Karen Chapman Novakovski - Associate Professor of Nutrition

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April/May 2014

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In This Issue

Diabetes - The Medical Perspective

Many people shy away from starting insulin. Most of the time, a fear of shots is why people don't want to start on insulin. They may be thinking about a flu shot or a vaccination. New and improved needles for insulin make insulin shots much less painful than flu shots or vaccinations.

The insulin needles are shorter and thinner than those used for other shots. They also use a special polishing technique and lubricants on the needle to decrease pain. This helps the needle glide through the skin rather than tear through the skin.

The "gauge" of the needle means how thick the needle is. A higher gauge number means a thinner needle. For instance, a needle with a 31 gauge is thinner than a needle with a 29 gauge. The 31-gauge needle is one of the most popular needle widths, and the thinnest for syringes. Insulin pen needles also come in 32-gauge.

Needles also come in different lengths. At one time longer needles were recommended for overweight people so that the needle could go deeper through the subcutaneous fat. However, others have found just as good blood glucose control with the shorter needles (8 mm) often recommended for normal weight people. Lengths for insulin pens come as short as 4 to 5 mm.

In discussing beginning insulin therapy with your doctor, ask about the types of insulin, the number of injections that may be needed, and whether you would need to use a syringe or a pen. Pen needles are usually shorter and narrower than syringes.

Talk to several people who are using insulin, and get their thoughts and advice, as well as those from your health care team. In addition to needle length and size, knowing how to rotate injections sites is important, as well as the method of injecting that is right for you.


Diabetes and Food

Spring is here and the weather has warmed up. In addition to outdoor activities, we start to think about warm-weather treats!

Although it is tempting not to plan or think very carefully about your treat - it is after all a "treat" - your hemoglobin A1c will look better if you do think and plan your "treats" as well as your meals. You might lose a little in the spontaneity of giving yourself a treat, but you gain in giving yourself the gift of better controlled blood glucose.

The types of ice cream can differ in calories by more than 100 calories per 4 ounce (1-half cup) serving. Hand dipped or hard packed is the highest in calories, often around 260 per 4 ounces. Ice cream that is sugar-free or no sugar added may be about 165 calories, while low-fat ice cream can be as little as 120 calories per 4 ounce serving.

We need to also think about the carbohydrates in ice cream, especially if we take insulin. The low-fat ice cream is close to the hard packed ice cream with 26 to 27 grams of carbohydrate per serving, but fat free ice cream may be higher. The frozen treat with the highest number of carbohydrates are sherbets or sorbets, often with 35 to 40 grams of carbohydrate per 4 ounce serving.

Don't forget the toppings and the cones! Lower carbohydrate toppings include small servings of chopped nuts or lower calorie whipped topping. Fruit is also a more nutritious topping as long as it is really fruit and not a heavily-sugared sauce with a fruit-like name. Crushed candies or cookies or coconut can add more than 100 calories to the frozen treat. For cones, of course, using a non-edible bowl or dish is the lowest in calories and carbohydrates, while the waffle cone is highest. If you have the waffle cone, not eating the whole cone may be a way to lower the carbohydrate and calories from the cone, which itself can be more than 150 calories and close to 30 grams of carbohydrate.

In planning your treat, it is best if you can include the ice cream into the meal plan, with the carbohydrates from the frozen treat replacing other carbohydrates normally in your meal. Eating the ice cream with a meal may also be a good idea, unless your meal plan normally includes a snack.

Adjusting meal carbohydrates to adjust for the extra carbohydrates from the treat can also be helpful. Your dietitian or diabetes educator can help you have some plans so that your treat is not as big a splurge to your blood glucose as it may be otherwise.

Recipes to Try

Apple and Pineapple Chill

Apple and Pineapple ChillIngredients

1 can (20-ounces) crushed pineapple in its own juice
1 small apple, grated
1 package unflavored gelatin
½ cup cold water
Non-fat whipped topping

  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.

Note: Gel will turn the color of the apple peel unless folded after the mixture begins to set, or peel the apple before grating.

Nutrition Facts per serving (6 servings per recipe)
1 gram
18 grams
1 gram
Calories from fat
0 gram
0 mg
3 mg

This and other recipes available at


Sloppy Pepper Joe's

Sloppy Pepper Joe'sIngredients

1 pound extra lean hamburger
½ cup frozen pepper strips, chopped
½ cup chopped onion
1 tablespoon vinegar
½ cup catsup
2 tablespoons prepared mustard

  1. Combine hamburger, peppers, and onion in skillet. Cook on medium heat until beef is browned.
  2. Add remaining ingredients, mixing well. Simmer 10 minutes.
Nutrition Facts per serving; (7 13 cup servings per recipe)
13 grams
6 grams
1 gram
Calories from fat
11 grams
45 mg
295 mg

This and other recipes available at


Menu Suggestions

Breakfast Amount/Portion
Banana Split Oatmeal 2 servings
Soft boiled egg 1
Fresh orange 1
Skim milk 1 cup
518 Calories; 90 Carbohydrates; 6 carb units
Sloppy Pepper Joe's 1/3 cup
Bun 1
Cut raw vegetables 1 cup
Low fat Ranch salad dressing 1 teaspoon
Low-fat yogurt 6 ounces
Banana 1
Skim milk 1 cup
686 Calories; 103 Carbohydrates; 7 Carbohydrate Choices
Grilled chicken breast 3 ounces
Baked potato 1 medium
Reduced fat sour cream 2 tablespoons
Green beans 1 cup
Apple and Pineapple Chill 1 serving
Skim milk 1 cup
644 Calories; 111 Carbohydrates; 7.5 Carbohydrate Choices
Total: 1848 Calories, 304 Carbohydrates, 20.5 Carbohydrate Choices

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