Having diabetes is
not just a problem of having high blood sugar, it puts you at a higher risk of
other diseases, such as heart attack, stroke and kidney disease. These diseases
are caused by damages to the blood vessels. This is why doctors prescribe
medications for diabetic patients that are not just for controlling blood
sugar, but are helpful in preventing damages to the blood vessels.
For example, sometimes
diabetes patients may wonder why their doctor prescribes a cholesterol
medication for them but their cholesterol is not very high. According to the
2013 Canadian Diabetes Association Clinical Practice Guidelines, diabetes
patients over the age of 40 should receive statin therapy (a type of drug
commonly used to treat high cholesterol) for blood vessel protection. What this
means is that although your cholesterol levels may not be high, diabetes
patients can still benefit from taking a ‘cholesterol drug’ to prevent heart
attack, stroke, legs and feet damages, and to delay the development of kidney
and eye diseases.
Another drug that
diabetes patients may be prescribed is a type of blood pressure medication such
as, Ramipril, Telmisartan, Coversyl, etc. Diabetic patients may not have high
blood pressure, however, they can still benefit from taking these drugs to
prevent damages to their blood vessels, especially the blood vessels of the
kidneys.
Some diabetes
patients may ask us about taking Aspirin to prevent heart and blood vessel
diseases. According to the current guidelines, Aspirin therapy is
recommended for patients that have ‘macrovascular’ diseases, such as heart attack, a stroke or
insufficiency in blood flow to legs or arms. Talk to your pharmacist or doctor to find out if you
should be taking Aspirin for cardiovascular protection.
Some diabetes
patients are now taking the newer drugs, such as Januvia, Trajenta and Onglyza.
These drugs need only to be taken once daily and they work on
lowering the blood sugar after each of your meal (which is the most common time
when your blood sugar is high). This also reduces the chance of lowering the
blood sugar too much because the effect of the drug is activated primarily only
after you eat. However, these newer drugs are not considered to be a
replacement for the older drug, Metformin. According to the current
guidelines, Metformin is still a first line therapy. The newer drugs can
be chosen to be added to Metformin therapy if the blood sugar is still high.
The cost of these newer drugs are much higher than Metformin, however,
they are covered under the Ontario Drug Benefit (ODB). If you have
questions about diabetes medications, Custom Care Pharmacy have Certified
Diabetes Educator Pharmacists that can help answer your diabetes
questions.
Diabetes & Diet - By Rowena Leung, Registered Dietitian, CDE
*** Don't forget to register for our FREE cooking demonstration on
Sunday, August 17th, 2014 2-4pm at Custom Care Pharmacy!***
When
someone has pre-diabetes or diabetes, many individuals automatically think to
control sugar intake. Sugar is definitely an area of concern; however, more
importantly, it is very important for an individual living with pre-diabetes
and/or diabetes to learn how to control carbohydrate intake.
Many
foods contain carbohydrates including: root vegetables, grains & grain
products, beans & legumes, milk & milk products as well as fruits. When
cooked, tomatoes also can be a source of carbohydrates. Carbohydrate is one of
the three macronutrients our body need and is made up of three components:
starch, sugar and fibre. Fibre is the one component of carbohydrate which won’t
be absorbed or digested by our body. As
a result, one of the functions of fibre is to help bring down blood sugar
levels.
FIBRE:
How
much fibre does the average man or woman need per day? According to the
Institute of Medicine, the chart below outlines the daily recommended intake of
fibre for a male and female.
|
Age Group
|
Adequate Fibre intake/day (g/day)
|
Male
|
50 years or younger
|
38
|
51 years or older
|
30
|
Female
|
50 years or younger
|
25
|
51 years or older
|
21
|
On
average, a serving of fruit (e.g. a small apple/orange/pear) gives you ~2 grams
of fibre. If you decide to cook a serving (i.e. 1 c) of broccoli and/or
cauliflower, this will only give you 3-4 grams of fibre. If you decide to eat a
plate of salad mixed with your dark green leafy vegetables, onions, cucumber,
different coloured peppers and other types of vegetables mixed in, you’re
getting close to 5 grams of fibre. As you can see, it is not very easy to get
21 grams of fibre/day let alone 38 grams of fibre/day.
CARBOHYDRATES:
Individuals living with diabetes and/or pre-diabetes don’t
have to avoid any foods. Portions for carbohydrate containing foods may change;
however, all foods can still be enjoyed. For example, for the general healthy
individual, ½ c of cooked rice is one serving of carbohydrate containing food;
however, when someone has diabetes, 1/3 c of cooked rice is one serving of
carbohydrate containing food. When
reading the food label, it is very important to remember that 1 portion of
carbohydrate containing food (e.g. 1 slice of bread, ½ c cooked pasta, 1/3 c
rice) is equal to 15 grams of carbohydrate.
