Back in November, the nearest hospital to Broadwater (sixteen miles) held a flu and pneumonia shot clinic at the church across from my house. That led to my wife receiving a diagnosis of Type II Diabetes.
More below the tangled orange glucose test strip.
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Village Vet writes:
Since my wife works regularly with the public (as the Library Director), she felt it was appropriate to get a flu shot. (Getting a shot for her birthday was another matter. She also has been ragging on me about flu shots: I have made a lifetime work out of avoiding them. The Veterans Administration periodically gets on my case about that and the pneumonia shots, because I had tuberculosis in the 1980's.)
At the shot clinic, the nurse offered a glucose screening at no additional charge. Both of us said "sure" (free being free). While I weighed in normally, my wife was told "You aren't managing your diabetes very well."
Of note, my wife had never been diagnosed with diabetes. She'd recently seen an ophthalmologist in Scottsbluff over normal vision issues.
Diabetes is often detected when retinal damage is discovered by an eye doctor; the ophthalmologist detected any damage the time he saw her.
But the nurse in the diabetes screening did detect a problem: a glucose level of 311 mg/dl. (By comparison, mine was 90. I occasionally play with my wife's meter, and it varies from a low of 49 to a high of 110.)
Her diabetes is under control now, but with a cost: my weight. My wife was familiar with diabetic diets and diabetes management, having worked as a home health care worker. She immediately embarked on a diet plan to manage her diabetes, resulting in weight loss: hers, mine, and the cat's. (I am not sure why the cat lost weight, but he dropped from 28# to 15#.)
In her case, as she was overweight to begin with, this was a plus to her health. As I started underweight, losing weight for me was an immediate problem. Moreover, I started developing the "shakes" common to low glucose levels (the 49 above).
She divided up the cupboard into two areas: carbohydrate-rich foods (Nutella, chocolate, chips, &c) that functions as my snack cupboard. She stays out of that. The remainder of the cupboard has all the other foods.
I've learned more about diabetes in the past two months than in the rest of my life. The only person in my family ever diagnosed with it was my great-grandmother, some fifty years ago.
Of interest, diabetes in the USA was estimated to cost $245 billion in total economic damage in 2012 (medical care, lost work, death and disease, &c).
The United Kingdom found that offering home glucose monitors through the National Health Service dramatically reduced medical and other costs to the government and economy. I suspect our fiscally-responsible conservatives here would find handing out "free stuff" (glucose meters and consumables such as lancets and test strips) to be anathema to reducing government spending. Let 'em eat cake (or in the case of diabetics, no cake), and the 1/5 of a trillion dollar costs associated with diabetes every year.
My wife notes below she has seen the results of poorly managed diabetes. I have too: when I was in Omaha the woman across the street never managed her disorder, resulting first in the amputation of one leg due to gangrene, and ultimately her death (discovered by her ten year old niece, a real trauma for the girl that took a long time to get past).
Miss Beth has a great deal of useful information below, including recent medical research, a few recipes that are good for both a person with diabetes and one who just likes to eat, and other useful and important information to avoid injury (or worse).
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FredFredZ writes:
I have two biological parents who had diabetes. As a result, that almost guaranteed that I would become a diabetic too – the only other option was for me to die young. That didn't work out so well (another story). As a result, I have tried to get a screening of my blood sugar once a year. I get them in a number of ways – most commonly, from organizations such as the Lions Club when they set up a community wellness exhibit.
What I have found odd, is that I've brought this up in doctors' offices, and sometimes I am given such a test, while other times they claim they “can't find” the glucose meter, or that I “don't need” such a screening test. I find that odd, as prevalent as diabetes is in this society, and given my genetics.
Anyway, what Village Vet wrote above is true. I was working in the Library one evening, when a young woman came in asking if she could hang up some flyers about the upcoming flu clinic, associated with the County Hospital. I pointed her to places where non-official bulletins could be hung, hung one on the Library door. We have a policy not to take certain flyers from commercial organizations or organizations that promote hate, but while most of us hate the flu, I felt it would be useful information for many people in the community. We have many elderly people, some of whom do not have cars, some younger people without reliable transportation, and it is about a 30 mile round trip to a doctor. I was unable to find a flu clinic anywhere within 100 miles last year, and went without. I prefer to avoid the flu, especially when working with the public.
