It is read by those interested in all aspects of diabetes and blindness. But even if you are careful, he says, diabetes can be “mean, nasty and insidious. …
Voice of the Diabetic
Voice of the Diabetic, published quarterly, is the national magazine of the
Diabetes Action Network of the National Federation of the Blind It is
read by those interested in all aspects of diabetes and blindness We show
diabetics that they have options regardless of complications We know that
positive attitudes are contagious
Send news items, change of address notices, and other magazine
correspondence to: Voice of the Diabetic, 1800 Johnson Street, Baltimore,
Maryland 21230; phone: 410 296-7760; e-mail: editor@diabetesnfborg
Find us on the World Wide Web at: wwwnfborg and click on Publications
Copyright 2006 Diabetes Action Network, National Federation of the Blind
ISSN 1041-8490
Note: The information and advice contained in Voice of the Diabetic are
for educational purposes, and are not intended to take the place of
personal instruction provided by your physician, or by your health care
team Discuss any changes in your treatment with the appropriate health
professionals
Voice of the Diabetic
Eileen Rivera Ley
Director of Publishing
Elizabeth Lunt
Editor
Suzanne Shaffer
Art Director
Ed Bryant
Editor
Emeritus
Gail Brashers-Krug
Director, Special Projects
Ann S Williams
Contributing Editor
Tom Rivera Ley
Technology Writer
Cover Photo: Ed Bryant standing with an award plaque from the Diabetes
Action Network of the National Federation of the Blind It reads: Award of
Gratitude, Ed Bryant, Editor, Voice of the Diabetic, 21 Years of
Distinguished, Dedicated Leadership and Service to the Diabetes Action
Network, July 3, 2006, NFB Convention, Dallas, TX
Photograph courtesy of Vicki Palmer
Voice of the Diabetic is published quarterly by the Diabetes Action Network
DAN of the National Federation of the Blind NFB It is read by over
320,000 diabetics and their care-givers who know that with the right
information and support, no diabetic has to feel helpless or hopeless,
regardless of medical complications Voice of the Diabetic is available in
print, audio, and e-mail versions and is the only magazine that focuses
specifically on making life with diabetic complications a lot less
complicated
Voice of the Diabetic: Educate, Empower, Inspire
Voice of the Diabetic
1800 Johnson Street
Baltimore, MD 21230; phone: 410 296-7760
wwwnfborg, click on publications
E-mail:
News items:
editor@diabetesnfborg
Subscriptions change of address: subscribe@diabetesnfborg
To distribute free copies: distribute@diabetesnfborg
To advertise: ads@diabetesnfborg
Note: The information and advice contained in Voice of the Diabetic are for
educational purposes, and are not intended to take the place of personal
instruction provided by your physician or by your health care team Discuss
any changes in your treatment with the appropriate health professionals
Copyright 2007 Diabetes Action Network, National Federation of the Blind
ISSN 1041-8490
Inside This Issue
FEATURE:
Ed Bryants Vision Gave Us Our Voice
by Elizabeth Lunt
Diabetes and Heart Health
by Paula S Yutzy, RN, BSPA, CDE
Dont Ignore Erectile Dysfunction: Its Treatable
by Ed Bryant
Tackling Trans Fats
by Lynn Baillif, MS, RD, LN, CDE
If Blindness Comes
The Unofficial Guide to Low Vision Services
by Eileen Rivera Ley
Pumps Are Possible Even If You Cant See Them
by Tom Rivera Ley
National Federation of the Blind Annual Convention
Letter to Our Leaders
Tribute to Ed Bryant
by Gary Wunder, President, NFB Missouri
Book Review: The Ultimate Guide to Accurate Carb Counting
Healthy Home Cooking
by Healthy
Exchanges
Resource Roundup
Voice of the Diabetic Subscription Form
[PHOTO/CAPTION: Ed at his desk with the Voice Photo courtesy of Vicki
Palmer]
[PHOTO/CAPTION: Betty Walker, Karen Mayry, Ed Bryant, Carol Anderson and
Delores Olson-Diabetes Action Network officers at the National Federation
of the Blind annual convention, Phoenix, Arizona, July 1987]
[PULL OUT QUOTES: Life is not hopeless if you have diabetes and blindness
is not synonymous with inability You can always find a way - Ed Bryant
His dedication and commitment are magnificent and unflagging
- Dr Marc Maurer, President, National Federation of the Blind]
Ed Bryants Vision Gave Us Our Voice
by Elizabeth Lunt
After 21 years as volunteer editor of Voice of the Diabetic, Ed Bryant has
retired Its been a labor of love, and his project has grown beyond his
wildest dreams In 1986, he sent out 600 copies of the brand-new newsletter
to rehabilitation agencies for distribution When he retired in 2006, over
320,000 copies were going out each quarter to subscribers and through
volunteer distributors to health care facilities, community centers and
anywhere people need help managing their diabetes It just took off like
a
rocket, Ed says The Voice has been soaring ever since-thanks to Eds
diligence, dedication and determination to get the word out to fellow
diabetics
Ed, now 62, was diagnosed with diabetes when he was 14 He had perfect
vision until he was 30 He was working as the national manager for a
portrait photography business when he realized that he was asking his
secretary to take dictation on tasks he had always done himself By the
time he made it to an ophthalmologist he had almost no vision in one eye
and the other was going fast The diagnosis: diabetic retinopathy Although
an operation restored vision in one eye, he lost that one about a year
later when a friend accidentally poked him All of a sudden, he was blind
Of course it was a shock he recalls After a pause he adds cheerfully:
The vision was gone, but you have to keep moving in life
And move he did, right to a chapter meeting of the Columbia, Missouri,
National Federation of the Blind NFB Ed had grown up in Columbia and
returned from St Louis when he lost his vision Gary Wunder, president of
the Missouri NFB, recounted in a tribute speech in February, 2007 see p
17 that although Eds career had been snatched away, Ed did not
despair
where others would have Gary recalls that Eds response to his sudden
blindness was: There are coping skills out there and Ill learn them
Once Ed started learning, he was unstoppable
Ed was learning to manage his diabetes without vision, but it irked him to
no end that his mother had to come over and draw his weeks supply of
insulin It was ridiculous, he says, a trace of impatience still in his
voice Refusing to rely on his mother, Ed set about inventing an insulin-
dispensing device that he could use himself The first version, which his
father and brother made for him in a woodshop, was big and bulky, but it
worked Today, he uses the Count-a-Dose available through the NFB and
says he hasnt found anything better
Ed is the first to admit that he did not manage his diabetes as well as he
could have when he was young He thinks better control might have prevented
some of his complications But even if you are careful, he says, diabetes
can be mean, nasty and insidious Ed firmly believes that people need
support to stay with their self-management, which is why he helped to get
the Diabetes Action Network DAN going and stayed with the Voice for so
long Theyre great projects for
the NFB, he says, because there are so
many myths in the public about the blindness part of it-and because so
many people lose vision from diabetes
The link between diabetes and vision loss is why Ed found so much support
from within the NFB His visionary and devoted leadership in developing
and editing the Voice of the Diabetic for years is a true testament to his
commitment and care for diabetics throughout the country, says Dr Joanne
Wilson, Executive Director of Affiliate Action at the NFB Eds
contribution to this important program of the Federation has been second to
none He is one of our most valued leaders
Eds vision to help people with diabetes became the Voice In 1985, DAN was
brand new, but Ed wanted to spread the word that life is not hopeless if
you have diabetes, and blindness is not synonymous with inability He
suggested to DAN founder Karen Mayry that they start a newsletter Great,
he remembers her saying Youre the editor And Voice of the Diabetic was
born
Over the years Ed found inspiration in his work from the many voices of his
fellow diabetics He took hundreds of calls and got hundreds of letters He
remembers one woman in particular whose doctor told her that
she was going
blind and that she would have to stay home and let her husband do
everything for her She called Ed to tell him she knew better than that
doctor-from reading the Voice Thats why he continued; so he could make
