L.B. Morse Plays It As It Lays : Diabetes calls for vigilance and dietary restrictions. But for this teenager, the diagnosis was a gift that has given him life.
L.B. Morse is a busy guy. At 17, he likes to hike, swim and ride mountain bikes, and he keeps up his grade-point average at LaSalle High School in Sierra Madre by studying a lot. He has a part-time job as a “coffee-jerk” at a local coffee bar and he’s the stage manager in the theater department at his high school. He’s also on the student council. For fun, he likes to go dancing.
But in 1989, Morse found himself in the hospital. He’d become ill when he was away at science camp at Lake Arrowhead. At first, it was thought he had the flu. By the time his problem was correctly diagnosed as Type I diabetes, he was in diabetic shock, slipping in and out of consciousness. His blood sugar level had skyrocketed to 700 (normal is 70 to 120), and he was in intensive care.
In the hospital, along with being tested and jabbed and fed through a tube, he learned why his breath often smelled like nail polish remover, why he was tired, grouchy and thirsty and why he was losing weight and just not feeling well. Those are symptoms of diabetes.
He was also told before leaving how his life would change--that he would have to prick his finger two or three times a day to monitor his blood sugar levels and then inject himself with insulin. And he was told his diet would change: no sweets or sodas or junk food.
It was his 11th birthday, and although it doesn’t sound like much of a party, he considers the experience a gift.
Type I diabetes is usually found in children and young adults. Because their bodies do not produce the insulin they need to break down glucose, they must inject it. Type II diabetes commonly starts later, typically in overweight adults 40 or older. That type of diabetes is usually not insulin-dependent and can normally be controlled by diet, weight loss and exercise.
Without treatment or monitoring, both types can cause blindness, kidney failure and poor circulation, which ultimately may require the amputation of a limb.
Of the 13 million people who have the disease, says the American Diabetes Assn., only half are aware of it.
“Being diagnosed is not the end of your life,” Morse says. “I’m much more careful about my health, and so I feel better. It’s more of a beginning.”
The challenge for people with diabetes is to balance insulin, exercise and diet. Each diabetic should follow a diet designed by a doctor and/or a dietitian. Age, need for weight loss, regular physical activity and gender are factors in determining diets.
One component of the diabetic diet is the exchange list system. There are starch and bread, meat, vegetable, fruit, milk and fat exchanges, and each has an established nutritional value. The total carbohydrates, fat and proteins provided in a diet correspond to the exchanges each person with diabetes is allowed in a day.
Because Morse is so active, and because he has been eating carefully for six years, he tends not to be hyper-vigilant about exchanges and instead adjusts his insulin and diet according to his blood-sugar readings.
Registered dietitian Mary Donkersloot says this is common practice with people who have difficulty sticking to a strict diet. At first, they follow the regimen using the exchange system, but in frustration they may then abandon healthy eating or find themselves bingeing. Then the troublesome symptoms return.
For the parents of an active adolescent, this poses a problem.
“We found ourselves really nagging him a lot,” says his father, Bill Morse. “It became a family joke: Did you feed the dog? Did you take your insulin? All that nagging really pushed his buttons. We don’t nag him about it anymore, because it’s important for him to develop his own independence and sense of responsibility. It’s important for him to be responsible for managing his own disease.
“Still, when you’re a teenager, you think you’re indestructible. And mistakes he makes today could affect him in years to come.”
Donkersloot encourages the people she works with to develop a rhythm to their meals, snacks, exercise and insulin. She stresses balance and variety in menu planning.
“It’s good to start out with the exchange system because it provides a framework when diabetics begin their new regimen,” she says. “We hope these guidelines for eating become internalized and become second nature. Too much structure can sabotage a person.”
L.B. Morse’s favorite cook is Allan Parachini, a friend of the family who cooks with a minimum of salt and fat. In fact, for Christmas, Morse asked Parachini for cooking lessons. When Morse and his family visit for dinner, Parachini says, he makes few changes, except for staying mindful of sugar consumption.
“Since L.B.’s dietary guidelines stress consistency of intake, diet composition and meal timing,” Parachini says, “there are never any surprises about what’s for dinner when L.B. comes to our house. The menu and dinner time are always arranged in advance. Dessert is either brought by L.B. or chosen with an eye to sugar avoidance.”
The following recipes, adapted from Parachini’s, are favorites of Morse. Keep in mind that he is an active teenager who takes insulin readings often. If you have diabetes, check with your doctor and/or dietitian before adding any of these recipes to your diet.
ROMAINE SALAD WITH CREAMY VINAIGRETTE
CREAMY VINAIGRETTE
1 tablespoon mayonnaise
1 teaspoon lime juice
2 tablespoons sherry
1 tablespoon red wine or sherry vinegar
1/2 cup safflower oil
1 teaspoon olive oil
1 teaspoon dried oregano or 2 tablespoons fresh
1 tablespoon dried tarragon or 2 tablespoons fresh
Salt
Freshly ground black pepper
Combine mayonnaise, lime juice, sherry, vinegar, safflower and olive oils, oregano and tarragon in mixing bowl. Whisk vigorously until thoroughly combined. Season to taste with salt and pepper. Pour into jar and refrigerate until ready for use.
