Karen Chapman Novakovski - Associate Professor of Nutrition

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December 2011/January 2012

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In This Issue

Diabetes - The Medical Perspective

Ketosis is the condition of having too many ketones in the blood.  Ketones are waste products made when your body is forced to burn body fat, instead of glucose, for energy. Your body gets rid of ketones by emptying them into your urine.

Your body will use body fat instead of glucose when any of the following situations occur:

  • You have a high blood glucose (hyperglycemia) caused by too much food and/or too little insulin. Without the right amount of insulin, your body burns fat for energy.
  • You have a low blood glucose (hypoglycemia) caused by too much insulin and/or too little food. When your body does not have enough glucose to be used for energy, it uses fat instead.
  • Using a lot of energy as in exercise, stress, or illness.

How do you know if you have ketones in your urine?  Signs of ketoacidosis or ketones in your urine, include...
    * dry mouth/great thirst
    * fruity breath
    * loss of appetite
    * nausea/vomiting
    * dry, flushed skin/fever
    * fatigue/drowsiness
    * frequent urination
    * labored breathing.

If you have these symptoms, or have a blood glucose level over 240 mg/dL, you should test your urine using a ketone test kit. If you have large amounts of ketones in your urine, you should call your diabetes team or health care provider immediately.

If you have a "trace" or "small" amount of ketones in your urine you should drink a glass of water every hour and test your blood glucose every three hours. If blood glucose and ketone levels are not going down after 2 tests, call your diabetes team.

Diabetes and Food

Nutrition bars are becoming more popular as a quick snack or meal replacement. Are they "okay" for those with diabetes? Although almost any food can fit into the meal plan with careful planning, nutrition bars are a special challenge.

There are many different kinds of nutrition bars - some are energy bars, some protein bars, some meal replacements, there are even high carb and low carb bars. Because nutrition bars have fairly high levels of vitamin and minerals added, they are considered a supplement, not a food.

What this means to the general public is that they are not regulated the same way as food. A few years ago an independent laboratory found that many of the nutrition bars on the market did not contain what their labels claimed.

This makes it very difficult for those with diabetes to use nutrition bars in their meal plans. Low carb bars may not be a good choice since they may really be high carb bars. Checking blood glucose levels two hours after eating may be the best plan.

Will an energy bar boost your energy? Probably not. An energy bar will have plenty of calories, which means they have energy.

But if you feel tired, it is most likely because you haven’t been sleeping well – not that you need more calories.

When choosing an energy bar, look at total calories, grams of carbohydrate, and saturated and trans fat. Lower calorie bars have 150 calories or less.  Mid-range calories will be above 150 to around 220 calories per bar. More calories than this is a higher calorie bar. The higher calorie bars would be more of a meal replacement than a snack.

When looking at grams of carbohydrate, remember than 15 grams of carbohydrate are a “carb unit” if you are counting carbohydrates. That’s the same amount of carbohydrates in 1 slice of bread, 15 pretzels, one-third cup rice, or one-half of a banana. Look for bars with 3 grams of less of saturated fat, and no trans fat.

Remember that nutrition bars are part of your meal plan, and need to be counted. Just because they have added vitamins and minerals does not mean they are a “free” food.

Recipes To Try

Apple and Pineapple Chill
6 servings

  • 1 can (20-ounce) crushed pineapple
  • ½ cup cold water
  • 1 small apple, grated
  • Non-fat whipped topping
  • 1 package unflavored gelatin
  1. Combine crushed pineapple and unflavored gelatin in a saucepan. Allow gelatin to soften 5 minutes.
  2. Bring to a boil, stirring to dissolve gelatin. Remove from heat. Stir in cold water.
  3. Fold in grated apple. Chill until firm.
  4. Top with 2 tablespoons non-fat whipped topping to serve.

Nutrition facts per serving:

Calories 74
Protein 1 grams
Carbohydrate 18 grams
Fiber 1 grams
Fat 0 grams
Calories from fat 0%
Cholesterol 0 mg
Sodium 3 mg

Preparation time 3 minutes; chill time 3 hours

Fruited Slaw
8 servings, 1 cup each

  • 1 can (20-ounce) pineapple tidbits
  • ½ cup chopped walnuts
  • 1 tablespoon lemon juice
  • ½ cup raisins
  • 1 medium banana, sliced
  • ½ teaspoon salt
  • 3 cups shredded cabbage
  • 6 ounces low-fat tropical yogurt
  • 1 can (15-ounce) mandarin oranges, drained
  1. Drain pineapple, reserving 2 tablespoons juice.
  2. Stir lemon juice into reserved pineapple juice. Add banana slices.
  3. In large salad bowl, combine cabbage, oranges, walnuts, raisins, salt, and juice mixture.
  4. Add yogurt. Toss to coat. Chill until serving.

Nutrition facts per serving

Calories 156
Protein 4 grams
Carbohydrate 28 grams
Fiber 3 grams
Fat 5 grams
Calories from fat 45%
Cholesterol 1 mg
Sodium 26 mg

Preparation time 20 minutes; baking time 30 minutes.

Menu Suggestions

BREAKFAST

Amount/Portion

French toast

1 slice

Low calorie maple syrup

1 tablespoon

Margarine, whipped

1 teaspoon

Banana

1 medium

Skim milk

8 ounces

 

403 Calories, 66 Carbohydrates, 4 Carbohydrate Choices

 

SNACK

Wheat crackers 8
Low fat Swiss cheese 1 slice
 
214 Calories, 22 Carbohydrates, 1.5 Carbohydrate Choice
 

LUNCH

Ham sandwich on whole wheat bread with lettuce

2 slices bread, 2 ounces ham

Fruited slaw†

1 cup

Baked potato chips

15, or 1 ounce

Skim milk 8 ounces

 

577 Calories, 87 Carbohydrates, 6 Carbohydrate Choices

 

DINNER

Fragrant fish fillets †

1 serving

Rice

.5 cup

Broccoli, steamed

1 cup

Italian bread 2 slices
Whipped margarine 2 teaspoons

Oatmeal raisin cookies†

2

 

609 Calories, 95 Carbohydrates, 6 Carbohydrate Choices

 

 

Total: 1803 Calories, 270 Carbohydrates, 18 Carbohydrate Choices

 

† recipes from Diabetes Lifelines or Recipes for Diabetes at http://urbanext.illinois.edu/diabetesrecipes/intro.cfm


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