sure people living with diabetes would know they have options The NFB is
full of people who prove this every day, he points out They get to where
they want to go, he says You can always find a way
But Ed is realistic about the fight With diabetes, he knows, it can be
long and hard Another reader he recalls was from Argentina and was only
able to get dialysis when she visited the US She eventually died because
the care in her own country was so poor Ed was shocked that she was
literally dying and could not get help or service Her fate renewed his
determination to show people that here in the US we have the resources,
he says People [can] continue to live and enjoy life and take care of
their diabetes
Many readers wrote and called Ed over the years to thank him for his
determination And NFB and DAN executives sing his praises His dedication
and commitment are magnificent and unflagging, states Dr Marc Maurer,
president of the NFB Tom Rivera Ley, a former DAN
president, believes that
Eds work on the Voice will have a positive impact on people for years to
come You could only accomplish something that great with true passion,
says Tom, and Ed has passion for educating people with diabetes
Indeed, Ed volunteers at a summer camp for diabetic children where he shows
them how to inject their insulin and helps them learn self-management He
also leads by example-his own diabetes is now in good control Three times
a week he goes to a gym where he uses a variety of exercise machines to
keep fit He monitors his diet carefully to keep his blood sugar down I
tell people to cheat in moderation, Ed says with a chuckle, maybe one
piece of pie instead of a chocolate cake For the most part, he says, hes
doing very well
So whats next for Ed? He still writes for the Voice and speaks to people
who call for support He spends time with Gail, his wife of 24 years Hes
developed an interest in Civil War artifacts and just had a large display
case built for his home Gary Wunder has invited Ed to help enlarge the
Missouri NFB Many people want a piece of Eds time One thing is certain:
We at the Voice have a tough act to follow Thank you, Ed
——————-
Diabetes and Heart Health
by Paula S Yutzy, RN, BSPA, CDE
Two out of three diabetics will die from a heart attack or stroke, which
means cardiovascular disease is more likely to kill you than any other
complication of diabetes I was dismayed to learn that in a recent survey
of people with diabetes, many did not even identify cardiovascular disease
as a complication of diabetes Yet your risk, just by having diabetes, is
very high You need to know how to stay on top of this threat to your
health Understanding your test results for what I call the Three
Musketeers of cardiovascular disease is a must for all diabetics and their
caregivers I encourage you to find a way to be physically active and watch
your diet as well These steps will help you reduce your risks from
cardiovascular
disease
The Three Musketeers
I call these three factors the Three Musketeers because where you find
one, you often find the others You need to know them by their descriptions
and their numbers
High Blood Sugar
You know that you need to pay attention to the amount of glucose in your
blood The A1c test indicates your average blood sugar level over the
preceding two or three
months The name comes from the fact that the
component of blood to which sugar sticks, and can therefore be measured, is
called hemoglobin A1c High blood sugar is generally regarded as an A1c of
over 65 percent The American Diabetes Association states the A1c goal for
most diabetics is under 7 percent and under 6 percent, if possible, without
significant hypoglycemia Consult your health care provider for an
individual goal
High Blood Pressure
High blood pressure causes stress on blood vessels and contributes to
damage that also leads to kidney failure and retinopathy People with
diabetes should be treated to achieve a systolic blood pressure under 130
mmHg and a diastolic blood pressure under 80 mmHg Many people are on
blood pressure medicine, but are not reaching these targets They should
check their own blood pressure with a sphygmomanometer blood pressure
machine at different times of the day Automatic and talking
sphygmomanometers are available If you get one of your own, take it to
the doctors visit with you and have its accuracy verified by comparing the
reading to what the doctor gets Some people have what we refer to as
white coat syndrome meaning they have an
increase in their blood pressure
when it is checked at the doctors office, but not at home Keep a record
of what you get at home and show it to the doctor when you go to your
visit
High Cholesterol
The cholesterol test measures three types of fats, or lipids, in your
blood You get high cholesterol in two ways: inherit it in your genes if
its in your family health history, and from the fat in meats, egg yolks
and dairy products that you eat
The most dangerous type of blood fat is the low-density-lipoprotein LDL
This is often called bad cholesterol, because it accumulates in blood
vessels and clogs them High-density-lipoprotein HDL is the good kind
of cholesterol that actually works to remove LDL from the blood
Triglycerides are storage and energy fats, and are the most common fat
cells in your body I frequently see diabetics who have high LDL and
triglycerides, and low HDL This combination increases the risk of
cardiovascular disease, and is one you should strive to avoid
Medications and Diet
There are several medications that can be used to lower the LDL Statins
eg Lipitor, Zocor are frequently perscribed Some people have bad
reactions to these and get muscle pain or
cramping; if this happens to you,
notify your doctor immediately You may need to change to another type of
cholesterol medication
I am amazed by the many people with diabetes who take expensive medication
to lower their blood fats and at the same time eat lots of fatty food which
raise their blood fats Every day in my practice I seem to run into someone
on cholesterol medicine who eats eggs, sausage and biscuits with butter for
breakfast and a burger and fries for lunch or dinner If you do this you
are defeating the efforts of the medication to lower blood fats by choosing
to eat these foods
I am also surprised that many people frequently men do not recognize
fatty food for what it is I have devised a simple solution: Put the food
on a napkin and walk away After five minutes, if you see a grease spot on
the napkin that food has too much fat and you should choose something else
to eat
Exercise
You should discuss your exercise plans with your doctor before you begin
If you have not had a stress test, ask if your doctor thinks you should
The stress test allows the doctor to see how your heart is working during
exercise and can identify problems before they become serious
Once
exercise is considered safe, you now have to decide what kind of
exercise you can
do You will begin slowly and gradually increase your activity You might
go to a gym or get a recumbent bike or stepper for use at home Chair
dancing is good for those who have mobility problems Put on your favorite
music cant be a waltz, sit in a chair without arms and dance with your
arms to the music Move your legs to the beat if you like You will be
surprised how much exercise this can be
I remember a patient I had years ago She was a tiny lady of about 70 I
described chair dancing to her and encouraged her to try it When she came
back, she told me that she and her 93-year-old mother would sit in the
kitchen each morning and chair dance to the oldies They laughed and had
a great time I can just see them in the kitchen dancing and giggling
together She reported that they had not had such fun for a long time
When you exercise you should warm up for five minutes by stretching and
easing into your activity Bike, walk, swim or whatever you have chosen
slowly at first Then increase your speed An easy way of judging your pace
is this: If you can talk while you exercise you are going the right speed
If
you can sing Happy Birthday you are not going fast enough, and if you
cant get words out, slow down Some people like to count their pulse, but
I think this is easier
Start exercise sessions with five minutes warm up Then do five minutes
going faster As you get in the exercise habit, increase the middle
exercise time slowly by two to three minutes every few days, until your
complete exercise period is at least 30 minutes This should include
cooling down for five minutes by going slower to give your heart time to
slow down too
The Three Musketeers are also known as the ABCs Do you know your ABCs?
