Supermarket Shopping List

In trying to increase my fish intake to 3 times a week, I have difficulty both affording the fresh fish that is recommended and finding it. As far as food recommendations go, they rarely include "off the shelf" supermarket items. Canned tuna fish for salads or sandwiches can become tiresome.
Surely it would benefit our readers if you listed foods that are appropriate for people with diabetes and that can be found in supermarkets. Also: Do fish oil pills belong on the list?
Jim Kelly
East Lansing, Mich.

Robyn Webb, MS, LN, responds: Congratulations on trying to increase your fish intake! Fish (particularly cold water fish like salmon or trout) provide high amounts of omega-3 fatty acids. There is some limited evidence suggesting that eating fish rich in omega-3 fatty acids may reduce the risk of mortality from cardiovascular disease.
Fish oil pills are okay, especially if you are a vegetarian or don't like fish, because they offer a way to still get your omega-3 fatty acids. But the pills are not a complete substitute for eating fish, which are a great source of protein, B6, B12, iron, and other nutrients that the pills don't provide.
Frozen fish is perfectly acceptable, and it is often less expensive than fresh fish. Just be sure to thaw the fish overnight in your refrigerator. Stock up whenever there is a sale to save money, but be sure to use the frozen fish within 3 months of purchase for the best results.
To revamp your tuna, try a vinaigrette-style dressing instead of mayonnaise. You can also try canned salmon or sardines as a change of pace. Make canned salmon patties. Use sardines in a salad topped with thinly sliced red onion, tomato wedges, and a dash of capers. (You can read more about the health benefits of eating fish in this month's Food for Thought column on page 45.)
When testing and providing recipes, I make every attempt to include foods that are widely available in supermarkets; however, because of seasonal availability, not everything is on sale all the time.
Finally, remember to discuss your meal options with your physician or dietitian, who know best your specific dietary needs.

Still Want More Info

I am very disappointed in the editors' response to Kim Seiber's letter in the October 2008 issue (p. 19). Ms. Seiber's intent in writing appeared to be to request more information as to how people featured in the magazine—in her case, athletes—manage their disease. They obviously are doing something correctly; otherwise you would not feature them.
While it may not be appropriate to include specifics about an individual in the feature article itself, what is to stop Forecast from having an expert comment on common "principles" pertaining to the theme of the article? Forecast does this sort of thing with the Ask the Experts section and Mail Call letters from time to time.
Please also keep in mind that telling readers to "ask your doctor" is unrealistic for many of us. My endocrinologist double books, and does not have a diabetes educator working with him. There simply is not the time to get this sort of information. Over the years, the advances in diabetes management that I use have 90 percent of the time come as a result of me being informed, and bringing this information to my doctor.
I have read Forecast since the mid-1950s. I appreciate the changes that have occurred in the magazine over the years, providing more information and responding to real questions. I hope with the new facelift, you maintain this informative approach, and use some creative thinking to accommodate Ms. Seiber's request. 
Larry W. Spielman
Victorville, Calif.

Editor's Note: For a related editorial, please see "The Informed Patient," page 11.

Congratulations, Forecast

I've been reading Diabetes Forecast for almost 15 years, and I can't remember enjoying an issue more than the October issue. It was a pleasure to read the personal stories of longtime diabetics and (as a Vanderbilt alumnus and someone who has diabetes) my favorite NFL quarterback, Jay Cutler.
Moreover, I felt that the level of scientific and research coverage was both sophisticated and intriguing. Lastly, there was a thread of "diabetes history" throughout the issue that gave a sense of meaning and perspective. Well done!
Daniel Martin
New York

I really enjoyed the article "Long Lives, Lived Well" by Andrew Curry in the October 2008 issue. It helped me better understand the history of diabetes treatment and how far we've come in effectively managing the disease. I plan to send copies of the article to several friends and family members.
Rebecca Watson
Fort Worth, Texas

Andrew Curry's "Long Lives, Lived Well" article was really excellent. The success of William Rounds, who has lived with diabetes for 85 years, and the interesting experiences of the other six who had diabetes for 60 years or more were cleverly intertwined with the significant developments that have occurred in the past 60 years.
I am a 76-year-old type 1 diabetic, and I was diagnosed in 1940 when I was just 8 years old. In 1999, I received the Joslin Diabetes Center medal recognizing that I had been an insulin-dependent diabetic for more than 50 years. They had recently initiated a special 75-year award which only four people had received so far, so I asked them to reserve one for me in 2015.
In October 2000, I published a 300-page book titled My First 22,000 Days with Diabetes, which features a decade-by-decade account of my living successfully with diabetes. I don't know how many diabetics there are who have had it for more than 60 years, but I bet that there are many who would be willing to contribute their stories if Mr. Curry would consider writing more articles or perhaps even a full book.
I know I would be glad to do so.
Art Lockhart
Asheville, N.C.