I had a cup of coffee with milk, then walked across the street to the church right after they opened. I hadn't gotten to the Lions Club exhibit this year, so it had been around 15 months since I had a blood sugar screening. Moreover, I felt that physically something just wasn't right. That wasn't concrete enough that it would take me to a doctor, and I wouldn't know what to say after I got there. In fact, I had gone to an urgent care clinic 6 weeks earlier, and while they did weight and blood pressure screening, there was no blood sugar screening. So, I jumped on it when they were offering a blood sugar screening. Watching it, I sort of had a bit of a hinky feeling that it would be kind of high. I never would have expected anything in the 300 range! They told me, “You need to be taking better care of your diabetes.”, to which I responded, “I never had diabetes before. I guess I'll have to go to a doctor and get something done.”
Symptoms of diabetes include:
• Excessive thirst
• Unexplained weight loss
• Sudden changes in vision
• Jitters or shakiness
• Fruity smell on the breath
• (More extreme) Smell of nail polish remover (acetone) on sweat, breath, or urine.
• (Even more extreme) Confusion, where the person acts like someone who is drunk.
• (Still more extreme) Coma.
• (End result) Death.
For the bottom three reasons above, more than one diabetic has died in the drunk tank. The diabetic coma was mistaken for passing out from alcohol intoxication. That is also why people who are seen as being drunk and gain police attention are now taken to the hospital rather than to jail. If they're drunk, they'll have a very high hospital bill, which could be the “bottom” they hit to stop their alcohol abuse. If they're diabetic, they'll get treated. This is one reason why it is a good idea to have a medic alert bracelet that says “Diabetic”, or if you'd rather keep your privacy or have additional health issues, one with a contracted company that says, “Medic Alert – Call”.
Indeed, I've seen the results of poorly-managed diabetes. My stepfather was diagnosed with diabetes in 1964. By the time he died in 1989, he'd lost his eyesight in both eyes, lost most of his kidney function, had both of his legs amputated, lost his ability to think clearly, and had numerous heart attacks and strokes. Many years ago, before there was much available to treat diabetes at all, many only lived 5 years after diagnosis. I was determined not to live out the last 15 years of my life existing as he had!
I have been less than impressed with two of the doctors in the next town, when Village Vet had an urgent situation, which the Veterans Administration thought was serious enough that he should be checked by an emergency room, and they not only failed to recognize the problem, but did some unrelated tests and treated him like a drug-seeker.
So, I found a doctor about 50 miles away that accepted my insurance, had some good reviews from patients on sites where people can comment good or bad about a healthcare provider. I called her office as a new patient, explained why I wanted to see the doctor, and they gave me a choice of the next day or the following day. I chose the following day as the one the next day interfered with my work schedule.
In the mean time, I stuck to broiled meat and green vegetables – which was the 1964 diabetic diet which my stepfather was on when I was a small child.
So, the doctor diagnosed me. My blood sugar was a little lower, but still way too high. She did another test, an “A1C”. This test tests the sugar in the red blood cells which is put there when they are formed. As they live about 3 months, this number is the average over the past 3 months.
I went away with a prescription for Metformin, a packet of information, a very short book on diets, carbohydrate counts of some extremely common foods. I could see where someone would get both frustrated and bored with that diet – it was far too simplistic. Everybody does not have the same tastes and preferences in food, the same availability, nor the same food budget. Better information must be given out to expect any sort of dietary compliance.
I went to the pharmacy to pick up my prescription. I thought about a glucose meter. Those were not available to my parents while I was growing up, but they are available now. And, it's useful to know where your blood sugar is, as well to identify a problem. When it's 16 miles to the nearest hospital and 50 miles to the doctor, I'm not going to be able to get to medical care if I'm feeling kind of shaky, weird, “under the weather”, or something like that. The pharmacist recommended a meter that was free with a $30 bottle of testing strips. I'm surprised that my doctor did not give me a prescription for a meter, as, per Village Vet's numbers above, saves on the cost of treating and living with diabetes. I'll talk to her next time, and see if I can get some of my test strips paid for by insurance.
I did find it odd that when I called and talked to the nurse, she said that I really shouldn't and didn't need to test my blood sugar, because metformin does not cause blood sugar to go low. The manufacturer of metformin says in their prescribing information to the FDA that is is a possible side effect. Also, since I am 50 miles from the doctor, and 16 miles from a hospital, it would be good to know if an odd feeling is high or low blood sugar. It's much much cheaper for me to test it at home too. It gives re-enforcement to how I am doing in controlling the diabetes. Especially since Metformin does not begin working until 4-12 weeks after someone begins taking it.
I had a head start on the average newly-diagnosed diabetic, with my parents, plus with homecare. Also, since I grew up eating diabetic diets (1964 version, 1972 version, and 1979 version). We rushed back to get my prescription filled, and I stuck with the 1964 diet until we'd eaten most of the perishable foods. I had occasion to be in a bigger nearby town 2 days later. I did not feel right about driving with diabetes that far out of control, as there is a risk of unconsciousness – not good while driving. He went with me and read a book during a 3 hour class, held in a library. After I was done with the class I went to, I told Village Vet, “I want to go to a grocery store and buy some things I can eat.” He gave me a quizzical look, but stopped at a grocery store. He found me buying a combination of the foods he was used to me buying (fresh meats, canned vegetables, frozen vegetables), and some staples – especially for him – like bread and Nutella (TM).