A is for A1c, B is for Blood Pressure and C is for Cholesterol see inside
heart The ABCs are manageable, but I see many who are not managing them
as well as they could A recent report said that only 37 percent of people
with diabetes had an A1c under 7 percent, only 36 percent had blood
pressure under 130/80 and only 48 percent had total cholesterol under 200
mg/dL Only 73 percent had all three in the control range
You can improve this situation and decrease the effects of cardiovascular
disease Until we do, two of every three people with diabetes will die of a
cardiovascular event
Although heart disease and stroke are the leading
causes of death in people with diabetes, they are preventable if you have
your ABCs in control Keep the Three Musketeers away
Diabetes ABCs
A1c under 65 or 7
Blood Pressure under 130/80 mmHg
Cholesterol, Total under 200 mg/dL
HDL over 40 mg/dL for men and 50 mg/dL for women
LDL under 100 mg/dL, under 70 mg/dL is preferred
Triglycerides under 150 mg/dl
———————-
[PHOTO/DESCRIPTION: A couple embraces]
Dont Ignore Erectile Dysfuntion: Its Treatable
by Ed Bryant
If you are a man with diabetes, weve got good news and bad news about your
sex life
The bad news: Men with diabetes are three times more likely to report
having problems with sex than non-diabetic men The most common sexual
problem is Erectile Dysfunction, or ED, sometimes called impotence Even
worse, because ED is such a private issue, many men feel embarrassed to
discuss the problem with their doctor, or even their partner, so the
problem is never addressed
The good news: ED is one of the most treatable complications of diabetes
In fact, over 95 percent of cases can be successfully treated With proven
treatments
available, diabetic men with ED have options It isnt something
you-or your partner-should have to live with
What ED Is-and What It Isnt
ED means the repeated inability to achieve or sustain an erection
sufficient for sexual intercourse Although sexual vigor generally
declines with age, a man who is healthy, physically and emotionally, should
be able to produce erections, and enjoy sexual intercourse, regardless of
his age ED is not an inevitable part of the aging process
ED does not mean:
An occasional failure to achieve an erection The adage is true: It
really does happen to everyone All men experience occasional difficulties
with erection, usually related to fatigue, illness, alcohol or drug use, or
stress It isnt fun, but it is totally normal
Diminished interest in sex ED occurs when a man is interested in sex,
but still cannot achieve or maintain an erection Many men with diabetes
also experience a decreased sex drive, often as a result of hormone
imbalances or depression Decreased sex drive is quite treatable, but it
is treated differently from ED
Problems with ejaculation Such problems often indicate a structural
problem with the penis The most common
treatment is surgical
How Diabetes Causes ED
Human sexual response requires several different body functions to work
properly and together: nerves, blood vessels, hormones, and psyche
Unfortunately, diabetes-and even the treatment for diabetes-can affect many
of these functions
Nerves: One of the most common complications of diabetes is neuropathy,
or nerve damage Erection is a function of the parasympathetic nervous
system, but orgasm and ejaculation are controlled by the sympathetic
system Neuropathy to either system can cause ED
Blood Vessels: Diabetes damages blood vessels, especially the smallest
blood vessels such as those in the penis Diabetes can also cause heart
disease and other circulatory problems Proper blood flow is absolutely
crucial to achieving erection Erection is a hydraulic phenomenon that
occurs involuntarily, says Arturo Rolla, MD, of Harvard University School
of Medicine Nobody can will an erection Anything that limits or impairs
blood flow can interfere with the ability to achieve an erection, no matter
how strong ones sexual desire
Hormones: Diabetes often causes kidney disease, and kidney disease, in
turn, can cause chemical changes in
the type and amount of hormones ones
body secretes, including the hormones involved in sexual response
Psyche: Psychological issues can cause a diminished sex drive, but they
can also lead to ED even when sex drive is fine ED can follow major life
changes, stressful events, relationship difficulties, or even the fear of
ED itself The physiological changes associated with fear can themselves
cause ED
Medications: About 25 percent of ED cases are caused by drugs Many
medications, including common medicines prescribed for diabetes and its
complications, can cause ED The most common offenders are blood pressure
drugs, antihistamines, antidepressants, tranquilizers, appetite
suppressants, and cimetidine an ulcer drug In addition, over-the-
counter medications, including certain eye drops and nose drops, have been
associated with ED That does not mean you should stop taking these
medications Rather, you should discuss them with your doctor to determine
whether a different dosage, an alternate medicine, or additional treatments
will resolve the ED
Treatments for ED
ED is easily and successfully treated If your sex drive is unaffected,
but you experience problems achieving
or sustaining erection for a period
of four to five weeks, you may have ED Talk to your doctor immediately
Dont delay-erectile dysfunction doesnt just go away Additionally, ED
could be a sign of a serious, even life-threatening complication, such as
congestive heart failure or kidney disease Ignoring your ED because its
embarrassing could jeopardize your health
Most men seek treatment from their family doctor, who may or may not be
familiar with the range of treatment options A specialist may be a better
choice Specialists include urologists and doctors practicing at ED
treatment centers
A thorough physical exam and medical history, along with certain laboratory
tests, can help your doctor determine what is causing ED, and then choose
an appropriate treatment The most common treatments for ED fall into four
categories: medications, external mechanical devices, counseling, and
surgery
Medications:
Oral medicines: The best known ED medications are the Big Three: Viagra
sildenafil citrate, made by Pfizer, Inc, Levitra vardenafil HCl, made
by Bayer and GlaxoSmithKline, and Cialis tadalafil, made by Eli Lilly
The three are chemically very similar, and all have proven very
effective
Because they are effective, convenient, and relatively inexpensive about
nine dollars per pill, these medicines have become the treatment of choice
for most men experiencing ED
The main difference among the three is in how long they last Viagra is
supposed to work for between 30 minutes and four hours; Levitra for 30
minutes to two hours, and Cialis for up to 36 hours In addition, Viagra
is slightly less effective if taken with food; Viagra can also cause
temporary abnormalities of color vision
In some cases, however, these drugs may be unsuitable for patients with
heart disease If you are considering one of these drugs and you have
heart disease, as many diabetics do, be sure to tell your doctor In rare
cases, the pills may create priapism, a prolonged and painful erection
lasting six hours or more although reversible with prompt medical
attention
Topical medicines: When the problem is insufficient blood flow,
vasodilators such as nitroglycerine ointment can be applied to the penis
to increase penile blood flow and improve erections The main side effect
of nitroglycerine ointment is that it may give the partner headaches To
prevent this, the man should use a
condom
Penile Injection Medication: This is just what it sounds like Injected at
home directly into the penis, the medication alprostadil produces erection
by relaxing certain muscles, increasing blood flow into the penis and
restricting outflow Although some sources report an 80 percent success
rate, the therapy has disadvantages, such as risks of infection, pain, and
scarring-fibrosis-in the penis, and it may also cause priapism A popular
version of this medication is Upjohn Corporations Caverject The MUSE
System, by VIVUS, involves the same medicine a pellet of alprostadil
applied with an eye-dropper-like applicator, directly into the urethra
External Mechanical Devices:
This category of treatments includes external vacuum therapies: devices
that go around the penis and produce erections by increasing the flow of
blood in, while constricting the flow out Such devices imitate a natural
erection, and do not interfere with orgasm External vacuum therapy
mechanisms are approximately 95 percent successful in causing and
sustaining an erection All are portable, and costs range between 200-
500, covered under most insurance plans and Medicare Part B
The vacuum constriction device
consists of a vacuum cylinder, various sizes
of tension rings, and a vacuum pump, either hand-operated or electric The
penis is placed in a cylinder to which a tension ring is attached Air is
evacuated from the cylinder by means of the pump, creating a vacuum, which
produces the erection The cylinder is removed, leaving the tension ring at
the base of the penis to maintain the erection
Vacuum therapy devices have a few disadvantages One must interrupt
foreplay to use them You must use the correct-size tension ring and remove
it, to prevent penile bruising, after sustaining the erection for 30
minutes Initial use may produce some soreness Such devices may be
unsuitable for men with certain bleeding disorders In general, vacuum
constriction devices are successful in management of long-term ED
Rejoyn is an inexpensive, nonprescription alternative to the vacuum-
actuated devices Described by its manufacturer as a support sleeve, it
does not cause an erection, but rather supports the flaccid penis as if
it were erect one wears it under a condom
Counseling:
The great majority of ED cases in diabetic men have a physical cause, such
as neuropathy or circulatory problems In some cases,
however, the cause
of ED is psychological, including depression, guilt, or anxiety With a
thorough exam, the doctor should be able to determine whether the ED is
psychological or physical in nature If the cause is psychological, your
doctor may refer you to a psychiatrist, psychologist, sex therapist, or
marital counselor Do not view such a diagnosis as an insult Most
psychologically-based ED is easily and successfully treated
Surgery:
There are two kinds of surgery for ED: one involves implantation of a
penile prosthesis; the other attempts vascular reconstruction Expert
opinion about surgical implants has changed during recent years; today,
surgery is no longer so widely recommended There are many less-invasive
and less-expensive options, and surgery should be considered only as a last
resort
The obvious risks are the same that accompany any surgery: infection, pain,
bleeding, and scarring If for some reason the prosthesis or parts become
damaged or dislocated, surgical removal may be necessary With a general
success rate of about 90 percent, any of the devices will restore
erections, but they will not affect sexual desire, ejaculation, or orgasm
Prostheses: Many
different types of penile prostheses are available, in
three categories: rods, inflatable prostheses, and self-contained
prostheses Semi-rigid or malleable rods are the simplest and least
expensive of all Their main disadvantage is that the penis remains
constantly erect, which may cause problems with concealment
Inflatable prostheses are complex mechanical devices that imitate the
natural process of erection Parts are inserted surgically into the penis
and scrotum, and activated by squeezing When erection is no longer
desired, a valve on the pump is pressed, and the penis becomes flaccid
Self-contained single-unit prostheses are similar to the inflatable types,
but more compact The entire device is implanted into the penis When
erection is desired, the unit is activated by either squeezing or bending,
depending on which of the two types of self-contained prostheses is used
Vascular Reconstructive Surgery corrects defects in penile blood vessels
The surgeon may reconstruct the arterial blood supply, or remove veins when
the cause is due to leakage Less than five percent of men with ED may
benefit from vascular surgery
Preventing ED
Like all diabetic complications, ED can occur
even when you have followed
your doctors advice and carefully managed your diabetes Also like all
diabetes complications, ED is less likely to occur with good blood sugar
control Poorly controlled diabetes and high cholesterol increase the
chances of vascular complications, which may lead to ED or other
circulatory problems In addition, regular smoking and alcohol use can
contribute to ED
You are not alone; others have faced these difficulties ED is treatable;
you do have options
————————
Tackling Trans Fats
by Lynn Baillif, MS, RD, LN, CDE
You may have heard that trans fats are going to be banned in certain states
and cities as a public health measure The following will help you
understand what these fats are and why you should minimize them in your
diet
What are trans fats?