ROMAINE SALAD
1 head romaine lettuce
1/4 large red, yellow or orange bell pepper, cut in very thin strips
3 slices jicama, cut in strips
1 carrot, shredded
4 Roma tomatoes, quartered
Separate romaine leaves into small pieces in salad bowl. Top with bell pepper, jicama and carrot. Arrange tomato wedges on top.
To serve salad, remove dressing from refrigerator and allow to return to room temperature. Shake well and pour over salad.
Makes 6 servings.
Each serving contains about:
226 calories; 28 mg sodium; 82 mg cholesterol; 21 grams fat; 6 grams carbohydrates; 2 grams protein; 1.02 grams fiber.
Exchanges: 1 vegetable; 4 fat.
HOT AND SWEET ITALIAN SAUSAGE RAGU OVER PENNE
2 teaspoons olive oil
3 hot Italian sausages
2 sweet Italian sausages
1 red onion, chopped
4 to 5 cloves garlic, peeled and minced
1 1/2 cups hearty red wine
1 (28-ounce) can salt-free crushed tomatoes
Freshly ground black pepper
2 tablespoons chopped fresh oregano or 1 teaspoon dried
1/4 cup chopped fresh basil or 2 teaspoons dried
1 tablespoon chopped fresh sage or 1/2 teaspoon dried
1/2 bunch Italian parsley, chopped fine
3/4 large red, yellow or orange bell pepper, chopped
1 pound Italian penne rigate pasta
Heat 1 teaspoon olive oil in 3-quart saucepan over medium heat. Add hot and sweet sausages and cook, covered, until browned. Remove and drain on paper towels.
Remove fat from saucepan and add remaining teaspoon oil. Add onion and garlic and cook over medium heat, stirring frequently. As onion softens, add 1 cup wine and crushed tomatoes and stir until dissolved. Add black pepper to taste, oregano, basil, sage and parsley. Stir. Add bell pepper and stir again. Add remaining wine. Cut sausage into 1/2-inch slices and add to sauce.
Cook pasta in plenty of rapidly boiling, lightly salted water until tender. Drain
Serve in pasta bowls, with sauce spooned on top.
Makes 6 servings.
Each serving contains about:
209 calories; 133 mg sodium; 14 mg cholesterol; 8 grams fat; 23 grams carbohydrates; 8 grams protein; 0.34 gram fiber.
Exchanges: 1 protein; 1 fat.
FROZEN FRUIT LAYER CAKE
L.B. Morse’s stepmother, Joyce Kohl, came up with this cake variation of a smoothie. We like the idea as a pure fruit dessert. Since it’s winter, this recipe calls for frozen fruit, but we think the flavors will be even better with fresh summer fruits, which are so sweet no sugar substitutes are needed. With fresh fruit, it may take a little longer for the individual layers to set. Be sure each layer is slightly set before topping with another layer.
1 (12-ounce) package frozen raspberries, slightly thawed
3/4 cup plain yogurt
1 1/2 teaspoons sugar substitute, optional
1 (16-ounce) package frozen peaches, slightly thawed
1 (16-ounce) package frozen mixed berries (blueberries, marion berries and raspberries) or other frozen fruit such as strawberries, slightly thawed
Place raspberries, 1/4 cup yogurt and 1/1 teaspoon sugar substitute if needed for flavor in blender or food processor and puree until smooth. Pour puree in bottom of 8-cup bundt pan and place in freezer to set at least 10 minutes.
Place peaches, 1/4 cup yogurt and 1/2 teaspoon sugar substitute if needed for flavor in blender or food processor and puree until smooth. Pour puree on top of set raspberry layer and place in freezer to set at least 10 minutes.
Place mixed berries, remaining 1/4 cup yogurt and remaining 1/2 teaspoon sugar substitute if needed in blender or food processor and puree until smooth. Pour puree on top of set peach layer and place dessert in freezer until frozen through, several hours.
Makes 16 servings.
Each serving contains about:
65 calories; 10 mg sodium; 0 cholesterol; 0 fat; 16 grams carbohydrates; 1 gram protein; 0.81 gram fiber.
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Food Guidelines for People With Diabetes
If you have diabetes or are cooking for someone who has diabetes, know that you don’t need to eat or serve special foods--just eat sensibly. What is healthy for you is also healthy for your dining companions. More important is how you eat: Proper timing and food combinations can help control blood glucose levels. What follows are a few tips from “The First Step in Diabetes Meal Planning,” a brochure from the American Diabetes Assn. and the American Dietetic Assn. For more information, call the American Diabetes Assn. at (800) 232-3472.
* Eat a variety of foods.
* Add less fat, sugar and salt to your food.
* Eat fruits, vegetables, grains and beans; they are high in fiber and will fill you up.
* Eat about the same amount of food at regular times each day.
* Don’t skip meals.
* To lose weight, cut down on portions, not on meals.
* Try new foods.
COOKING TIPS
* Aspartame (NutraSweet) loses sweetness when cooked for long periods, so it’s best to add it to cooked food that has cooled. Acesulfame-K (Sweet One) may be used in baking and cooking because it doesn’t break down under heat. It may, however, change the texture of baked items.
* Use methods that require little or no fat--boil, bake, broil, roast, stir-fry, poach or steam.
* Trim all visible fat before cooking meats. Skim or drain all fat after cooking.
* Use nonstick pans or nonstick cooking spray when possible.
* Use skim milk, dry nonfat milk and nonfat yogurt.
* Do not add fat, bread crumbs or coating mixes to foods being prepared.