The change in food wasn't as dramatic as Village Vet seemed to indicate. One of my favorite cookbooks is Healthy & Hearty Diabetic Cooking by Diabetes Self-Management. A review and other information is available from Goodreads (they don't have anything for sale, but suggest bookstores and libraries where you can get it) http://www.goodreads.com/...
In the mean time, I sought to update the information I knew. I went to the American Diabetes Association's website. I read some of their information, and sought their support forums at http://community.diabetes.org/ They have groups for people living with type 1, type 2 diabetes, those newly diagnosed (and not knowing where to turn), groups for parents of diabetic children, and adults living with or love someone with diabetes.
I have been “eating to my meter” - that is, when my blood sugar is down in the normal or low-normal range, I'll have a larger meal with more carbohydrates and sugars. When my blood sugar is higher, I will have a smaller meal with more protein and fiber, few carbohydrates and avoid all sugar (including fruit). When I was bringing my blood sugar down, poor Village Vet was starving for carbohydrates! A few times I'd make a side dish of something like rice, pasta, or potatoes to fill him up. As I've been working on getting my blood sugar under control, now keeping it that way, at least to begin with, I was eating some very low calorie meals.
He ran out of bread over Christmas. I made some. To keep myself out of it, I made the bread to include some very hot peppers. Village Vet likes food which is very hot and spicy. I have a lower tolerance. The plan there was to make the high-carb fresh bread (Yum!) unappetizing to me. It worked. I couldn't eat much of that bread.
He's eating lots of jam, peanut butter and Nutella (TM) – things which I don't like or don't particularly like. I encourage him to eat things with lemons, oranges, or grapefruit. They are high-sugar foods or juices, and I'm allergic to them such that my skin or lips will break out almost immediately – so I'll stay away from them.
We bought a new kitchen cabinet. While setting it up, I organized the cabinet so Village Vet could have his food in its own place, and I would refrain from even looking there.
As for the cat losing weight, I don't have any explanation for that one. The cat food hasn't changed.
There are a number of common misconceptions about diabetes.
Myth: Diabetics must have special diabetic foods.
Fact: A diabetic diet is mainly just a very well balanced diet, although quite low in carbohydrates and sugar. Foods which are marked for diabetics are basically using a marketing tool to get sales. Sometimes, the ingredient lists of those are troublesome, and the nutritional information shows it to be very high in carbohydrates and sugars. Note too that things which are ADA approved may be approved by the American Dietetic Association, not the American Diabetic Association. The latter of which may approve the food as being good in some way for the diet of ordinary people, but it may or may not be appropriate in very large amounts for someone with diabetes.
Note too that someone with diabetes can eat virtually any food, subject to other dietary requirements, but the portions may need to be tightly managed.
Myth: Diabetes is caused by obesity.
Fact: While obesity and type 2 diabetes are associated, it mainly works the other way. Insulin resistance causes one to gain weight, and insulin resistance progresses to type 2 diabetes. One symptom of diabetes is unexplained weight loss. People with type 1 diabetes tend to be quite thin. Some people with type 2 diabetes are also thin. My father is 6 feet tall, usually weighed around 140-150, and was never over 170 lbs.
Myth: If you eat a lot of candy, cake or cookies, it'll make you diabetic.
Fact: People with undiagnosed or uncontrolled diabetes often crave sweets, including candy. Someone who eats a lot of candy, especially if they don't gain weight, should be tested for diabetes.
Myth: Diabetes means you can't have ANY sugar.
Fact: While excess sugar will worsen diabetes, sugar of any type can be included in a diabetic diet, so long as the sugar and carbohydrates are considered and appropriate trade offs made. Maybe you can't have half a birthday cake, but you can have a small piece, and forgo breakfast cereal and a dinner roll. Note too that diabetics can get low blood sugar as well as high, especially if they are type 1, taking insulin, or have gone too long without eating. Sugar may be appropriate in that case. However, the symptoms of high blood sugar are amazingly similar to those of low blood sugar. That is why an objective test with a glucose meter is important as to know what to do.
Myth: Diabetics can eat all of the fruit they want. Fruit is good for you.
Fact: Fruit is good for you, and contains a number of important nutrients. However, it has fructose, which is sugar, and it must be accounted for. Fruits are a part of a diabetic diet, but portion size is a consideration.
