DIABETIC EXCHANGE DIET

What is it? A diabetic exchange diet is a list of serving sizes of foods that you can choose to eat every day. These foods are divided into 6 groups. You need to eat the right number of servings from each food group every day to control your diabetes.
· Carbohydrates from food become blood sugar (glucose) in the body. In diabetes, the body does not make enough insulin, or the insulin it makes does not work properly. This causes the blood sugar to be too high.
· You can help control your blood sugar by limiting the carbohydrate and total calories in your diet. You may prevent kidney, eye, nerve, or heart problems by keeping your blood sugar within normal range.
· You will need to measure your food while on this diet. Most people on a diabetic exchange diet need to eat 3 meals and 1 to 3 snacks every day. You can exchange or trade one food for another from the same food group. For example, 1 slice of bread can be exchanged for 3/4 cup dry cereal. Or you can exchange 1/2 cup fruit juice for 1/2 of a 9 inch banana.

Carbohydrate Intake
· Read the labels of packaged foods to find out how many grams of carbohydrate a serving has in it. Check with your dietitian or caregiver before eating foods with the following:
o Added sugar, corn syrup, honey, molasses, maple syrup, jams and jellies.

· Talk with your dietitian/doctor before eating any foods on the "Carefully Use the Following Foods" section. These foods contain sweeteners that can make your blood sugar too high. You should eat healthy foods with your meals if you eat foods or drink liquids that contain sugar.
· The lists below tell you how much carbohydrate is in each food group. Eat only the amount that is on the food list. You also need to eat foods from the meat/meat substitute list and the fat's list to have a balanced diet.

