.

Women with diabetes are up to 5

times as likely to develop toxemia,

a disorder of unknown cause usu-

ally marked by hypertension, pro-

tein in the urine, edema, headache,

and visual disturbances, and hy-

dramnios (excessive amounts of

amniotic fluid) as women without

diabetes.

Approximately 40% of women

with gestational diabetes who are

obese before pregnancy develop

type 2 diabetes within 4 years.

Continued on pg. 5 . . .

About 2-5%

of all non-

diabetic

pregnant

women

develop

gestational

diabetes.

Diabetes is at

least 2-4 times

more common

among black,

Hispanic,

Latino,

American

Indian, and

Asian/Pacific

Islander

women than

among white

women.

P A G E 5 V O L U M E 1 , I S S U E V

For more information in English or Spanish, contact the

American Diabetes Association at 1-800-DIABETES (1-

800-342-2383), or visit their Web site at ww.diabetes.org.

Information taken from: www.fda.gov/womens/taketimetocare/

diabetes/fswomen.html

. . . Continued from page 5

Diabetes and Birth Control

Birth control pills can affect blood glucose levels and diabetes

control. The intrauterine device (IUD) may lead to infec-

tions. Because women with diabetes are already at a higher

risk of infection, most shouldn’t use the IUD.

Non-diabetic pregnant women should be checked for gesta-

tional diabetes between the 24th-28th week of pregnancy.

How Does Diabetes Affect Women?

Meal Food Pyramid Group Servings Suggested Menu

Breakfast Fruit 1 Fresh orange, 1 medium

Grains/Beans/Starchy Veg. 2 Baked plantain, 1 medium

Milk 1 Milk, 1% low fat, 1 cup

Fat 1 Oil, 1 teaspoon

Lunch Meat 1 Two Cheese Pizza

Grains/Beans/Starchy Vegetable 2 2 slices (see recipe)

Fat 1

Fruit 1 Melon, 1 cup/cubes

Vegetable 1 Mixed green salad

Afternoon Snack Fruit 1 Apple, 1 medium

Meat 1 Peanut butter, 2 tablespoons

Grains/Beans/Starchy Vegetable 1 Whole wheat crackers, 5

Dinner Grains/Beans/Starchy Vegetable 1 Rice with Chicken Spanish Style

Meat 1 1 cup (see recipe)

Vegetable 1

Fruit 1 Pineapple rings, 1/2 cup

Vegetable 1 Spinach, 1 cup raw

Fat 1 Vinaigrette, 1 tablespoon

Evening Snack Milk 1 Yogurt, low fat, 1 cup

Grains/Beans/Starchy Veg. 1 Bread sticks, 2

* This is just an example. If you have diabetes, consult a registered dietitian to help you make your own meal plan. Your meal plan will be based on many factors, includ-

ing your weight goal, height, age, and physical activity.

SPOTLIGHT ON:

Sample Meal Plan for a Day*

851 Grand Concourse, Rm. 914

Bronx, NY 10451

Phone: 718-590-2648

www.bronxhealthlink.org

Communication Network which has over 500

subscribers. The E-Comm provides e-mail mes-

sages on a wide scope of information and re-

sources including funding/grant/job opportuni-

ties, community health and public health issues,

community events and resources, provider

events and resources, and resources from our

Perinatal Information Network unit.

Our mission is to improve community health by:

• identifying emerging community health is-

sues;

• increasing communication to better serve

the community;

• providing information to providers and com-

munity residents on services and resources;

• increasing access to available services and

programs.

Teens & Eating Out

We’re on the Web! www.BronxHealthLink.org

T H E B R O N X H E A L T H L I N K , INC .

Our MissionOur MissionOur MissionOur Mission

The Bronx Health Link, Inc. (TBHL) is a Bronx-

wide network of diverse service providers, or-

ganizations, coalitions, agencies, community

stakeholders, residents, and students. We serve

the Bronx and NYC in various ways, including as

a clearinghouse for Information & Referral, pro-

viding technical assistance as needed, and broad-

casting information through the TBHL Email

. . . Continued from pg. 2

• Split with a friend. Are you hun-

gry for some fries? Order a

healthy sandwich and side salad

for yourself and share a few of

your friend’s fries. Also dividing

an entrée or sandwich between

friends also helps keep portion

sizes under control.

• Go light on buns and crusts.

Choose thin-crust pizza over the

deep-dish pie and skip double

burgers and extra-long hot dogs

to keep carb intake under con-

trol. And keep in mind that Eng-

lish muffins, bread, and small buns

often contain fewer calories and

fat than croissants and biscuits.

The same tips apply to eating at your

school cafeteria. To be a healthy eater

t school, make sure you pick a variety

of healthy foods and stop to think

about when you're getting full.

What Should I Bring With Me?

When you go out to eat, you should

bring the things you take with you

everywhere, like testing supplies,

snacks, and medications. A quick-

reference guide to food content and

portions can make choosing healthy

foods a little easier. (If you don't have

one, you can get one from your doc-

tor or dietitian.) If you use things like

artificial sweeteners or fat-free

spreads, bring them along.

If you take insulin, eating later than

usual might mean making a few adjust-

ments to your medicine schedule.

There's no need to stay home, though

if you’ll be eating later than usual, hold

off on your insulin injection, eat a small

snack at your normal mealtime, and

take the insulin.

Do you have questions about how to

make eating out even easier? Talk to

your doctor or dietitian.

Information compiled from NeMours

Foundation, at http://www.kidsheal

th.org/teen/managing_diabetes/

living/eating_out_diabetes.htm