Diabetes FAQs

Click on the question to read the answer.

How is the Berrie Center different from other diabetes practices?

The Naomi Berrie Diabetes Center at Columbia University Medical Center is recognized nationally and internationally for excellence and innovation in patient care and research in diabetes. The Berrie Center combines a large multi-disciplinary clinical care program for children and adults with diabetes with a cutting-edge basic and translational diabetes research program. More than 50 faculty at Columbia are involved in diabetes research at the Berrie Center; 143 graduate and postdoctoral students have or are being trained in the Berrie Center. 

More than 10,000 patients are cared for at the Berrie Center. Our pediatric diabetes program has rapidly become among the nation’s largest. The caliber of care these patients receive is superb. Diabetes education is central to the Berrie Center program. We have the faculty and resources to work with patients as individuals, to engage their families and loved ones, and to help them with the challenging self-care practices that are necessary to achieve optimal care of diabetes. Our goal is wellness, maintenance of good health, and prevention of complications.

Our extensive clinical trials program affords patients access to cutting-edge research in type 1 and type 2 diabetes. The close proximity of our clinical and basic science faculty and programs greatly facilitates translational research in diabetes.

Why should I see a nurse educator?

A diabetes nurse educator is a caregiver, a teacher, a coach and a counselor. The key to managing your diabetes is knowing enough to do it yourself and feeling supported in your efforts by your loved ones and your diabetes team. Studies over the last 10 years have shown that normalizing the blood sugar (as well as blood pressure and cholesterol) helps prevent or delay diabetes complications. This requires a great deal of hard work and needs to be kept up for the long-term — diabetes control is a marathon, not a sprint. In order to normalize your sugar, you’ll need to know how to monitor your own blood sugar and match your treatment to your food and exercise. Our nurse educators’ goal is to teach you everything you need to know to take care of yourself and lead an active, healthy life. Even people with long-standing diabetes learn a lot of things they didn’t know before.

You are the only one who can control your diabetes — and you can’t do it alone. Diabetes and nutrition education at the Naomi Berrie Diabetes Center involves not only you, but also your family or friends. We help everyone learn how best to offer support so that your diabetes can be optimally controlled. Often, addressing the fears and concerns of your loved ones about diabetes is critical to helping you do what needs to be done.

Our approach is individualized and compassionate. We teach you to be independent — to focus on the diabetes only as much as is necessary for wellness - and we’re there for you if you need us.

Why should I see a nutritionist?

Nutrition therapy is an essential part of diabetes management. Good nutrition knowledge is a very powerful tool for the person with diabetes for patients with type 1 diabetes and those with type 2 diabetes.

Many people with diabetes are frightened about the prospect of meeting with a nutritionist. They are worried (needlessly — it usually turns out!) that they will be told to give up all their favorite foods forever; that they will never be able to eat out in a restaurant again; and that they will have to eat “prisoners’ rations” instead of “real” food. No wonder they’re scared!

The good news is that these fears are unfounded. We’ve discovered that people are amazed by one of our guiding principles — any food can fit. Gone are the days of the preprinted, 1800-calorie diet. One of the primary goal of nutrition therapy is to integrate people’s food preferences as well as their overall lifestyles into their meal plans.

Where can I get some tips about carbohydrate counting?

Basics of Carbohydrate Counting

  • The nutrients in food can be separated into three main groups: CARBOHYDRATE, PROTEIN & FAT
  • Blood glucose levels are most affected by the CARBOHYDRATE content of food
  • Carbohydrates are an important part of a balanced diet and can be an excellent source of vitamins, minerals and fiber
  • Adjusting the INSULIN dose based on the amount of CARBOHYDRATE that will be eaten is critical to keep blood glucose levels in the target ran
  • Foods that contain carbohydrate are:
    1. Grains (pasta, rice, cereal, bread)
    2. Starchy vegetables (potato, corn, peas, plantain)
    3. Beans
    4. Fruits & fruit juices
    5. Milk products (milk, yogurt, ice-cream)
    6. Sugar & sweets
  • Foods that contain carbohydrates must becounted” so that the proper dose of insulin can be given

Meat, meat products, eggs, cheese, fish, fat & oil, nuts and non-starchy vegetables contain little or no carbohydrates. 