Other Concerns
· Increase your activity level to help control your blood sugar. Talk to your dietitian/doctor about your exercise plan so your diet can be changed, if needed. You may need extra carbohydrate before exercise to keep your blood sugar from getting too low.
· Choose high fiber foods to help control your blood sugar. Examples of high fiber foods are fresh fruits and vegetables, whole grain breads, cooked dried beans, and bran cereals.
· Talk with your caregiver if your blood sugar levels are too low or too high. Make sure your cholesterol and other blood lipids (fats) are checked at least once a year. A balanced diabetic diet will also help control the amount of cholesterol and other fat substances in your blood.
Serving Sizes:
Use the list below to measure foods and serving sizes. A serving size means the size of food after it is cooked or prepared.
· 1 pint or 2 cups (16 fluid ounces) of liquid is the size of 1-1/3 soda-pop cans.
· 1-1/2 cup (12 fluid ounces) of liquid is the size of a soda-pop can.
· 1 cup of food is the size of a large handful, or 8 fluid ounces of liquid.
· 1/2 cup of food is about half of a large handful, or 4 fluid ounces of liquid.
· 2 tablespoons (Tbsp) is about the size of a large walnut.
· 1 tablespoon (Tbsp) is about the size of the tip of your thumb (from the last crease).
· 1 teaspoon (tsp) is about the size of the tip of your little finger (from the last crease).
· 3 ounces of cooked meat, fish, or poultry is about the size of a deck of cards.
· 1 ounce of cooked meat, fish, or poultry is about 1/4 cup (c).
· One ounce of hard cheese is about a 1 inch cube.
· A serving of vegetables is 1/2 cup (1/2 handful) cooked, or 1 cup (1 handful) raw.
Breads and Starches: Each serving below has about 15 grams carbohydrate. Eat ____ servings a day from this list. Most people need 6-11 servings a day.
· 1 slice bread (4-inch square) or small (2-inch square) dinner roll
· 1/2 cup cooked cereal
· 1/2 cup corn or 1 medium corn on the cob
· 6 saltine crackers or three 2-1/2 inch squares graham crackers
· 8 animal crackers
· 1/2 cup cooked dried beans (like kidney, pinto, lentils, chick peas, white, or navy)
· 1/2 of an English muffin, or hot dog bun, hamburger bun, or frozen 3-inch bagel
· 1/2 cup cooked green peas or lima beans
· 4 slices melba toast or 24 oyster crackers
· 1/2 cup cooked pasta, mashed potatoes, winter squash, or corn
· 1/2 of 6-inch piece pita bread or 1 6-inch tortilla
· 3 cups popped popcorn without added oil or butter
· 1 3-inch baked potato
· 3/4 ounce pretzels or 1 ounce low fat potato chips
· 1/3 cup cooked rice
· 2 rice cakes (4-inches across)
Fruit: Each serving below has about 15 grams carbohydrate. Eat ____servings a day from this list. Most people need 3-5 servings per day.
· 1 medium (3 inch) apple, peach, or orange
· 1 small (5-inch) banana or 1/2 of a large (9-inch) banana
· 17 small or 12 large grapes (any kind)
· 1 kiwi fruit
· 1 cup cubed melon (cantaloupe, honeydew, or others)
· 1/2 of a large (4-1/2 inch) pear
· 1/2 cup pineapple or other fruit canned in water
· 2 small plums or 3 dried prunes
· 2 Tbsp raisins (any kind) or 1/4 cup dried fruit
· 1-1/4 cup whole strawberries
· 1-1/2 cup cubed watermelon
Vegetables: Each serving below has about 5 grams carbohydrate. Only count a vegetable as carbohydrate if you have more than 2 servings per meal. Eat ____ servings per day from this list. Most people need 3-5 servings per day. One serving is 1 cup raw or 1/2 cup cooked of most vegetables.
· Asparagus
· Beets or turnips
· Broccoli, cabbage, cauliflower
· Carrots
· Celery, radishes, or cucumbers
· Eggplant
· Green beans or wax beans
· Kale, mustard, turnip, or collard greens
· Mixed vegetables (without corn or peas)
· Mushrooms
· Onions (all kinds)
· Pea pods
· Peppers (all kinds)
· Salad greens (lettuce, romaine, spinach)
· Summer or zucchini squash
· Tomatoes (fresh or canned)
Dairy: Each serving below has about 12 grams carbohydrate. Eat ____ servings per day from this list. Most people need 2-4 servings per day.
· 1/3 cup nonfat dry milk
· 1/2 cup evaporated milk
· 1 cup skim, 1%, or 2% milk
· 1 cup plain or sugar-free yogurt
· 1 cup skim or low fat buttermilk
Meat / Meat Substitutes: These foods do not count as carbohydrates. The amounts listed below mean cooked serving sizes. Eat ____ portions per day from this list. Most people need 4-8 ounces or portions from this list per day.
· 1 ounce chicken or turkey without skin
· 1/4 cup low fat cottage or ricotta cheese
· 1 inch cube or 1 ounce low fat solid cheese
· 1 large egg or 1/4 cup egg substitute (no more than 3 eggs each week)
· 1 ounce fish (not breaded or fried)
· 1 ounce lean beef, pork, or lamb
· 1/4 cup canned tuna or salmon
· 1/2 cup tofu
Fats: These foods do not count as carbohydrates. Eat ____ servings per day from this list. Most people need 2-4 servings per day.
· 6 almonds or cashews, 10 peanuts, or 4 pecan halves
· 1/8 of a medium avocado
· 1 Tbsp regular cream cheese or 2 Tbsp low fat cream cheese
· 1 tsp oil, like safflower, canola, corn, or olive
· 1 tsp regular margarine or 2 tsp low fat margarine
· 1 tsp regular mayonnaise or 1 Tbsp low fat mayonnaise
· 8 ripe olives or 10 green stuffed olives
· 2 tsp peanut butter
· 1 Tbsp regular salad dressing or 2 Tbsp low fat salad dressing
· 2 tsp sesame butter or tahini
Combination Foods: Each serving contains about 15 grams carbohydrate. Eat ____ servings per day from this list. Most people need 1-3 servings per day.
· 1/2 cup of any casserole, like tuna or chicken noodle, macaroni and cheese, chili with meat, or spaghetti and meat sauce
· 1 cup cream, bean, tomato, or vegetable soup
· 1/8 of a 10-inch pizza
· 1/2 of a store-bought pot pie, like chicken, turkey, or beef
· One 3 ounce taco
Free Food Lists: The foods on this list have very few calories and should not change your blood sugar if you do not eat too much of them. You may have 3 servings a day from this list. Eat only the amount listed and count it as 1 serving.
· 1 Tbsp catsup
· 1 Tbsp unsweetened cocoa powder
· 1 Tbsp fat-free cream cheese
· 1-1/2 large dill pickles
· 2 tsp low sugar or light jam or jelly
· 4 Tbsp fat-free margarine or fat-free mayonnaise
· 1 Tbsp fat-free salad dressing or fat-free sour cream
· 1/4 cup salsa
· 2 Tbsp sugar-free syrup
· 1 Tbsp taco sauce
You may have these foods as often as you want.
· Artificial sweeteners that contain aspartame (ah-spar-tame) or saccharin (sah-kuh-run)
· Bouillon or fat-free broth
· Bubbly or mineral water
· Horseradish
· Lemon or lime juice
· Mustard
· Seasonings, like herbs, spices, garlic, and flavor extracts (vanilla, almond, and others)
· Sugar-free drink mixes or gum
· Sugar-free gelatin without added fruit
· Sugar-free soda pop
· Vinegar
Carefully Use the Following Foods: Do not use these foods until you have talked to your dietitian/doctor. Eat only the amounts that your dietitian has said are OK. These foods contain simple sugars and will increase your blood sugar if you eat too much of them.
· Cake, cookies, and candy, Frosting
· Corn sugar or corn syrup
· Dextrose, glucose, fructose, maltose, and sucrose
· Granola bars
· Honey, molasses, and syrups
· Ice cream, Regular soda pop
· Jelly and jam
· Pie, pastries, sweet rolls, and donuts
· Powdered, brown, or granulated sugar
· Sugar-covered cereals--------------------------------------------------------------------------------------------------------------------------