There are many many other myths about diabetes, which can be read about and dispelled by the American Diabetes Association at http://www.diabetes.org/...
You have certain rights as someone with diabetes too. Although diabetes is not a disability in the classic sense, at least on its own, the Americans With Disabilities Act applies. If you are flying, you are allowed to carry supplies used to manage your diabetes – including glucometers, lancets, insulin, needles, and medication – as well as some of your own food. You are allowed to request a diabetic meal – although anecdote says that these vary a lot in how appropriate they may be or not be for a diabetic diet. You should carry a doctor's prescription or letter explaining that you need these things. You cannot be discriminated against in employment – and you must be allowed meal times at appropriate intervals, as well as the ability to test your blood sugar and take medication – including injected insulin, if prescribed. There are a few jobs you may be legally prevented from doing.
Feet:
People with diabetes often have trouble healing wounds, especially if those wounds are on their feet or legs. This becomes a worse problem if one's blood sugar is out of control (generally, under 150 mg/dl). It's a good idea to always wear shoes – even around the house. It's also a good idea to check your feet daily for wounds, abrasions, or other odd breaking-out. If these do not heal in a few days or appear infected, go to the doctor. These could be the start of diabetic ulcers, which if left unattended can become gangrenous and lead to the amputation of a foot or leg!
Myth: Diabetics must control their diet, limit their sugar intake, avoid high-sugar sweets at all times. If they don't, they're not following their diet, so they might as well stop pretending they are.
Fact: A person with diabetes can live a normal life, enjoy an occasional beer, cake, or indulge in a special meal occasionally. Even if one completely “blows” their diet at a wedding or Christmas dinner, and their diabetes is (generally) under control, will see their blood sugar rise. For a person with type 2 diabetes as well as many people with type 1 diabetes, such occasional overindulgence will balance-out within a few days of tightly managing sugars, carbohydrates, and fast. It becomes more important though to monitor one's blood sugar during and after the event in question, to ensure that blood sugar does not rise (nor fall) to dangerous levels, and take action before there is a medical emergency.
Occasional indiscretions, even pre-planned or impulsive ones, are not the end of it all. It is very important to not take the notion of, “I really blew it now. I should just give it all up, and stop even trying to monitor sugars and diet. It's impossible for me.” It's most important to control one's diet even tighter until one gets their diabetes back in control. Granted, each of these does some damage to health, but the sooner it ends and normal control is restored, the less damage. The important word is occasional. If these are a regular occurrence, they will cause serious long-term health problems. If they are happening regularly, one should look at how or why they are happening, and see what needs to be changed to prevent them.
Complementary and Alternative Medicine
Well, indeed, one can call the diabetic diet a “complementary” medicine to prescription medications and insulin, as they “complement” the pharmaceutical approach. A diabetic diet is a pretty conventional, mainstream essential piece of controlling diabetes. In this section, I'm mainly referring to herbs and supplements.
Please do not stop using, or forgo obtaining, a prescription medication to control your blood sugar and substitute any of these CAM items. While some of them have been shown to help in valid scientific research, many have been shown to have no effect, some may work by a yet-not-understood mechanism (with an unknown set of potential side effects), and none work as well as modern medications – including injectable insulin. As a standard piece of advice, tell your doctor if you're using or want to start using any of these alternative treatments. Some of them may interact badly with other medications you may be taking.
Numerous herbal remedies have been suggested for diabetes. Note that if any of these were a complete answer, most diabetics would not have died within 5 years of being diagnosed. That was reality before the beginning of the 20th century. Still, some of these herbs and supplements might, or could possibly help a little. Note that ginger, ginseng, nettles, garlic, hawthorn, and fish oil all lack scientific evidence that they help at all with diabetes control in scientific studies. There may be scientific evidence that they help with other conditions which are sometimes correlated to or caused by diabetes, but those are outside the scope of this diary. They are still claimed for that purpose in some brochures, mass-mailing, and websites. These, and the ones below currently being touted by some supplement producers and sellers as a “natural” way to control, or even “cure” diabetes. Anything offering a “cure” for diabetes is automatically suspect: There is no cure for diabetes. If there were, with nearly 1 American in 3 having diabetes or at risk for it, it would be all over medical journals one week, and all over the news the next day! Corporations would be stumbling all over themselves to trademark it, patent the active component, and market it. Trillions of dollars would be made by someone who actually had this! There is no cover-up specifically because there is so much money to be made. Ideally, those claims should be reported to the FDA at http://www.fda.gov/... and FCC https://consumercomplaints.fcc.gov/... and FTC https://www.ftccomplaintassistant.gov, as making a medical claim violates FDA and FCC rules. At the best diabetes can be controlled.
