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Karen Chapman Novakofski

Professor of Nutrition

Marilyn Csernus

Extension Educator, Nutrition and Wellness

 

October/November 2016

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In This Issue

Diabetes - The Medical Perspective

Diabetes Foot Care

Diabetes can damage nerves and reduce blood flow to your feet, making foot problems a risk for anyone with diabetes. Foot problems are the reason one in five people with diabetes seek hospital care, according to the American Diabetes Association. The link between diabetes and foot or leg amputation is well known. Less well known is that, most people can prevent serious foot problems if they follow a few simple steps.

Prevention is key! Take off your shoes and socks while waiting for a check-up with your doctor. A complete foot exam should be done at least once a year, and more often if you have foot problems. Your doctor may refer you to a foot specialist known as a podiatrist. Do not try to trim corns or calluses yourself. Your health care provider or podiatrist can take care of any foot problems, and can also trim your nails if you are unable to safely do so on your own. Contact your health care provider anytime you notice a cut, break in the skin, or change in foot color or shape. Furthermore, never ignore changes in foot sensitivity or foot pain.

Diabetes Foot Care Tips:

  • Wash and dry your feet daily using mild soap and water.
    • Thoroughly pat feet dry with a soft towel.
    • Rub feet with lotion to prevent cracking, but do not put lotion between toes.
  • Examine your feet daily.
    • Look at the top and bottoms of your feet. If unable to do so yourself, use a hand held mirror or ask someone else to assist you.
    • Look for cracked or dry skin.
    • Check for sores, blisters, and cuts.
    • Feel for warmth and check for areas of tenderness and redness.
    • Monitor feet for corns, calluses and in-grown toenails.
  • Do not walk around bare-foot. Wear shoes or slippers that will protect your feet against cold and moisture.
  • Wear socks made of natural fibers such as cotton or wool and change socks daily.
  • When purchasing new shoes, try them on with the socks you plan on wearing. When wearing new shoes limit to one hour at a time until broken in.
  • Check shoes before putting them on to assure there are no rough or jagged edges.
  • Wear special shoes if recommended by the podiatrist. If you are Medicare age, ask about coverage for special shoes.
  • Protect your feet from temperature extremes. Test hot water before submerging your feet because having neuropathy can make your feet less sensitive to hot and cold. Avoid using heating pads, hot water bottles, and electric blankets.

Don't pop any blisters. Place a bandage over any blister or sore and wear a different pair of shoes. Do not ignore any foot issues. Sores, cuts and blisters may not heal as quickly with diabetes. Report any foot injuries to your health care provider right away.

Diabetes and Food

Keeping blood glucose levels as normal as possible is the key to preventing complications associated with diabetes, including foot problems. Discuss your individual diabetes goals and target numbers with your health care provider. The general hemoglobin A1C (HbA1C) recommendation is less than 7%. HbA1C is a measure of your average blood glucose over the last three months. Depending on your age and other medical problems your HbA1C target level could be a little lower or a little higher.

To reach and maintain your HbA1C goal, follow a diabetes meal plan that works for your lifestyle. This will look different for different individuals. Overall, eating a lower carbohydrate intake with lean protein, lower fat dairy, and healthy fats is the goal. All carbohydrates turn into sugar, but you want to choose carbs that are nutrient-dense. This means you are eating carbs that provide nutrients and not just empty calories. Healthier carb choices are fruits, vegetables, whole grains and lower fat dairy. Less healthy carbs are sweetened beverages, cakes, candy, and chips which are high in carbs and calories, but lacking in nutrients.

Choosing whole grains in place of refined grains may be beneficial to blood glucose control also. Refined grains are highly processed and lacking in dietary fiber. Dietary fiber is not digested, so it doesn't provide calories and doesn't raise blood glucose. So, little changes like eating whole wheat bread or brown rice in place of white bread or white rice may make a difference over time. Eating more foods with fiber can also help you feel full longer. Fruits and vegetables are good sources of dietary fiber. Although choosing whole grains and fruits and vegetables is wise, don't forget about their carbohydrate content.

An easy way to think about diabetes meal planning is the Plate Method depicted below from the American Diabetes Website @http://www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate/#seven. Check it out and try out the Plate method of meal planning.

Fill half of your plate with non-starchy vegetables. See this list of non-starchy vegetables.
About one quarter of the plate should be grains and starchy foods. See this list of grains and starchy foods.

Lean protein should fill the other quarter of the plate. See this list of protein foods. Depending on your carbohydrate meal allowance add a fruit, and/or a serving of dairy. Round out your meal with healthy fats. For a beverage stick with carb free water, tea or coffee. Low fat milk can be used as your dairy choice.

Recipes to Try

Asian Chicken Breast

6 - 3 ounce servings

Ingredients

  • 6 boneless chicken breast
  • ¼ cup olive oil
  • 2 tablespoons reduced sodium soy sauce
  • 2 garlic cloves, crushed
  • 1 tablespoon minced ginger
  • 1 ½ tablespoon country Dijon mustard
  • ¼ teaspoon salt
  • ¼ teaspoon freshly ground black pepper

Directions

  1. Place chicken breast in a plastic storage bag and pound lightly with the flat side of a meat mallet.
  2. Combine olive oil, soy sauce, garlic, ginger, mustard, salt, and pepper.
  3. Brush chicken breast with marinate mixture.
  4. Refrigerate at least for 2 hours.
  5. Grill on medium-high for about 12 minutes on each side or until internal temperature of 165° Fahrenheit.
Nutrition Facts per serving
Calories 183
Fat 10 grams
Protein 20 grams
Calories from fat 90
Carbohydrate 2 grams
Cholesterol 48 mg
Fiber 0 grams
Sodium 476 mg

Crunchy Coleslaw

2 - ½ cup servings

Ingredients
  • 1 cup angel hair coleslaw or shredded cabbage
  • ⅓ cup chopped green pepper
  • 1 tablespoon lite balsamic dressing
  • ½ tablespoon slivered almonds
Directions
  1. Combine all ingredients.
Nutrition facts per serving
Calories 34
Fat 2 grams
Protein 0 grams
Calories from fat 16
Carbohydrate 4 grams
Cholesterol 0 mg
Fiber 1 gram
Sodium 476 mg

Sample Menu

BREAKFAST

Oatmeal½ cup
Blueberries¾ cup
Walnuts4 halves
Soft tub margarine spread2 teaspoons
Hard-cooked egg1 egg
Whole-wheat toast1 slice
Skim milk1 cup
Nutrition Facts
Calories 520
Carbohydrates 56 Grams
Carbohydrate Choices 4

LUNCH

Turkey sandwich3 ounces sliced turkey
Whole wheat bread2 slices
Lettuce and tomato slicesAs desired
Lite mayonnaise1 tablespoon
MustardAs desired
Lentil soup*1 serving
Apple slices1 small
Unsweetened tea1 cup
Nutrition Facts
Calories 488
Carbohydrates 60 Grams
Carbohydrate Choices 4 Choices

DINNER

Asian chicken breast*1 serving
Roasted sweet potatoes and onions*1 serving
Pecan crusted broccoli*1 serving
Sliced pears½ cup
Skim milk1 cup
Nutrition Facts
Calories 567
Carbohydrates 68 Grams
Carbohydrate Choices 5 ½ Choices

Total:

Calories 1575
Carbohydrates 184 Grams
Carbohydrate Choices 13 ½ Choices

*Recipes from Recipes for Diabetes at extension.illinois.edu/diabetesrecipes/ or this newsletter


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