As you can see on the label to the left, the word carbohydrate is
bolded. Underneath, the components of carbohydrates are listed including fibre
& sugar. Starch is typically not listed but it is to be understood that
once you subtract the fibre & the sugar from the total amount of carbohydrates, what is left over is the starch amount.
What is of importance now is to pay
attention to the carbohydrate to fibre ratio. Because fibre is not absorbed or
digested by our body, we can subtract the fibre from the total amount of
carbohydrate. To know that you are eating an item that is a high source of
fibre, it must have at least 4 grams of fibre/serving or 15% or more of your %
daily value (%DV). Once you subtract the
fibre from the total amount of carbohydrate, you would like to end up with 15-45
grams (i.e. 1-3 servings of carbohydrate containing food). **
**1 serving of carbohydrate containing food=
snack
2
servings of carbohydrate containing food= reflective of a female appetite
@ a
meal
3
servings of carbohydrate containing food= reflective of a male appetite @ a
meal
SUGAR:
As mentioned before, sugar is an area of concern as well. As always,
sugar intake is always recommended to keep to a minimum. The newest
recommendation for sugar intake/day is as follows:
Women are
allowed 6 added teaspoons of sugar/day.
Men are
allowed up to 9 added teaspoons of sugar/day.
Please keep in mind that 1 teaspoon of
sugar is equal to 4 grams of carbohydrate.
Do you really enjoy eating vermicelli
and/or rice noodles? Unfortunately, both these items are not very good for
someone living with diabetes because both products are made of refined sugar
and not very high in fibre. Eating these items will make blood sugar levels
rise very quickly. Don’t worry, you can still enjoy a similar item but not have
to worry about the carbohydrate intake! Curious as to what this item is? It is
Shirataki noodles!
Shirataki noodles are made from a Japanese
yam called Konjac yam. If you eat the whole package of Shirataki noodles,
you’re only getting 3 grams of net carbohydrates. This is the equivalent of eat
1/5 of a standard piece of bread. The nice thing about shirataki noodles is
that it’s already pre-cooked so all you have to do is warm the noodles up and
enjoy!
Do you really enjoy eating pasta? Did you
know that 1 c cooked pasta is like eating two pieces of bread? Most individuals
cannot be full after only eat 1 c of cooked pasta. This is why you can enjoy
spaghetti squash, another low-carbohydrate, but spaghetti-like option.
For every ½ c of cooked spaghetti squash,
you only absorb 4 grams of carbohydrate which is the equivalent of eating ~1/3
of a piece of bread. This is much better than ½ c of pasta which is equivalent
to eat 15 grams of net carbohydrate. Spaghetti squash is easy to prepare as it
only takes ~40 minutes to bake or ~20 minutes if you choose to steam the
squash. Once the squash is cooled down, take a fork and peel out the strings of
spaghetti! Spaghetti squash has a very mild flavor; therefore, treat it like
regular pasta but you don’t have to worry about it being as high in
carbohydrate content.
On Sunday, August 17th, 2014, we will be doing a live demonstration on cooking with Shirataki noodles and Spaghetti Squash. Please register at Custom Care Pharmacy in store or by calling us at 905-305-0111!
有些糖尿病患者会问我们关于服用阿司匹林，以防止心脏和血管疾病。根据目前的指引，阿司匹林疗法推荐用于有以下疾病，如心脏发作，中风或血液流向腿部或手臂不充分的患者。向您的药剂师或医生諮詢，你是否需要服用阿司匹林來保护心血管。
当一个人有糖尿病或處於糖尿病前期，许多人不由自主地想到要控制糖的摄入量。糖是绝对值得关注的問題; 然而，更重要的是，糖尿病人要学会如何控制碳水化合物
(carbohydrates)的摄入量。
患有糖尿病或處於糖尿病前期的個人不必戒食任何食物，但含碳水化合物的食物的分量可能会改变;然而，所有的食物仍然可以享用。例如，对于一般的健康人，½杯米饭是算一份含碳水化合物的食品;然而，對有糖尿病的患者，1/3
杯米饭就算一份含碳水化合物的食物。当阅读食品标签，这點非常重要，需要记住，1份含碳水化合物的食物（如1片面包，½杯煮熟的面食，1/3
杯大米）是等于15克的碳水化合物。
糖:
白泷面条是从日本山药叫魔芋山药制成。如果你吃了整包白泷面条，你只是獲得3克净碳水化合物，只相當于吃了1/5块标准面包。关于魔芋面条的好处是，它是预先煮熟好的，因此，你只需加熱就可吃了！