Contemporary items or substances which are used or claimed to be of use include:
1) Chromium. Chromium, especially chromium picolate has been touted as a supplement to help control diabetes. Several scientific studies conclude that chromium supplements improve diabetes control. It is known that chromium is needed to make glucose tolerance factor, which helps insulin utilization. It is uncertain whether more than the micrograms found in the average diet are beneficial.The scientific papers are contradictory and as a whole, inconclusive.
2) Magnesium. It appears that a magnesium deficiency, which is all-too-common in the typical US diet, will worsen type 2 diabetes and make it harder to control. There is no good reason to take more than the RDA levels of this mineral. A diabetic diet, which by definition is well-balanced, should provide you with more than enough magnesium.
3) Vanadium. This mineral has been touted as a prevention or cure for type 2 diabetes. It has not been well studied, and there is a lack of actual evidence either way. One recent study showed that it gave diabetics using insulin a modest increase in insulin sensitivity, and they were able to slightly decrease the insulin they took. More studies need to be done to first understand how Vanadium is used, what role it takes, and whether a deficiency of this contributes to diabetes or not.
4) CoQ10 There have been numerous studies on Coenzime Q-10, but they have not shown any effect on blood sugar.
5) Fenugreek. These are seeds used as a seasoning in Middle Eastern and Indian cooking. Studies have shown them to have some effect on lowering blood sugar. However, it may interact with blood sugar-lowering medications. It has a lot of fiber, and might help with cholesterol or constipation. Notably though, in higher quantities than used to season food, it seems to increase estrogen levels. It's known to help some women with lactation, but higher estrogen levels have also been linked to such things as cancer and central obesity – which in turn is linked to diabetes.
6) Cloves, or clove oil, appears in some studies show cloves or clove oil to lower blood sugar or decrease insulin sensitivity. I need to do more research into cloves before I consider them.
7) Coffee also appears to have an ingredient, not caffeine, which help with the metabolism of sugar, according to several scientific studies. More research needs to be done to find out what the substance is and how it works. In the mean time, drink coffee if you like it, and don't if you don't. Any supplement that claims to have the “active ingredient” that helps with the metabolism of sugar has no evidence supporting their claim.
8) Cinnamon was recommended to me by a person with diabetes who I trust to have looked into the actual evidence. I've looked at a lot of research. There is a lot of conflicting results of the scientific research. I looked at a meta-analysis of a number of these studies, and they made one notation: The variety of cinnamon that was studied made a huge difference. Ceylon Cinnamon, Cinnamomum Zeylanicum, or True Cinnamon, which is the most common variety used as a spice throughout the world does seem to have an effect of lowering blood glucose by as much as 10% (about the same as the first-generation diabetes drugs, such as orinase). E.g., http://www.npr.org/... and it may make a difference on how the cinnamon was extracted, http://www.diabetes.org/... It appears that Cinnamomum Cassia, the variety that you are most likely to find in your spice cabinet in the US or Canada, is unlikely to have a significant effect on your blood sugar. A word of caution is in order with this: Cinnamomum Cassia can contain about 5% coumarin, a naturally occurring ingredient that, when more than about a teaspoon-full per day, can cause reversible liver toxicity in a small group of individuals sensitive to it. Ceylon cinnamon, True Cinnamon or Cinnamomum Zeylanicum is milder, but less toxic, containing approximately 0.004% coumarin.
A few supplement companies have supplements of Cinnamomum Zeylanicum, but most “cinnamon” supplements I found on the shelves were Cinnamomum Cassia. I would be hesitant about taking more than a gram or so of this per day.
Of note, products, even food products sold as supplements are regulated differently by the FDA than are food products or drugs. http://www.fda.gov/... One is not even assured of getting the product claimed, nor the advertised amount of it. Some supplements have even been found to contain pharmaceutical drugs which should only be sold on prescription. The American Cancer Society has a good write-up on these and other problems at http://www.cancer.org/... While the FDA is trying to crack down on “misbranding” of supplements, the penalties are not nearly as harsh as if it's done to something sold as a food or as a drug. Caveat Emptor. If you are going to try using cinnamon, PLEASE get Cinnamomum Zeylanicum or Ceylon Cinnamon or True Cinnamon from a company selling gourmet foods or spices. If you do not like (that much) cinnamon, put it in capsules yourself. You can get empty capsules for a few cents from any pharmacy. Or, as cinnamon is tasty, you can use it to spice-up your meals and beverages. I've found it's wonderful in coffee.