Trans fats are manufactured by adding hydrogen to liquid vegetable oil
The result is a product that is solid at room temperature You may have
seen the terms hydrogenated or partially hydrogenated on food labels
This means the product contains trans fat
How do trans fats affect my health?
We used to believe that trans fats were a heart-healthy alternative
to
saturated animal fats Years ago you may have been encouraged to switch
from stick butter to stick margarine However, a growing body of
scientific evidence has shown that this is untrue Trans fats increase the
risk of heart disease by raising LDL bad cholesterol and lowering HDL
good cholesterol thus changing the ratio of HDL to LDL in the body
The Harvard School of Public Health estimates that 30,000 premature
cardiovascular deaths per year could be prevented by replacing trans fats
in the food supply with liquid vegetable oil unsaturated fat
Why are trans fats used in food?
Trans fats were developed in the early 1900s as a low-cost alternative to
butter They are frequently used in packaged food products because of
their extended shelf life This means the cookies, crackers and chips in
your cabinet will last longer without becoming rancid If you look around
your kitchen you may find vegetable shortening like Crisco and stick
margarine, which are both high in trans fats They have a longer shelf
life than butter, which contains no trans fat You can keep the can of
vegetable shortening on your shelf for 1 year Margarine will keep in your
refrigerator for six months
compared to one to three months for butter
What foods have trans fats?
Although stick margarine is high in trans fat, its use accounts for only
one-third of the trans fat intake in the American diet The vast majority
of the trans fat we eat comes from fast food, commercial baked goods and
other prepared foods For example, a donut has approximately three grams
of trans fat and a large order of french fries has approximately seven
grams of trans fat So you can see how easy it is for you to consume the
eight grams of trans fat each day that is the average intake for Americans
How do I know if there are trans fats in foods I buy at the grocery store?
As of January 1, 2006, the Food and Drug Administration has required
manufacturers to include trans fat on the nutrition facts label You will
find it listed underneath total fat Products can be labeled as zero grams
of trans fat if they contain less than 5 grams trans fat per serving So,
you may see partially hydrogenated oil on the ingredient list even though
the label states zero grams of trans fat In such a case, be careful If
you eat a large amount of the product your trans fat intake can add up
Can I continue to eat
trans fats?
According to the American Diabetes Association 2007 Nutrition
Recommendations and Interventions for Diabetes, you should minimize your
consumption of trans fats Although there are trace amounts of trans fats
which occur naturally in beef and dairy products, there is no need to avoid
these foods since the amounts they contain are
negligible
Should I use margarine or butter?
The answer depends on how often you use it and for what purpose If you
rarely use butter or margarine, having whichever you prefer is fine
Otherwise, it is a good idea to explore this question Light butter has
less unhealthy animal fat than stick butter while tub margarine has less
trans fat than stick margarine As a spread, tub margarine with water or
liquid vegetable oil as the first listed ingredient or labeled as no trans
fat is a wise choice If your goal is to prevent food from sticking to a
pan while cooking or baking you can use a vegetable oil cooking spray or
nonstick pans so you do not need to use butter or margarine When
flavoring vegetables, potatoes, popcorn or other foods, try a butter-
flavored powder like Butter Buds It contains no fat If you prefer the
flavor of butter
in your homemade baked goods, try using half light butter
and half regular butter for the fat in the recipe You can also decrease
the fat in the recipe by one-third without changing the texture of the
finished product Another option when baking is to use a fruit puree
applesauce, mashed banana or baby food prunes to replace up to three-
quarters of the fat in the recipe But remember this will increase the
carbohydrate content of the finished product
What else can I do to avoid trans fats?
When dining out, ask what type of fat is used in preparing your food Some
establishments are making an effort to reduce their use of trans fats For
example, McDonalds now uses an oil for cooking french fries that contains
no trans fats Marriott International has undertaken a company wide
program to rid its hotel restaurants of trans fats without compromising
food quality However, it is important to remember that even if fried
foods and baked goods are made without trans fats, they are still often
high in total fat content We will talk about how to manage your overall
fat intake in a future column
—————–
IF BLINDNESS COMES
Welcome to the Voices
newest feature If Blindness Comes is a special pull-
out section on diabetes and vision loss, printed in a larger font If you
know someone living with diabetes and vision loss, please pull this section
out and share it
This issue of If Blindness Comesis sponsored by a generous educational
grant from GlaxoSmithKline
[PHOTO/Description: A man uses a magnifier to read a notice]
The Unofficial Guide to Low Vision Services
by Eileen Rivera Ley
Many people with diabetes experience some vision loss, and getting help can
be confusing For some, the loss comes from retinopathy; for others the
culprit may be macular degeneration or glaucoma While causes and severity
vary, the solution may be the same-low vision services There are
excellent resources for people who are neither fully blind nor fully
sighted, and I hope the following will answer your questions about them
Q: What exactly is low vision?
A: You have low vision if your best corrected visual acuity is 20/70 or
less You are not legally blind until visual acuity drops to 20/200 or
less Incidentally, someone who has no vision is also legally blind
But those numbers dont tell the whole story Visual field loss and blind
spots
have profound effects on vision For example, a blind spot obscuring
your central field can make reading regular print nearly impossible, even
if your visual acuity is 20/20 Specially trained low-vision optometrists
will evaluate functional vision beyond visual acuity
Q: Who uses low-vision services?
A: Anyone with deteriorating or permanently damaged vision The typical
patient is a senior with macular degeneration-the main cause of blindness
Since diabetes is the second-leading cause of blindness, however, low
vision practitioners see many people with diabetes They therefore know
that diabetes self-management goals like measuring insulin and reading your
meter are as important as reading your bills, price tags, or computer
Q: Who provides low-vision services?