A Different Kind of Diet

You know what all of your recipes in the November 2008 issue (and all other issues) have in common? The fact that few if any of us will use them!
Personally, I would appreciate it if you'd put the time you spend collecting formulas for diabetic cookies into discussions of the effects of Byetta on the incidence of foot ulcers in users of the drug; or on whether it's possible or not to reverse the effects of peripheral neuropathy; or on how best to store insulin or Byetta on long trips. Now that could be a recipe for a worthwhile magazine!
Lee Quarnstrom
La Habra, Calif.

I believe that the November 2008 issue of Diabetes Forecast promotes the wrong image for a diabetic diet. Some of the articles and ads mask the dangers of carbohydrates in a diabetic's diet. I realize that getting people to improve their eating habits may mean starting where they are in order to lead them to something better; however, you missed an opportunity to say that a better way to achieve a lower blood sugar is to not eat sweets, starchy vegetables, pasta, cereals, and most prepared foods. 
I've been living with type 1 diabetes since 1949, and after starting a low-carbohydrate diet in the summer of 2008, I have achieved better blood glucose control than ever before. I urge you to concentrate future stories on recipes and treatments that will help diabetics achieve a normal life. Do not delude us with appetizing desserts, hidden carbs, and misleading ads. I have learned that everything I eat counts. 
Terry Kuhn
Kent, Ohio

Bring Back the Sweet Stuff

In the November 2008 Forecast, it was all I could do to not eat some of the wonderful recipes!
I have been on insulin for 40 years. When Splenda came out, I was thrilled. However, my system does not like Splenda! My testing spiked from 120 (or less) to 300 to 500 within an hour of eating anything made with Splenda. 
I have read a couple of articles that say Splenda is not for everyone. All but four recipes in that issue of the magazine had Splenda. Could you include a sugar equivalent for the recipes from here on?
Carolyn Ruck
San Jose, Calif.

Robyn Webb, MS, LN, responds: We don't provide sugar equivalents in our recipes in the magazine because it would not be appropriate for most people with diabetes. But let me give you some tips for making our recipes fit your needs. When I want to modify a recipe that would usually contain sugar (but I want to reduce or replace the sugar by using an artificial sweetener), I start out using the manufacturer's equivalent (for example, 1 cup of granular Splenda equals 1 cup of sugar). While this equivalency may be "tweaked" during the testing I do before publishing a recipe, the above "exchange" is usually what I use.
In your case, I would suggest that you try experimenting with the level of pure sugar you can have. For instance, if a brownie recipe calls for 1 cup of sugar, try using ½ cup of sugar. Depending on the recipe, you can try substituting applesauce or juice concentrate in place of sugar or Splenda. It's important to remember that the structures of the ingredients you're using interact in a specific way to create a dish, so these changes may work on some recipes and not on others.

Sweet Tea Substitutes

I am responding to Cherri Dellinger's comment about hating to give up sweet tea (Nov. '08, Question of the Month, p. 16). I have type 2 diabetes and I make my own sweet tea with Splenda—it is fabulous! I brew two pots' worth in my coffeemaker, which generates half a gallon using three family-size tea bags, and I run the water through twice.
Karen Bottomley
Atlantic Beach, N.C.

Lipton makes a powdered iced tea mix that is labeled calorie free, with lemon natural flavor and saccharin. It comes in a 6-ounce jar. Lipton makes other iced tea mixes (some sweetened with NutraSweet), but this one is the best.
Karen L. Cordes
Mt. Prospect, Ill.

Saving on Test Strips

In the December 2008 issue, Kelli Lewis questions the cost of test strips with her health insurance (Mail Call, p. 15).
I had a similar situation, and found a solution. When I was diagnosed with type 2 in 2007, my doctor wrote a prescription for me to use a particular meter. My co-pay for 50 strips was $45! I started buying them online from several diabetes supply companies for about $30 and not even using the insurance.
Several months later, I found out that my insurance treated different brands as "preferred." With a new scrip from my doctor, I now get a 90-day supply of strips for $70. Now I can afford to check my glucose enough times each day to enable me to control it better.
Readers should check with their insurance companies to see if they can enjoy similar savings.
Phil Schwier
Griffith, Ind.