Personally, I use Ceylon Cinnamon, but only when I get more carbohydrates than I usually get in my home-cooked meals. This can happen from restaurant food, eating a meal at someone else's house, or in holiday festivities. I do not use it at all medicinally under ordinary circumstances, and I'm not sure that it even works, or very much, but I'm still trying it. I like the taste of cinnamon, and it's especially good in coffee or on cereal such as bran flakes or oatmeal. Another way Cinnamomum Zeylanicum is described is Sweet Cinnamon. I'm not sure whether it's real or a life-long association, but it seems that Cinnamomum Zeylanicum makes something it's added to taste sweet.
Cinnamomum Zeylanicum is milder than Cinnamomum Cassia, so it takes more in a recipe to get it equally as “cinnamony”. In general, about double the amount called for in the recipe.
Recipes
As a general note, I highly recommend the ample use of herbs and spices to season your food. That is for the simple reason is that these meals will satisfy your taste buds in ways that do not adversely affect your diabetic diet or your health. Note that salt and sugar are not seasonings nor spices. Generally, they are to be used sparingly.
Note that fiber is your friend. Undigestable, or unsoluble fiber keeps you full and adds no calories, as well as keeps you regular. Soluble fiber though has been shown in studies to lower cholesterol and blood sugar. See http://www.mayoclinic.org/...
Many of these take hours to make. You can do this on weekends, or at times when you are “free” to do this. Make a lot and freeze individual portions in microwavable containers. You've got an item with a known set of ingredients, which has controlled amounts of carbohydrates and sugars. You can re-heat it after you get home from work, or take these to work or school with you for lunch. You can avoid both high-carbohydrate restaurant food with unknown ingredients that can possibly cause youunexpected trouble and high-carbohydrate pre-made frozen dinners. Plus, you get things according to your tastes! You will also likely find this saves money.
I have included recipes for:
Seafood Vegetable Soup
Curried Vegetable Stew
Mikie's Etouffee
Chicken Paella
Deluxe Garbanzo Bean Salad
Portabella Steak
Cheese Grits, Geens, & Beans
Seafood Vegetable Soup
I got this recipe from a man in a Society of Friends group, who was from Australia.
The original recipe uses winter squash as a vegetable. I have, however, had this soup with asparagus, carrots, pumpkin, spinach, or summer squash substituted for the winter squash, and all of those were wonderful. Note that the green, leafy vegetables, sometimes called “free” vegetables on some diabetic diets, make this dish much lower in carbohydrates.
In all cases, one must account for the carbohydrates, sugars, fats, and protein. Note too, that this recipe calls for coconut milk. I haven't found any acceptable substitute for it, but note that coconut milk contains a good deal of saturated fat, which turns into LDL or “bad” cholesterol. For the same reason, note that shellfish are high in saturated fat and cholesterol. Using a non-fatty fish might be a better choice.
Simply measure or weigh what you put in, figure the amount of nutrients in each, divide by the number of servings you make, and you've got the numbers you need to figure this into your diabetic diet.
Ingredients
• 1-2 lbs winter squash, or any other vegetable
• Equal quantity, by volume potatoes, peeled, boiled. Dry beans, boiled, may be substituted to add more fiber.
• 1 6 oz can clams, shrimp, or other seafood, or equivalent fresh.
• 1 12 oz can coconut milk, or equivalent fresh
• 1 dash curry powder
• Salt and pepper to taste
Cooking
• Heat until warm.
• Add salt and pepper to taste.
Yield: 4-8 servings
Serving
• Serve as soup to begin a meal, or serve with whole-grain bread.
Curried Vegetable Stew
This recipe originated in my own mind and my own kitchen. I like vegetables and I like curry. I developed it using "common sense" of cooking, and trial and error over time, or what foods were especially appealing or available that day.
You can make as little or as much of this as you want to, depending on what is available and how big of cookware you have. I make this in big batches, freeze and reheat this for a "quick" and healthful meal.
Since there are so many variations in how this is made, it never comes out the same way twice. If you ever find something you particularly like, write down THEN what you put into it. Send it to me too. I have a few ways I've done this that worked better than others.
Ingredients
• However much of whatever combination of vegetables appeals to you, are on sale, or are plentiful at the local grocery store, your garden, produce stand, or farmer's market. These can be any combination of fresh, frozen, or dried.
• Dry beans
• Panir, or "Indian Farmer's Cheese", farmer's cheese, or ricotta cheese (optional).
• Curry powder.
• Salt, ginger, and other seasonings to taste.
Cooking
• Start dry beans (if using them)
• Begin by preparing "hard" vegetables, such as winter squash, potatoes, rutabagas, beets, or carrots. Peel or scrape and remove stems, roots, or seeds if applicable. Wash. I have found that if I am including winter squash in this, it helps to bake the squash and remove the edible matter. It is FAR too easy to cut yourself with an uncooked winter squash while trying to peel it!