A: Optometrists They spend four years learning about the eye, lenses and
visual function, and some get extra training in low-vision services; they
will know the most about prescribing specialized low-vision lenses and
devices Ophthalmologists are medical doctors who specialize in the health
of the eye; they examine all parts of your eyes, prescribe medications, and
do surgery Many can test you for lenses and give you a
prescription for
glasses, but optometrists are the optical experts You need to see both
specialists: your optometrist to help you cope with your low vision and
your ophthalmologist for your eye disease
Q: What are the goals of low-vision services?
A: You and your practitioner will determine these together What is most
important to you? Checking a price tag in the store, studying a road map,
reading the nutrition label, sorting mail, looking up a phone number, and
viewing a theatrical performance are the types of things you might ask
about Finding the right low-vision tools will take time Usually, the
specialist will explore the optical alternatives first by assessing
reading, writing, distance viewing, mobility, and lighting options
Q: What is the Best Way to Work with My Low-Vision Specialist?
A: Ask questions, and make sure your specialist knows you want to hear all
the options Sometimes low vision specialists feel pressured to recommend
only visual solutions because they know how much you want to see Ask them
to recommend anything they think will help you function best, whether their
recommendation makes use of your eyes, your ears, or your sense of touch
Q: How Difficult
is Reading with Magnification?
A: You may need a variety of magnification devices to accomplish your
goals, as they tend to be task-specific In prescribing a reading device,
the practitioner must balance the tradeoffs among magnification levels,
fields-of-view, and working distance The stronger magnifiers require you
to be one inch from the lens, a less-than-comfortable position for
sustained reading Powerful magnifiers also tend to have a small field-of-
view and can enlarge only a few characters at a time These constraints may
reduce reading speed
A trained low vision specialist will systematically evaluate your reading
by measuring speed and accuracy at different print sizes and documenting
the print size of the last good reading Then the specialist will select a
magnification system that converts actual print size to the size you can
see most clearly
Endurance is perhaps the most important factor in determining an optimal
reading system Rarely will a low-vision device enable you to curl up
comfortably with a book and read for hours If the only way you can read
unaided is by holding a book up to your nose, chances are that the reading
system will become more cumbersome and
inadequate as time progresses This
is true even when your visual condition is reported as stable
Q: What are Low Vision Recommendations?
A: Low vision optometrists will provide you with a shopping list of
choices, usually ranging in price and effectiveness, that they think will
help you the most with your pre-determined goals They should explain the
pros and cons of specific systems and introduce non-visual options as
needed If you dont understand, ask questions If information is missing,
ask questions For example, you may be offered lighting advice for your
home, but will need to ask about a plan for times when lighting is not in
your control The low vision optometrist should be realistic about the ease
of use, practicality, and comfort level of a prescribed device
If you have progressive retinopathy you may find low-vision services
frustrating, because prescribed devices may quickly become ineffective as
your condition gets worse In such cases, you should evaluate whether your
time and resources might be better spent in refining non-visual skills such
as typing, Braille, and cane travel
Q: How Can I Be a Wise Consumer of Low Vision Services?
A: Think about your needs, and
insist on getting help The fact that vision
enhancement is technically feasible doesnt automatically make it a good
idea Ask yourself if a low-vision optical system will meet your needs at
home and at work Consider the ergonomics working conditions of a device
Will using the device give you a headache, back pain, or eye strain?
Understand the field-of-view limitations and necessary lighting conditions
Consider portability Will you need training to use the device? Ask about
the usefulness of the device as vision fluctuates, a common complaint of
people with diabetes Selecting low-vision devices is highly individual
During your comprehensive low vision evaluation, ask your provider to lend
you a device to test at home this may not always be feasible
Also consider economics For example, telescopic lenses are a big-ticket
low-vision device and they definitely work Many people with low vision
keep a telescope handy for occasional spotting tasks, but they are
expensive Is the investment warranted? How much benefit will you gain
from the device compared to the cost? Are there community resources that
might assist with the cost? Sometimes state vocational rehabilitation
services and
groups like the Lions Clubs can help
Keep in mind that visual goals change as technology changes, so plan to
return to the low-vision center every few years to see whats new You may
be pleasantly surprised, as I was when I first saw the hand-held CCTV
electronic magnification products
Part of being a satisfied consumer is to understand your own needs and
limitations, as well as the available options Keep traditional low-vision
solutions in perspective; many low-vision people never learn to make the
most of their other senses, so they cling to their visual solutions,
reducing overall efficiency If you are significantly visually impaired or
are legally blind, consider non-visual techniques for reading, such as
audio books Even if non-visual strategies are your second choice today,
familiarity with them will serve as an excellent resource in later years
Having a full range of alternative techniques is always your best bet
You can learn more about your options and meet others with diabetes and low
vision by contacting the Affiliate Action Office of the National Federation
of the Blind, at 410 659-9314
The NFB Diabetes Action Network NFB DAN will hold its annual meeting July
2,
2007, in Atlanta, Georgia The NFB DAN, which publishes Voice of the
Diabetic, is a peer support and action group for diabetics experiencing
complications of their illness The annual meeting will be held in
conjunction with the annual convention of the National Federation of the
Blind
The NFB DAN meeting promises to be exciting and informative This years
theme is Lose to Gain We all know that we should lose weight, but most
people dont know that taking off just a few pounds can really improve your
diabetes management, noted NFB DAN president Lois Williams Glenda
Somerville, a Certified Diabetes Educator, will be the featured speaker,
providing practical advice about losing weight and managing diabetes
In addition, the Voice of the Diabetic team will discuss recent changes in
the magazine and their plans for even more improvement over the coming
year Voice Director of Publishing Eileen Rivera Ley encourages all
readers to attend: We love hearing from our readers Help us make the
Voice great Theres lots of fun to be had Its wonderful to see other
diabetics who are thriving, despite complications, with the support and
encouragement of fellow travelers I hope to meet you
there
The NFB DAN Meeting will be held in Atlanta, Georgia, on Monday, July 2,
2007, at the Marriott Marquis Hotel, 265 Peachtree Center Avenue For
registration information, contact the NFB DAN at 410 659-9314 or on the
web at wwwnfborg/voice For reservations at the Marriott Marquis, call
888 218-5399
Optical Devices
Reading glasses
Magnifiers
Telescopes
Binoculars
Electronic Magnifiers CCTVs
Computer magnification software
Non-Optical Devices
Bold line paper
Felt tip markers
Large-print books
Jumbo-print playing cards
Adapted board games
Large checkbook and registers
Non-Visual Devices
Talking and Braille watches
Talking blood glucose meters
Talking thermometers
Books on Tape
Self threading needles
Talking calculators and clocks
Computer screen readers
Long white canes
——————————
Pumps Are Possible Even If You Cant See Them
by Tom Rivera Ley
Have new designs made insulin pumps more accessible to those of us who
cannot depend on our sight to read their small screens? The answer is a
resounding no Should blind and visually impaired diabetics avoid using
pumps? Again: a resounding no
The number of pump users has grown from
around 10,000 in1990 to an
estimated 250,000 users worldwide in 2006 Competition in this exploding
market has been good for consumers, sparking advances in pump technology
and ease of use Some are even kid friendly Kid friendly, you ask? Yes
Many school-age children with type 1 diabetes now use insulin pumps by