Libyan Experiences

I have always wanted to share my experiences in life with my friends but thought not worthy of it, till my neighbour, friend and coffee mate encouraged me to Blog down the stories I had been telling him off and on. This is the first one .
In 1974 I went to Libya on deputation to serve in the Libyan Army, this was going to be my first trip abroad. I had got married only a few months ago. Maj.Abdullah Aswad who came to select the doctors from Pakistan told us not bring any thing except for a suitcase of clothes as we were to get a fully furnished accommodation. He also gave us the address to let him know of our arrival date so that arrangements to pick us up may be made. On 6th of Sept 1974 Shahla and myself left for Libya via Jeddah where we wanted to perform Umrah. Not knowing that i needed a special Umrah Visa to do that , we only got the transit Visa for 48 hours. How we performed the Umrah is another story which I will post later.
We arrived Tripoli two days later, to our utmost surprise there was no one to receiver us at the airport, the customs and immigration staff treated us as if we were not supposed to be there and were trying to sneak in their country,to top it all I did not know a word of Arabic and they only knew Arabic, all the signs at the airport were also in Arabic, with great difficulty we manage to come out and started looking for someone to escort us to our hotel, but found none. We were relieved to see Mazhar Hussain (one of Shala's cousin s working in Libya). With his help and his broken Arabic we managed to get a Taxi, and started on a hotel hunt. After about couple of hours and almost all the decent hotels in the city of Tripoli the Taxi driver dumped us at Mediterranean Hotel and refused to take us any where else. Here too we faced the same problem No room since we did not have any reference or any previous reservation neither did we have any local identification, I told the reception clerk that I will sit in the lounge the whole night and will get the letter from army in the morning,my newly wedded wife was very disturbed and confused at the whole episode. the clerk took pity on us and gave us a room with the promise that I will get the letter next day. We stayed in the hotel for almost a month and nobody ever asked for any letter or identification or any other document.
The next day I managed to contact Maj. Abdullah Aswad with great difficulty, a car was sent to fetch me from the hotel. I was told two things, i will get the hotel rent only for two days , No accommodation will be provided by the army, on my reminding him of his instructions at Karachi ,he sarcastically said ,"we gave the best house on the base to your General and he shifted to a private flat after a week most of the senior officer who came before me have shifted out so we decided to give you the money and not the accommodation". That was the end of the subject. I came back to the hotel with a long face with the letter to the manager to accommodate me for two days in the hotel on Army's expense,no body asked me for it and I continued to stay there.
Next day I resumed duty at the Army training center, I was guided to the commanding officer office, on my knocking his door he said "Naam" and I said Shamimuddin, nome thing happened and i knocked again and this time he again said "Naam a little loudly and i repeated my name a little more loudly,he kept writing something and did not even look up , so I knocked again this time more loudly and he shouted very loudly and rather angrily "Naam"and I replied in the same volume , he looked up and started laughing and called me in and told me that Naam means "yes". I was offered Coffee or Miranda (Orange cola ). I prefered to have Coffee, and was offered a small cup of black coffee and a glass of cold water, the first sip of coffee reminded me of most bitter medicine (Quinine) I ever had, thanks for the glass of water which helped me in swallowing the small amount of that bitter coffee that was the end of my coffee. I was instructed to sign the attendance register every morning at the CO's office. The routine began after signing the register I would be offered a drink of coffee or Miranda and then to work . After sometime one day my CO Capt Mustafa asked me that first day I had asked for coffee and never after that I had it again, I told him the reason ,to which he said that from now on i will only get coffee in his office to develop the taste , which i did and now I do not like coffee with milk or sugar.
Now the first day at work , after the bitter coffee I was guided to my room which was in a long trailer on wheels, there were a number of soldiers in uniform standing around , I was introduced to the guy sitting inside wearing a white coat over his uniform, since everyone was speaking only Arabic I did not understand a word , however the they all seem to be very friendly and polite. I was shown to my table and a chair placed in a small portioned room of the trailer, the first patient walks in and sits on the stool next to my table and starts telling me about his ailment in fluent Arabic, I did not understand a word......my nursing assistant comes to my help and tells me in broken English that the patients needs tablets for fever which was given to him.
the day passed and I saw a number of patients in the similar fashion , not knowing what the patients complain or ailment was what was the diagnosis leave alone treatment. After finishing the sick parade I totally felt like a quack. In the evening I visited a col luge of mine who had been here for a longer time, i told him about the morning, he laughed and said it happens to all of us, he then took out a note book and gave it to me,the note book contained the English translation of all the com man medical complaints like fever ,head ache etc, it also had the com man question written in Arabic but Urdu style, he told me that when a patient comes to me i should begin 'what is your problem " written in the book ,the patient will start talking and I can think of any thing i want,once he finishes ,then start asking if he has any of the symptoms mentioned in the note book , and give treatment for that. Thank God most of them were healthy and fit soldiers and did not need treatment, this went on till I learnt to speak reasonably good Arabic.