• Boil potatoes and other hard vegetables over low heat.
• Add baked winter squash, and continue to boil.
• Stir occasionally.
• Add curry powder to taste.
• Add "soft" vegetables, such as green beans, peas, tomatoes, broccoli, cauliflower, peppers, or other similar vegetables. add more curry or other seasonings, if desired.
• Add panir or fried Indian cheese, if desired.
• Boil for approximately 20 minutes longer.
• Add "leafy" vegetables, such as spinach or other greens.
• Taste and add curry, ginger or other seasonings, if desired.
Yield: MANY servings - quite variable.
Serving
• Serve hot, over rice
Mikie's Etouffee
The original idea for this recipe came from a telephone conversation with my brother regarding Cajun Gumbo, criticisms of it, and a better suggestion, obtained from his south-Texas fishing buddies.
Ingredients
• 1 lb fish fillets
• 12 oz smoked Keilbasa or other smoked sausage
• 1 lb breakfast sausage (pork or turkey recommended)
• 1 skinless, boneless chicken breast, chopped
• 1 onion
• 2 tbs dried garlic, or equivalent fresh
• 1 green pepper, seeded and chopped
• 1 14 oz can Rotel (TM) diced tomatoes and peppers (original, hot, or habanero)
• 1 teaspoon black peppercorns
• 1 tbs all-purpose flour
• 20 "grinds" black pepper, or 3/4 teaspoon ground black pepper
• 1 tsp Cayenne Pepper
• 2 Tbs Old Bay Seasoning
• 1 Tbs Commercial Crushed Dried red Pepper
• 1 tbs gumbo file
• 1 tsp salt, to taste
• Water
Preparation
• Cut sausages into small rounds
• Chop chicken breast into small pieces
• Cut fish into small pieces
• Chop onion
• Seed and chop pepper
• Chop garlic if using fresh
Cooking
• Place sausage, fish, chicken, onion, garlic, tomatoes, salt and spices to large dutch oven or crock pot.
• Cover with water
• Simmer over low heat for 4-6 hours, stirring occasionally. Add water if necessary.
• Mix flour with
• Mix the flour with the next six spices and seasoning ingredients on the list. Mix with 1 cup cold water.
• Stir the flour mixture into the boiling etouffee. This will cause mixture to thicken.
• Continue cooking over low heat, stirring constantly, for 10 minutes. Taste and adjust spices if necessary.
Yield: 12 servings
Serving
• Serve in bowls over rice.
• This can be filled-out to a full meal by including a green salad and corn bread. For a variation, try serving with Zatarain's Dirty Rice.
Chicken Paella
Several years ago, I was trying to make my cooking lower in cholesterol. This recipe is an adaptation of the recipe Paella with chicken, leeks and tarragon found on the Mayo Clinic's Heart-healthy recipes, http://www.mayoclinic.org/... a site which I highly recommend for their recipe suggestions. I adapted it with the addition of spices used in Spanish chorizo, eliminating the leeks, parsley, and lemon, and including the traditional saffron to the recipe.
Ingredients
• 1 - 8 oz boneless, skinless chicken breast
• 2 medium onions
• 1 bell pepper
• 1 - 15 oz can diced tomatoes
• 2/3 cup brown rice
• 1 pinch saffron
• 1 teaspoon ground cinnamon
• 1/2 teaspoon ground cloves
• 1 teaspoon minced garlic
• 2 tablespoons paprika
• 1/4 teaspoon ground cumin
• 1/4 teaspoon ground oregano
• 1/2 teaspoon hot sauce
• Salt to taste
• 2 cups fat-free chicken broth
• 1 cup frozen peas
• 1 teaspoon extra virgin olive oil
Preparation
• Slice chicken breast into stips, about 1/2 inch wide and 2 inches long
• Slice and quarter onions, or chop very coursely
• Wash and seed bell pepper, and cut into slices
Cooking
• Heat olive oil in heavy skillet over medium heat
• When hot, add chicken strips, garlic, and onions
• Cook, stirring frequently, for about 10 minutes, until chicken is turning white, onions are transparent, and both are browning slightly
• Add broth, rice, spices, tomatoes, and peppers
• Bring to boil, stirring frequently
• Reduce heat, cover, and simmer about 20 minutes
• Add peas
• Simmer about 40 minutes more, stirring occasionally and adding water if necessary
Yield: 2 hearty servings
Serving
• Serve hot in bowls
Deluxe Garbanzo Bean Salad
I got the basic Garbanzo Bean Salad recipe off the side of the Goya can. To me, clearly, it needed more vegetables, it needed whole wheat macaroni instead or regular macaroni, and additional spices. Hence, I called this the Deluxe version.