themselves In an effort to target this life-long market, manufacturers
have focused on smaller size and hip new colors and patterns And pediatric
endocrinologists are now prescribing pumps for parents to use with their
diabetic children who are as young as two years old
New features include:
Lots of stylish colors
Smaller size
Wizards to assist in calculating the mealtime bolus
Wizards to assist in calculating a high blood sugar correction bolus
Added safety features, such as waterproofing
Ease-of-use enhancements, such as menu-driven programming
But Voice of the Diabetic readers may recall numerous articles over the
past decade outlining the inaccessible features of these devices
Unfortunately, even with all of these useful or cosmetic advances, pump
manufacturers continue to ignore our voices pleading for an accessible
pump
Almost all pumps on the market
today offer a way to administer a mealtime
or correction bolus accurately without seeing the pump screen, but this is
no advancement from a decade ago, as insulin pumps in the 1990s also had
this feature Whats worse, nearly all of the new advances in convenience
and safety, such as the bolus wizards, variable bolus deliveries and more
powerful basal features are completely inaccessible without the ability to
read the pump screen
I am greatly disappointed as each new insulin pump comes to market without
addressing the accessibility issue But the good news is that the new
models are no less accessible than the old If you want to take advantage
of the unique benefits of an insulin pump over a multiple daily injection
MDI regimen, you can, with very little sighted help at first
I am totally blind and have used an insulin pump successfully for nearly a
decade It offers greater control in preventing low blood sugar and added
convenience when Im on the go Also, the pump is the only way I can match
my basal insulin delivery to the peaks and valleys caused by the Prednisone
I take daily I do need sighted assistance to set the time/date,
preferences and basal profiles But once I have set
those, I manage daily
operation without assistance This includes bolus administration, changing
the batteries, and replacing insulin and infusion sets I am very happy
with my pump and plan to continue using it I must assure you, however,
that as soon as a manufacturer decides to make a truly accessible insulin
pump, I will immediately change to that pump and will announce it boldly
and loudly to all diabetics I know
I am confident that sooner or later, and hopefully sooner, a company will
produce an accessible insulin pump It is the right thing to do, and it is
the smart business thing to do as well The National Eye Institute NEI
states that 40 to 45 percent of diagnosed diabetics have some level of
diabetic retinopathy Furthermore, diabetics are living longer and
healthier lives than ever So even if diabetic retinopathy were not an
issue, glaucoma, cataracts and age-related macular degeneration will be
And the fact is that nearly all pump users would benefit in some way from
pumps that you dont have to see to use Turning on a light is not always
convenient or desired, and poor lighting abounds Pulling out your pump is
not always physically or socially convenient Many diabetics
experience
fluctuating vision: fine one day, relatively poor the next Most pump users
encounter one or more of these circumstances routinely, and all would
benefit from an accessible pump
So, which company will finally listen to our voices and make the smart
business decision? Who will create a fully accessible pump? Only time will
tell, but the first producer stands to reap rich harvests of loyal new
customers, good will, positive press, and competitive advantage Until
then, I will make do with my semi-accessible model, which does allow for
good self-management while I wait
————————
National Federation of the Blind Annual Convention
The NFB Diabetes Action Network NFB DAN will hold its annual meeting July
2, 2007, in Atlanta, Georgia The NFB DAN, which publishes Voice of the
Diabetic, is a peer support and action group for diabetics experiencing
complications of their illness The annual meeting will be held in
conjunction with the annual convention of the National Federation of the
Blind
The NFB DAN meeting promises to be exciting and informative This years
theme is Lose to Gain We all know that we should lose weight, but most
people dont know that
taking off just a few pounds can really improve your
diabetes management, noted NFB DAN president Lois Williams Glenda
Somerville, a Certified Diabetes Educator, will be the featured speaker,
providing practical advice about losing weight and managing diabetes
In addition, the Voice of the Diabetic team will discuss recent changes in
the magazine and their plans for even more improvement over the coming
year Voice Director of Publishing Eileen Rivera Ley encourages all
readers to attend: We love hearing from our readers Help us make the
Voice great Theres lots of fun to be had Its wonderful to see other
diabetics who are thriving, despite complications, with the support and
encouragement of fellow travelers I hope to meet you there
The NFB DAN Meeting will be held in Atlanta, Georgia, on Monday, July 2,
2007, at the Marriott Marquis Hotel, 265 Peachtree Center Avenue For
registration information, contact the NFB DAN at 410 659-9314 or on the
web at wwwnfborg/voice For reservations at the Marriott Marquis, call
888 218-5399
Will you need dialysis in Atlanta?
If so, have your home dialysis unit contact a unit in Atlanta well in
advance You can work with your social
worker or unit coordinator for
reservations Information on dialysis centers in every state is available
at 1-866-889-6019 or at wwwdialysisfindercom Remember, you must have a
transient patient packet and completed physicians statement when you
arrive for dialysis
Diabetes Action Network Annual Meeting
Featuring:
Lose to Gain theme
Information about the latest technologies for diabetes management
An extensive exhibit hall
Special recognition for anyone whose A1c is less than seven for our
Less Than Seven by 7/07 initiative
A chance to connect with other diabetics experiencing complications
The annual election of NFB DAN officers
NFB Convention is Really a Reunion
by Anil Lewis
As I was growing up, the third Sunday in August was always rejuvenating
because my extended family from around the country came to my grandmothers
little house in Woodville, Georgia, for our family reunion
Fortunately for me I have another extended family, and from June 30
through July 6, 2007, approximately 3,000 of my sisters, brothers, aunts,
uncles, nieces, nephews, and cousins will be attending the largest family
reunion of blind people in the country Most refer to this week of
fun and
fellowship as the annual convention of the National Federation of the
Blind
This year Tour Day falls on Independence Day, Wednesday, July 4, and there
is so much to do in Atlanta The Marriott Marquis is only a few blocks from
Centennial Park, which is sure to have an outstanding Independence Day
celebration Also the Georgia Aquarium and the new Coca-Cola Museum are in
walking distance of the hotel Conventioneers will be a short MARTA train
ride away from Underground Atlanta or Lenox Square, which, in addition to
being a wonderful shopping experience, will provide an entertaining
atmosphere on the holiday The Georgia affiliate is arranging
transportation for those who would like to visit the Martin Luther King Jr
historic site or the Carter Center Library
Even as we make plans to have a grand old time, we must remember the real
reason for the reunion A full agenda of presentations will cover an array
of issues that are important to the nations blind Our national-office
staff will no doubt have a mix of training sessions on advocacy, self-
determination, and strategies for collective action that will educate and
empower The convention provides a real opportunity to remind
ourselves and
others about the true potential of the blind I cant wait to see yall in
Atlanta
Join us in Atlanta
June 30 - July 6
To register, visit wwwnfborg or call the NFB at 410-659-9314
The 2007 convention of the National Federation of the Blind will take place
in Atlanta, Georgia, at the Marriott Marquis Hotel at 265 Peachtree Center
Avenue, Atlanta, Georgia 30303 For room reservations call 404 521-0000
or 888-218-5399
The Marriott has several excellent restaurants and features indoor and
outdoor pools, solarium, health club, whirlpool, and sauna Convention room
rates are: singles/doubles, 61; triples/quads, 66 per night, plus a 15
percent sales tax The hotel is accepting
reservations now A 60-per-room deposit is required Fifty percent of the
deposit will be refunded if you cancel your reservation before June 1,
2007 The other 50 percent is not refundable
Rooms will be available on a first-come, first-served basis but the special
rates will not be available after June 1, 2007
——————-
Letter to Our Leaders
