Karen Chapman Novakovski - Associate Professor of Nutrition

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February/March 2009

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In This Issue

Diabetes - The Medical Perspective

When should you go to the emergency room if you have diabetes?

First of all, remember that if you have diabetes you should have some kind of identification like a diabetes bracelet or pin.  That way, the emergency room personnel will know you have diabetes even if you can’t tell them.

Both high and low blood glucose may be a reason to visit the emergency room.  It really depends on how high or low your blood glucose is, and how you feel.

If you have checked your blood glucose and it is 240 mg/dl or higher, you should check your urine for ketones.  Ketones can build up when blood glucose becomes this high.  They can change the pH or acidity of your blood and have a bad effect on you.  Extreme cases of high blood glucose with ketones can result in coma or death.  The worst part is you can’t feel your blood glucose rising.  Symptoms of high blood glucose include

  • Increased thirst
  • Increased urination
  • Deep and/or rapid breathing
  • Nausea and vomiting
  • Fruity smelling breath from the ketones

Having your blood glucose fall too low can also be a reason to go to the emergency room.  Technically, blood glucose below 60 mg/dl is low blood glucose (hypoglycemia).  However, this can vary from person to person. Symptoms of hypoglycemia include

  • Headache
  • Dizziness
  • Blurred vision
  • Lack of coordination
  • Shakiness or trembling

Taking a glucose tablet, orange juice, or hard candy may help alleviate symptoms.  If this doesn’t help or the person can’t swallow, and emergency room visit is needed.

Diabetes and Food

Vitamin D is in the news quite a bit these days. Until recently, vitamin D was only known for bone health and preventing osteoporosis. Today, research is linking vitamin D to many diseases including diabetes and heart disease.

This research has started many wondering how much vitamin D we should have.  With the current recommendations, adults 19 to 50 years old need 2 to 3 cups of vitamin D fortified milk (or other dairy equivilents) ; adults 51 to 70 need 4 cups; and those over 70 need 6 cups!  That can be a lot of milk.  Researchers say even this much may not be enough to help prevent chronic diseases.

Fortified milk is not the only source of vitamin D.  Some juice, yogurt, cereal, breakfast bars, and margarine are now fortified with vitamin D as well. Read the label to be sure.  Natural sources of vitamin D include salmon, tuna, and mackerel, with less in beef liver and egg yolks.  Some mushrooms have vitamin D as well.  Skin exposed to sunlight can make vitamin D, but this doesn’t happen to a great extent in northern climates, when skin is usually covered, or when sunscreen is used.

Medication Update

Should you take a vitamin D supplement?  It is generally recommended to get your vitamins from food whenever possible.  This is because supplements make it easier to take too much.  Upper limits for vitamins have been set at levels that researchers have found might be bad for health.  It is harder to reach those levels with food than with supplements because food generally has less vitamin D than a supplement does.

The second reason for recommending food over a supplement is that food contains many other nutrients we need to be healthy – not just one in a supplement. However, some people may benefit from a vitamin D supplement. Older adults do not make as much vitamin D from sunlight because of changes in their skin.  Those with darker skin tones also may not be getting enough vitamin D.

There is a blood test to determine your vitamin D status.  Talk to your doctor or dietitian if you have concerns or questions

Recipes To Try

Baked Steak Fries
6 servings, 4 fries each

3 medium large potatoes
1 teaspoon garlic powder
2 teaspoons chili powder
1/2 teaspoon salt
2 teaspoons onion powder
Non-stick cooking spray

  1. Preheat the oven to 425°F. Wash and slice each potato into 8 wedges. Spray wedges with non-stick spray.
  2. Combine remaining ingredients in a plastic bag. Add wedges and gently shake to coat.  Bake for 30 minutes.

Total preparation and cooking time: 35-45 minutes
Per serving:
Calories 112
Fat 0 grams
Protein 3 grams
Calories from fat 0%
Carbohydrate 25 grams
Cholesterol 0 grams
Fiber 3 gram
Sodium 210 mg

Applesauce Molasses Cake
16 servings

36 ounces unsweetened applesauce
1/4 teaspoon salt
1 cup dried apple slices
1/3 cup shortening
2-3/4 cup flour + 2 tablespoons
3/4 cup Splenda®
2 teaspoons cinnamon
1/3 cup molasses
1/4 teaspoon nutmeg
2 eggs
1/4 teaspoon allspice
6 ounces lowfat buttermilk
1 teaspoon baking soda
non-stick cooking spray

  1. Spray 3 9"cakepans with cooking spray and dust with 2 tablespoons flour. Preheat oven to 350°F
  2. Combine applesauce and apple slices in saucepan; bring to boil and simmer about 20 minutes until thick. Set aside to cool.
  3. Combine flour, spices, baking soda, and salt. In another bowl blend shortening, Splenda®, molasses, and eggs.  Combine dry and wet ingredients, alternating with buttermilk.
  4. Turn into pans, patting batter out towards pan edges. Bake 20 minutes. Cool.
  5. Use applesauce mixture as frosting between each layer and on top.  May serve with fat-free whipped topping (adds 15 calories per 2 tablespoons). Refrigerate cake to store.

Total preparation and cooking time: 45 minutes
Per serving:
Calories 201
Fat 5 grams
Protein 4 grams
Calories from fat 20%
Carbohydrate 36 grams
Cholesterol 27 grams
Fiber 2 gram
Sodium 60 mg

Menu Suggestions

Breakfest

Amount/Portion

Scrambled eggbeaters

1/2 cup

Bran muffin, low-fat

1

Apple juice 6 ounces

462 kcal, 77 gm carbohydrate, 5 carb units

   

Lunch

 

Crustless Spinach Quiche*

1 serving

Whole wheat toast with whipped margarine

2 slices, 2 teaspoons

Lettuce salad with fat-free French dressing

1-1/2 cup salad, 2 tbsp dressing

Peaches in juice

1 cup

Skim milk

1 cup

575 kcal, 78 gm carbohydrate, 5 carb units
   

Dinner

 

Tuna rice pie*

1 serving

Seasoned green beans*

1 cup (lots of beans!)

Breadsticks 2
Whipped margarine 1 tablespoon

Applesauce molasses cake (this issue)

1 serving

595 kcal, 79 gm carbohydrate, 5 carb units

Total: 1632 kcal, 234 gm carbohydrates, 15 carb units

Meals may also include a calorie-free beverage (diet soda, tea, coffee, etc.).


 

* Visit www.urbanext.uiuc.edu/diabetesrecipes/ for recipes in menu above.


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