It is useful to keep something like this salad, something like a 3-bean salad, tomato salad, to allow you to have something to snack on, if you have a problem with that, so as to stay away from things that can cause you more problems with your diet.
Ingredients
• 1 15-oz can garbanzo beans
• 1 cup whole wheat macaroni
• 1 medium cucumber
• 1 anheim chili pepper
• 1 poblano chili pepper
• 1 medium tomato
• 1 medium onion, or 1 large sweet onion
• 1 carrot
• 1 teaspoon powdered garlic
• 1 teaspoon oregano
• 1/2 teaspoon basil
• 1 pinch garam masala (optional)
• 3 tablespoons wine vinegar
• 4 tablespoons extra virgin olive oil
• 1/8 teaspoon freshly ground black pepper
• 1 dash Tabasco or other hot sauce
• Salt to taste (optional)
Preparation
• Prepare macaroni according to package directions. Boil until just "al dente", then drain in colander and rinse thoroughly until cool.
• Drain garbanzo beans and rinse thoroughly.
• Chop all vegetables, seeding or scraping as appropriate.
• In large mixing bowl with cover, combine vinegar, olive oil, hot sauce, and all spices.
• Add vegetables, garbanzo beans
• Mix well.
• Chill for at least 30 minutes.
Yield: 6 Servings
Serving
• Serve in bowls at the start of a complete dinner
Portabella Steak
This recipe was given to me by my friend, Chris. It is an easy and delicious way to cook steak. It is chewable by persons whose teeth may not be the best, yet this is enjoyable by everyone who eats beef.
The wine must be considered as fruit, as it contains sugar. After being boiled for several hours, the amount of alcohol is negligible.
Ingredients
• One "broilable" steak, such as sirloin, t-bone, rib, or such thing, about 12-16 oz. Do Not use round steak or chuck steak.
• 6 oz portabella mushrooms, sliced
• 1/4 cup butter
• 1 tsp pepper corns
• 6 bay leaves
• 1 tbs poultry seasoning
• 1 tsp thyme
• 2 tsp sage
• salt to taste (optional)
• 2 cups port wine (cheap wine is best for cooking)
Preparation
Add all ingredients to large dutch oven or soup pot with lid.
Cooking
• Bring to boil over medium heat. Reduce heat to simmer.
• Check and stir occasionally. Add water if needed.
• Check for flavorings by sampling a piece of mushroom. (This may also stave off the need to stop cooking and eat it).
• Adjust seasonings, as needed.
• Cook for several hours, until the smell has everyone in the household ready to devour it.
Yield: 4 servings
Serving
• Serve with rice or mashed potatoes, and the salad and vegetables of your choice.
• Refrigerate or freeze any leftovers. Reheats on stovetop, oven, or microwave very well.
Cheese Grits, Greens, & Beans
This is a southern recipe. I originally heard it talked about by a friend from North Carolina, and subsequently found discussions of it in several books. My recipe is a "best of" from several of these.
Ingredients
• ½ cup dry black or red beans, or 1 can.
• 10 oz package frozen greens, or equivalent fresh, of any type, or any combination, including the following:
o Mustard greens
o Dandelion greens
o Turnip greens
o Collard greens
o Kale
• 1/8 tsp red pepper
• 1/3 cup quick grits
• 2/3 cup water
• 1/4 tsp salt (optional)
• 1/4 cup + 2 tbs grated cheddar cheese
Preparation
• If using dry beans, soak and boil them until soft. This can be done the evening before.
• Cook greens according to package directions, or rinse and steam if using fresh greens
• Meanwhile, boil the water with optional salt. Add grits, and cook until thick and soft.
• Whisk in 1/4 cup cheddar cheese.
• Pour cooked greens into greased loaf pan.
• Add the cooked beans – warm or cold.
• Cover with grits and cheese mixture
• Top with 2 tbs grated cheddar cheese
Cooking
• Pop under preheated broiler until cheese is melted and bubbly, approximately 3 minutes.
Serving
• Serve hot.
Panic now, while there's still time.
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My blog, Cynics for a Better Tomorrow, the blog for the insufficiently depressed.
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Addition: Mettle Fatigue Kosmailed me some additional informational links, they are included below.
If you're not yet registered at Medscape, it's free (you may have seen my blockquote of intro to medscape at various UpScheds and diaries) and i just found this item today:
http://reference.medscape.com/... — a professional brief educational "quiz" for physicians but anyone can do it.
Some months ago i put together this collection of links: http://www.dailykos.com/...