Drs Maurer Wilson:
I am a current member of the National Federation of the Blind here in the
wonderful state of
Nebraska I was recently diagnosed with type 2 diabetes,
and began treatment including medication, diet changes and exercise Upon
discovering that checking my blood sugar would be a regular thing, I joined
the Diabetes Action Network DAN and the diabetes talk list on NFBnet
Let me tell you what I have gained in just a short time of involvement with
this wonderful group of people:
1 Information:
Carb counting was new territory for me; planning balanced meals a new
frontier I knew I needed a map of sorts for navigating this new
territory The people on the diabetes list referred me to articles from
Voice of the Diabetic that had the very information I needed for planning
meals, among other things I found articles on finger-sticking techniques
for doing the blood sugar checks on a glucometer and even dealing with
stress There is a wealth of information to be found in Voice of the
Diabetic, and Ive only scratched the surface
2 Support:
I admit, despite knowing that diabetes is in my family, I took the
diagnosis very hard Upon joining the diabetes talk list, I found
immediately a network of people who because of their love, encouragement,
camaraderie, understanding and so much
else is more aptly described as a
familymuch like the Federation as a whole In fact, Ill go so far as
to say that the DAN is a family within the Federation family I say this
because they have shown love and support and affirmed me at times I felt
afraid especially of the finger sticking, and reminded me that its okay
to be afraid, but its what you do with that fear-how you handle that fear-
that matters Iwish that I [could] meet these people in person and
give each and every one of them the biggest bear hug my six foot frame
would allow
Thank you for taking the time to read this I felt it important for you to
know just what the Diabetes Action Network and Voice of the Diabetic means
to someone like me
Sincerely,
Alan Wheeler
Editors notes: Dr Marc Maurer is President of the National Federation of
the Blind; Dr Joanne Wilson is Executive Director for Affiliate Action To
join the National Federation of the Blind/Diabetes Action Network chat list
via the World Wide Web, visit
http://wwwnfbnetorg/mailman/listinfo/diabetes-talk or, via email, send a
message with subject or body help to diabetes-talk-request@nfbnetorg
You can reach the person managing the list at
diabetes-talk-
owner@nfbnetorg
—————–
Tribute to Ed Bryant
February 10, 2007
by Gary Wunder, President NFB Missouri
People come to blindness in different ways-some by birth, some by accident,
some by age, but many by medical conditions we cant yet prevent Not only
do people come to blindness differently, but they react to it differently
as well Some view it as a tragedy which soon becomes their reason to have
someone else do all of the work which should be theirs Others come to
think of blindness as a disadvantage but one they can use to their benefit:
Im blind; I can stay home; this misfortune, as bad as it is, has given me
a life-long income, so Ill enjoy the internet, my music, Ill become an
expert on Ebay Again, the message is the same: Ill let someone else
take care of me
Ed, as much as anyone, had these options Not only did blindness take his
vision, but it took his livelihood I know blind people who enjoy
photography, but I dont know any blind photographers, and this is the
profession blindness snatched away from our friend
So, how did he react? He looked at blindness and said: There are coping
skills out there and Ill
learn them He looked at the source of his
blindness, diabetes, and again he said: There are coping skills out there
and Ill learn them What he did next is the reason were here today He
didnt stop with learning and inventing skills-he decided to share them
Share them with his family and friends? No, not Ed-our friend decided if he
had skills to share, hed share them with the world, and what better way to
do that than through the written word?
In his quest for a partner to help in this sharing, Ed found an ally in the
National Federation of the Blind, and together they started a publication
which has been the voice of hope for many who feared their lives were over
Through Eds voice, and the voices of hundreds of his fellow travelers,
people have learned that blindness and diabetes dont have to mean living
in a nursing home or forever depending on someone else to draw and
administer medication, fix meals, do laundry, and carry on all the life
activities many of us take for granted
To the man who could have retired 20 years ago and considered himself
deserving of pity and care, we today come to say Thank you for charting a
different course To the man who has taught so many to
use a needle, and
who has needled so many of us, diabetics or not, to do more than we would
otherwise do, we meet here today to tell you how much you mean to all of
us
And now that much of your work is over in starting and running the
publication so aptly named The Voice, I come to recruit you for yet another
Federation task-help us grow the NFB of Missouri in the same way you have
helped to grow the Diabetes Action Network You deserve the right to
retire but we hope that youll pass on that, as you did once before, and
start another phase of changing what it means to be blind
Members of the NFB in Columbia, Missouri, gave a party to honor Ed Bryant
on February 10, 2007 Gary Wunder, president of the NFB of Missouri,
delivered this speech at the event
Book Review: The Ultimate Guide to Accurate Carb Counting
If you administer mealtime insulin, being off by 10 or 15 carbs can make a
difference But carb calculations can be complicated Does sugar free
mean no carbs? How does fiber content affect carb count? What is the
glycemic index, anyway? And how does that exchange list work?
Gary Scheiner, type 1 diabetic and certified diabetes educator, answers
these questions and
many others in his new book, The Ultimate Guide to
Accurate Carb Counting Scheiner writes with a witty and engaging style
that makes reading a pleasure as he takes an in-depth look at all aspects
and theories behind carb counting He explains how to understand food
labels, make estimates for unlabelled foods, and cope with eating out Four
Tool Kits entitled: Exchange Lists, Carbohydrate Factors, Glycemic Index
Values and Carb Listings for 2,500 foods round out the excellent
information in this very useful book Scheiner makes a sometimes-
complicated subject as simple as pie apple, small slice 46 carbs
————————-
Healthy Home Cooking
by Healthy Exchanges
Hi Thanks for joining us in the kitchen again, where the cooking is easy
and the food is both healthy and tasty Enjoy
Are you trying to reduce your sodium intake? Good for you; youre doing
the right thing Lowering your sodium will help drop your blood pressure
and benefit your cardiovascular system On average, you should consume less
than 2,300mg of sodium per day Foods with 200mg of sodium or more per
serving are considered high-sodium, foods with less than 140mg per serving
are
low-sodium
Here are some foods that you may not have thought of as high-sodium foods
Deli meat: 1oz - 396mg or more
Packaged pudding mix: 1/2 cup serving made with milk - 470mg
Ketchup: 1 tablespoon - 167mg
Soy sauce: 1 tablespoon - 1029mg
Canned soup: 1 cup - 1000mg
Chili: 1 cup - 1200mg
TV Dinner: 1150mg
Pizza: 1 slice - 900mg
To help maintain a low salt intake try some of the following tips:
Dont use salt at the table, and reduce the salt used in food preparation
Try 1/2 teaspoon when recipes call for 1 teaspoon Many cakes and desserts
can be prepared without adding salt Use herbs and spices for flavoring
meats and vegetables instead of salt If you prefer a pre-mixed spice blend
make sure it does not include salt Avoid salty foods such as processed
meats deli, pickles, soy sauce, salted nuts, chips and other snack foods
Three more salt-reducing quick tips to keep in mind in the kitchen: Dont
add salt to dried beans before you cook them as it will prevent them from
getting soft Dont salt meat or a roast as youre browning it Salt
draws out moisture so it will stay more moist if you leave salt out of the
process And finally: If you mistakenly add too much salt to a dish
youre
preparing, drop in a potato and continue cooking The potato will help to
absorb the extra salt
Now for our Recipe Low-Salt Makeovers:
MP of IA sent this recipe to be revised from a 50s recipe into a recipe of
today, using the great food items that are now available in the grocery
store
CONGEALED AMBROSIA SALAD
1 4-serving package JELL-O sugar-free orange gelatin
1/2 cup Splenda Granular
1 cup boiling water
1 8-oz can crushed pineapple, packed in fruit juice, undrained
1/2 cup no-fat sour cream
1/2 teaspoon coconut extract
1 11-oz can mandarin oranges, rinsed and drained
1 8-oz can pineapple tidbits, packed in fruit juice, drained
1/4 cup flaked coconut
1/4 cup chopped pecans
