Karen Chapman Novakovski - Associate Professor of Nutrition

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October/November 2013

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In This Issue

Diabetes - The Medical Perspective

Your liver handles much of the “factory work” that your body needs. This means that much of the storage, distribution, and manufacturing of immune or clotting factors or protein carriers are done in the liver. The liver does more than 500 things! These often involve carbohydrates, proteins, and fats as well as other nutrients and biological compounds. The liver also breaks down harmful substances so they are not so toxic.

The liver can keep working even after losing three-fourths of its cells. It can also regenerate itself. That means it can grow itself back!

However, the liver can become damaged or sick. Liver disease is more common in those with diabetes. The most severe type of liver disease is called cirrhosis. With cirrhosis, the liver has fibrous, hard parts that don’t work and scars from damage. Cirrhosis is not reversible and the liver can’t regenerate once the damage has gone this far.    

Hepatitis is another form of liver disease. Hepatitis is usually caused by viruses. The type of hepatitis is important to know if the disease will go away and the liver will recover or not.

Fatty liver is another type of liver disease. Fatty liver is just what it sounds like. Too much fat has been stored in the liver. This occurs more often in those who are overweight. Losing weight will help reduce the fat in the liver. Fatty liver has no symptoms and is difficult to diagnose. However, it does increase the chance of additional damage to the liver, including the development of cirrhosis.

Practice guidelines recommend weight loss, but not vitamin E or omega 3 fatty acid supplements for those with diabetes.


Diabetes and Food

If you have diabetes do you need special “diabetic” foods? No, you do not. If you have diabetes, or are at risk for diabetes, you need to eat a balanced diet. You also need to eat in moderation. With this plan you should reach a healthy weight.

“Diabetic” foods won’t harm you, but are usually not needed. “Diabetic” foods usually have a sugar substitute to replace sugar. This often will reduce the calories. Reduced calories are good because most people with diabetes struggle to maintain a healthy weight.

However, people with diabetes can have sugar. The sugar’s calories “count” just like any other calories. It is better to have foods with sugar added as part of a meal, or a larger snack.

Consider a concord grape jam that has 50 calories per tablespoon and 13 grams of carbohydrate, as compared to the jelly that has the same calories and carbohydrates as compared to the simply fruit jam
that has 40 calories and 10 grams of carbohydrate, as compared to the sugar-free grape jam with 10 calories and 5 grams of carbohydrates. In this case, the sugar-free jelly would be a better choice to lower both calories and carbohydrates.

Now let’s talk ice cream. A no sugar added butter pecan ice cream (1/2 cup) has 100 calories and 13 grams of carbohydrates. The butter pecan regular ice cream has 140 calories and 18 grams of carbohydrate. Once again, the sugar-free is a better choice. Remember, the sugar-free does not mean a “free” food. For the jam or jelly, only 2 teaspoons are considered “free”. Both the ice creams would be 1 “carb unit” if you are counting carbohydrates. If you are using the exchange system, the sugar-free ice cream would be 1 fat-free dairy and the regular ice cream would be 1 starch and 1 fat.    

“Diabetic” foods can help you reduce both calories and carbohydrates, but the calories and carbohydrates have to be part of the overall meal plan. You also need to remember to check the Nutrition Facts serving size and analysis. A regular chocolate chip cookie (small) from 1 company has 102 calories (16 grams carbohydrate, 4 grams fat), while their sugar-free chocolate chip cookie has 117 (16 grams carbohydrate, 5 grams fat). Not much reason to choose the sugar-free version in this case and it may cost more.


Recipes to Try

Low Fat Cake Mix Cookies


Non-stick cooking spray
8 oz lite cool whip
1 low fat cake mix
1 egg
1/3 cup powdered sugar

  1. Spray cooking spray on cookie sheet.
  2. Combine cool whip, cake mix, and egg in a medium mixing bowl.
  3. Chill for 30 minutes.
  4. Preheat oven to 350 degrees.
  5. Put powdered sugar in plastic container large enough to also fit 2 or 3 cookies.
  6. Scoop 1 rounded spoonful of cookie dough and place 2 or 3 in plastic container. After putting lid on container, gently shake to coat with powdered sugar.
  7. Place on cookie sheet and bake for 10 to 12 minutes. Let cool on cookie sheet for 1 to 2 minutes. Remove to finish cooling on cooling rack.
  8. Store loosely covered.
Nutrition Facts per serving; 1 cookie per serving, 45 cookies per recipe
0 grams
10 grams
0 grams
Calories from fat
1 grams
4 mg
39 mg


Philly Steak Quesadilla


1 green pepper, thinly sliced 
½ medium onion, thinly sliced 
6 tablespoons shredded part-skim Mozzarella cheese 
4 slices deli-sliced roast beef 
2 low-fat 10 inch flour tortillas 
Cooking spray

  1. Cook peppers and onion on medium heat in a non-stick skillet until onions tender, stirring occasionally. Remove from skillet.
  2. Spray skillet with cooking spray. Add one tortilla. Sprinkle with 3 tablespoons cheese. Top with 4 slices beef. Add vegetables. Top with tortilla.
  3. Cook on medium heat about 3 minutes. Use spatula to flip the quesadilla. Cook additional 3 minutes. Slide from skillet onto cutting board. Cut into 6 slices.
Nutrition Facts per serving; makes 2 servings; 3 slices each
13 grams
30 grams
10 grams
Calories from fat
4 grams
18 mg
642 mg

This and other recipes available at

Menu Suggestions

Breakfast Amount/Portion
Scrambled egg substitute 1 serving
Whole wheat toast 2 slices
Sugar free blueberry jam
Whipped cream cheese

2 teaspoon
1 tablespoon

Orange juice, unsweetened 8 ounces
Skim milk 1 cup
465 Calories; 73 Carbohydrates; 5 Carbohydrate Choices
Philly Steak Quesadilla 1 serving
Baked chips 15
Chunky salsa 3 tablespoons
Tossed salad 1 medium
Low calorie Italian salad dressing 2 teaspoons
Skim milk 1 cup
470 Calories; 71 Carbohydrates; 5 Carbohydrate Choices
Meatloaf 3 ounces
Baked potato 1 cup
Fat free sour cream .25 cup
Carrots, cooked 1 cup
Skim milk 1 cup
Low fat cake mix cookies 2
523 Calories; 72 Carbohydrates; 5 Carbohydrate Choices
Total: 1458 Calorites, 216 Carbohydrates, 15 Carbohydrate Choices

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