Karen Chapman Novakovski - Associate Professor of Nutrition

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August/September 2014

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In This Issue

Diabetes - The Medical Perspective

Want to cure your diabetes? If you are overweight, losing weight may "cure" your diabetes. At least, your blood glucose can become normal without you using medication. This possibility occurs more frequently in the early stages of diabetes.

Another way that type 2 diabetes may be "cured" is with bariatric surgery. Severe calorie reduction, change in gut hormones and weight loss contribute to the "cure", that is, blood glucose becoming normal. Bariatric surgery has some risk such as infection or bleeding related to the surgery. More long-term concerns may be abdominal cramping, diarrhea and nutritional deficiencies.

When are you "cured" or in remission? There is little scientific evidence to establish guidelines defining when remission of diabetes starts or how long an individual must maintain normal blood glucose levels to be considered in remission. Without scientific evidence we can rely on expert consensus which suggest partial diabetes remission is achieved when AIC (3 month average glucose) and fasting glucose fall to the level indicative of prediabetes for at least 1 year. When AIC and fasting glucose are in the normal range for at least 1 year complete diabetes remission is suggested. These new glucose levels must be maintained without the help of diabetes medications or ongoing bariatric procedures.

How do you preserve the normal blood glucose? Keep the extra pounds off. All the factors that contributed to developing diabetes in the first place such as being overweight, not getting regular physical activity and having a family history of diabetes can cause it to reappear. Eating healthy and getting regular physical activity is especially important to maintain normal glucose since diabetes risk increases with age.

Most experts use the term remission rather than "cure" because it is common for diabetes symptoms to return. Even short periods of remission can be helpful in preventing some of the complications of diabetes. Continued glucose monitoring and regular medical check-ups are necessary to make sure blood glucose remains in the normal range.

 

Diabetes and Food

One of the most important steps in reversing insulin resistance and restoring normal glucose levels is reducing calories enough to produce a modest and lasting weight loss. There is no "one size fits all" when it comes to losing weight or controlling carbohydrate intake. Long-term weight loss is more realistic when a healthy eating plan is adopted as a lifestyle rather than following a "diet" that may be difficult to endure over time.

Adding more non-starchy vegetables to meals and snacks is a good way to keep calories and carbohydrates in check without feeling deprived. Non-starchy vegetables are good sources of dietary fiber and eating 3 servings throughout the day or at any meal only equals 15 grams of carbohydrate.

15 Grams of Carbohydrate = 1 Serving of Carbohydrate = 1 Carbohydrate Choice

1 cup of raw vegetables or ½ cup of cooked non-starchy vegetables equals only 5 grams of carbohydrate and 25 calories. Starchy vegetables provide 15 grams of carbohydrate and about 80 calories per serving. These include corn, potatoes, pumpkin, winter squash and succotash. Beans peas and lentils are also starches and higher in carbohydrate content. All other vegetables are non-starchy. A complete list of non-starchy vegetables is available from the American Diabetes Association's My Food Advisor at http://tracker.diabetes.org/explore/browse/non-starchy-vegetable/

Calorie and carbohydrate needs should be individualized but the following tips are a good place to start with a healthy eating plan:

  1. Fill half your plate with non-starchy vegetables
  2. Choose more lean proteins - fish, skinless poultry
  3. Choose low-fat dairy products
  4. Choose healthy carbohydrates such as whole-grain breads, cereals, pasta, and brown rice
  5. Choose healthy fats such as olive, canola, peanut oil and nuts
  6. Portion control leads to calorie reduction which is necessary for weight loss
  7. Avoid sweetened beverages
  8. Match your plate to the plate method of healthy eating

 

Recipes to Try

Oven Poached Fish

Zucchini SaladIngredients

1 pound fresh or frozen fish fillets
½ cup skim milk
¼ cup seasoned bread crumbs
Black pepper
1 tablespoon grated Parmesan cheese
Cooking spray

Directions
  1. Preheat oven to 400°.
  2. Rinse fish fillets and pat dry. Spray baking dish lightly with nonstick spray. Put fish in single layer in baking dish.
  3. Pour skim milk over fish fillets. Sprinkle bread crumbs on the tops of the fillets and season with black pepper.
  4. Sprinkle Parmesan cheese on tops of the fillets. Spray quickly with nonstick spray.
  5. Bake at 400° for 15 minutes, or until fish is white and hot to the touch in the thickest part of the fillet.

Note: Baking time depends on thickness of fillets. Any firm, white skinless fish fillets will work very well in this recipe. Haddock, flounder, sole, orange roughy, and catfish are good choices.

Nutrition Facts per serving; (4 servings per recipe)
Calories
Protein
Carbohydrate
Fiber
164
27 grams
8 grams
0 grams
Fat
Calories from fat
Cholesterol
Sodium
2 grams
10
58 mg
338 mg

 

 

Carrot Cucumber Salad

Dark Chocolate Strawberry FondueIngredients

1 cucumber
2 cups grated carrots
½ cup non-fat plain yogurt
1 teaspoon dill weed
1 teaspoon lemon juice

Directions
  1. Peel cucumber, leaving stripes of peel on it if more crunchiness is desired. Slice lengthwise in fourths. Gently scrape seeds out. Thinly slice each cucumber fourth.
  2. Mix yogurt, dill weed, and lemon juice.
  3. Add cucumber and carrots. Gently toss to coat vegetables.
Nutrition Facts per serving; (4 servings per recipe)
Calories
Protein
Carbohydrate
Fiber
34
2 grams
7 grams
2 grams
Fat
Calories from fat
Cholesterol
Sodium
0 grams
0
0 mg
30 mg

This and other recipes available at
http://urbanext.illinois.edu/diabetesrecipes/intro.cfm

 

Menu Suggestions

Breakfast Amount/Portion
Hard-boiled egg 1 egg
Whole wheat toast 1 slice (15 grams carbohydrate)
Margarine, whipped 1 teaspoon
Non-fat vanilla Greek yogurt 4 ounces (6 grams carbohydrate)
Fresh sliced strawberries 1 ¼ cups (15 grams carbohydrate)
Chopped almonds 1 ounce (5 grams carbohydrate)
Skim Milk 2 cups (6 grams carbohydrate)
549 Calories; 47 grams Carbohydrates; 3 Carbohydrate Choices
 
Lunch
Shrimp Tacos 3 tacos (15 grams carbohydrate)
Red bean salad 1 cup (29 grams carbohydrate)
Garden salad 1 cup (5 grams carbohydrate)
Herbed vinaigrette 2 tablespoons
Skim milk 1 cup
552 Calories; 61 grams Carbohydrates; 4 Carbohydrate Choices
 
Dinner
Grilled chicken breast 3 ounces
Brown rice ⅔ cup (30 grams carbohydrate)
Steamed fresh green beans 1 cup (10 grams carbohydrate)
Margarine, whipped 2 teaspoons
Sliced cubed cantaloupe 1 cup ( 15 grams carbohydrate)
Skim milk 1 cup
710 Calories; 67 grams Carbohydrates; 4.5 Carbohydrate Choices
Total: 1811 Calories, 175 grams Carbohydrates, 11.5 Carbohydrate Choices

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