In a large bowl, combine dry gelatin, Splenda, and boiling water Mix well
to dissolve gelatin Refrigerate for 15 minutes Stir in undrained
crushed pineapple, sour cream, and coconut extract Add mandarin oranges,
pineapple tidbits, coconut, and pecans Mix well to combine Spread
mixture into an 8-by-8-inch dish Refrigerate until firm, about 3 hours
Cut into 8 servings
Serves 8 - Each serving equals: 101 Calories, 3g Fat, 1g Protein, 15g Carb,
60mg Sodium, 29mg Calcium, 1g FiberDiabetic Exchanges:
1 Fruit, 1 Fat
Carb Choices: 1
MS of OH, sent in a great way to serve chicken
CHICKEN SALAD ORIENTAL
1/3 cup Land O Lakes no-fat sour cream
1 8-oz can pineapple tidbits, packed in fruit juice, drained and 2
tablespoons liquid reserved
1/2 teaspoon ground ginger
2 cups diced cooked chicken breast
1 8-oz can sliced water chestnuts, rinsed, drained and coarsely chopped
2 tablespoons sliced green onion
4 lettuce leaves
1/4 cup slivered almonds
In a large bowl, combine sour cream, reserved pineapple juice, and ginger
Add chicken, pineapple, water chestnuts, and onion Mix well to combine
Cover and refrigerate for at least 15 minutes For each serving, place 1
lettuce leaf on a plate, spoon about 1 cup chicken mixture on lettuce, and
sprinkle 1 tablespoon almonds over top HINT: If you dont have
leftovers, purchase a chunk of cooked chicken breast from your local deli
Serves 4 - Each serving equals: 242 Calories, 6g Fat, 25g Protein, 22g
Carb, 89mg Sodium, 68mg Calcium, 4g Fiber Diabetic Exchanges: 3 Meat, 1/2
Fruit, 1/2 Fat, 1/2 Vegetable
Carb Choices: 1 1/2
We hope you enjoyed our time together in the kitchen Remember, if youd
like us to revise one of your family favorites so
its healthier, send your
request to: Healthy Exchanges, PO Box 80, DeWitt, IA 52742 Also, be
sure to visit our Web site at wwwhealthyexchangescom for more common
folk healthy recipes to try Until next time
——————–
Resource Roundup
Note: Resources mentioned below do not imply endorsement by the Diabetes
Action Network of the NFB
The National Kidney Foundation can assist diabetics
The National Kidney Foundation NKF publishes a variety of informational
materials about diabetes and chronic kidney disease The NKF also provides
resources and support for those undergoing dialysis or kidney transplants
The NKF seeks to prevent kidney and urinary tract diseases, improve the
health and well-being of individuals and families affected by these
diseases, and increase the availability of all organs for transplantation
For more information, call the NKF at 800 622-9010, or go to
wwwkidneyorg
Bilingual Talking Glucose Meter
The Prodigy Autocode delivers clear, audible readings in both English and
Spanish, is affordable and fits in your pocket No coding is necessary and
youll have results in six seconds You may be eligible for a free meter
Call
toll free: 866 540-4815
Talking microwave
Bravo to Hamilton Beach for their Talking Microwave Product 87106 and
87108 This machine is available at retail stores such as Walmart and
Best Buy for under 100, a remarkable achievement considering that most of
its predecessor talking microwaves averaged well over 300
Amazing new reading device that talks
The new Kurzweil-National Federation of the Blind reader is a portable hand-
held device that talks Simply position over documents, nutritional labels,
book pages, recipes, etc and the tool will read the contents aloud The
retail price of this revolutionary new product is 3,495 but for a limited
time the NFB is offering a 200 discount A new feature enables the reader
to identify paper money For more information or to order, call 877 708-
1724 or to go wwwnfborg
Accessible Glucose Meter
The new Advocate is compact, it talks, and its display is clear and bright
The meter uses capillary action, touchable test strips and tests across a
20mg/di range, with a tiny blood sample Contact the retailer: Diabetic
Support Program, 3381 Fairlane Farms Road, Wellington, FL 33414; telephone:
800 990-9826 wwwprescriptionspluscom
A wealth of
information at one site
DiabetesXChangeorg is a new online clearinghouse for promising initiatives
in diabetes care, prevention and management in the US Whether its a
small community-based initiative, university-sponsored effort, corporate
wellness program or large government project, visit the Web site to learn
more
Help for Diabetic Amputees
The mission of The Amputee Coalition of America ACA is to reach out to
people with limb loss and to empower them through education, support and
advocacy This includes access to, and delivery of, information, quality
care, appropriate devices, reimbursement, and the services required to lead
fulfilling lives The ACA publishes InMotion,
a magazine that addresses topics of interest to amputees and their
families The ACA toll-free hotline provides answers and resources for
people who have experienced the loss of a limb In addition, the
organization develops and distributes booklets, video tapes,
and fact sheets to enhance the knowledge and coping skills of people
affected by amputation To contact the ACA, call 888 AMP-KNOW 888-267-
5669, or check out the Web site at wwwamputee-coalitionorg
Talking health-monitoring devices
You can buy a
number of useful medical tools, such as the Lo-Dose Count-A-
Dose tactile insulin syringe-filling tool, a talking blood pressure cuff, a
talking digital thermometer, and a talking prescription bottle reader
Prices are reasonable, and in some cases the lowest anywhere Enhance your
independence and health Contact the NFBs Independence Market at
telephone: 410 659-9314 select option 4 from the voice menu; Web site:
wwwnfborg
Low Vision Tools
The NFB Independence Market has many useful assistance aids for low vision
individuals If you need assorted magnifiers, low-vision felt-tip pens or
large-print items such as address books, calendars or check registers, you
will find them among the useful items in the market Contact the NFBs
Independence Market at telephone: 410 659-9314 select option 4 from the
voice menu; Web site: wwwnfborg
Full Service Diabetes Supplier
Access Diabetic Supply promises free glucose monitors, delivery, and in-
home training in the use of blood glucose testing devices Your private
insurance is welcome, and they accept Medicare, too Check them out online:
wwwdiabeticsupplycom or call: 800 285-1430
Read the Paper by PHONE with NFB-NEWSLINE
NFB-NEWSLINE makes
daily newspapers and magazines accessible by phone
Users listen to the news via synthesized voice No computer is needed and
it is FREE New feature: national television listings To subscribe
contact: NFB-NEWSLINE, 1800 Johnson Street, Baltimore, MD 21230;
telephone: 866 504-7300
Diabetes Supplies
American Diabetic Supply, Inc, will ship your diabetes supplies to your
door They handle all insurance claims and provide free delivery Those
with Medicare and/or private insurance no HMOs may receive supplies at no
further cost For information, contact: American Diabetic Supply, Inc,
telephone: 800 453-9033, ext 611; Web site:
wwwamericandiabeticsupplycom
Flying With Insulin or Supplies?
Terrorist activity has caused the United States Transportation Safety
Authority, the TSA, to limit carry-ons What about insulin, glucose
tablets, and other diabetic supplies?
Passengers may bring insulin on board as long as the prescription label
matches the name of the traveler For more details go to: wwwtsagov
NOTE: wwwdiabetesandtravelcom also contains useful advice for diabetic
travelers, for example, how to manage time zone changes
Support for Self-Management-and a Free Meter
Liberty Medical
can help Medicare patients with low-cost supplies delivered
to your door They also offer healthcare professionals on the telephone and
reminders when you may need refills Call 800 786-9835 to ask about your
free meter
Attention Voice Readers
We will be sending out a survey to randomly-selected Voice readers soon If
you get one, please fill it out and mail it back Tell us what you want to
read about Tell what you think would make Voice of the Diabetic more
useful to you
Your opinions are vital to our continued success
Thank you
voice of the diabetic
SUBSCRIPTION FORM
Order Your Free Subscription TODAY
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Voice Subscriptions are offered free of charge, but cost the NFB about 20
per year Your charitable donations are most welcome Thank you
Return to: Voice of the Diabetic
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phone: 410 296-7760
email: subscribe@diabetesnfborg
wwwnfborg/voice
March for Independence
Join our Voice of the Diabetic Team, as we March for Independence this
summer
Voice readers, writers, staff and supporters will come together to
participate in the National Federation of the Blinds March for
Independence, in Atlanta, Georgia, on July 3, 2007 at sunrise Cant be
there with us in Atlanta? Join us in spirit by sponsoring a marcher To
learn more, call the NFB at 410 659-9314, extension 2406, or visit us on
the Web at wwwmarchforindependenceorg