**When consuming a reasonable portion size, these foods do not need to be “counted”

  • Foods that contain little or no carbohydrate may be considered “free” foods that do not require insulin coverage
  • Your care plan will include a ratio of 1 unit of insulin for every _______ grams of carbohydrates
  • This ratio may need to be adjusted to assure that you are getting the right amount of insulin for your carbohydrate intake

Benefits of carbohydrate counting

  • All foods can fit in your meal plan, sweets are not eliminated
  • There is greater flexibility and freedom to choose what and when to eat
  • Better control can be achieved by matching insulin to carbohydrate
  • Carbohydrate counting gives you more control of your diabetes care

 

Super Snack Suggestions

 

When choosing snacks, make your selection based on the following tips:

C  Balancing your snack by including a protein & good fat along with the carbohydrate will help to achieve good blood sugar control.

C  Plan ahead: measure correct portions sizes and put them in baggies or small containers so they will be ready to grab & go.  Prepare enough to last you the whole week!

15 -30 grams Snacks:

C  1 medium apple or equivalent sized fruit with 1 tbsp peanut butter

C  1 medium apple or equivalent sized fruit with a small handful of nuts (almonds, walnuts, peanuts, pistachios or soy nuts)

C  1 oz of light cheese (Vermont Cabot, Alpine Lace, Laughing Cow, Baby Bell, part-skim mozzarella cheese sticks) with 2-3 high fiber crackers (Ryvita, Wasa, Kavali, Finn Crisps)

C  Homemade Trail mix: combine your favorite high fiber cereal, small handful of mixed nuts and seeds—almonds, walnuts, peanuts, pistachios, soy nuts, sunflower seeds & pumpkin seeds

C  2 tbsp of hummus spread on 1 slice of whole wheat bread, pumpernickel bread or high fiber cracker mentioned above.

C  ½ whole wheat pita or English muffin with 1 slice of low-fat cheese and tomato

C  ½ cup low-fat cottage cheese with 1 cup sliced fruit

C  3 cups popcorn with small handful of nuts (as noted above)

C  ½ cup low-fat ricotta cheese with ½ cup berries

C  1 cup low-fat or fat free yogurt with small handful of nuts and seeds

C  ½ cup low-fat or fat free pudding

Uncovered Snacks:

C  Raw vegetable sticks (carrots, celery, cucumbers, peppers) alone or with 2 tbsp of hummus spread, low-fat or fat free dip.

C  Small handful of mixed nuts (as noted above)

C  3-4 celery sticks with 2 tbsp of peanut butter or cream cheese

C  1-2 oz of sliced turkey or lean ham with 1 oz of light cheese and mustard

C  1 hard boiled egg

Tips for a Healthy Breakfast

 

When preparing breakfast, keep in mind…

C  Balancing your meal by including a protein & good fat along with the carbohydrate will help to achieve good blood sugar control.

C  READ the Nutrition Facts label!  Make sure to look at the Serving Size and Total Carbohydrate.  Pay extra attention if you are having milk and/or fruit for breakfast as they are higher in simple sugars and can raise your blood sugar faster in the morning. 

Breakfast Options:

C  2 slices of whole wheat toast with 1 tbsp peanut butter (~30 grams)

C  2 sliced of whole wheat toast or whole wheat English muffin and 2 scrambled eggs, egg substitute or egg whites (~30 grams)

Breakfast Burrito: 1 large or 2 small soft corn tortilla with scrambled egg whites, 1 slice of low fat cheese and salsa (~30 grams)

C  1 whole wheat English muffin or toast with 1 slice low fat cheese and tomato slices (~30 grams)

C  2 whole grain crackers (Wasa, Kavli, Ryvita, Finn Crisps) with ½ sliced banana and 1 tbsp nut butter (~30 grams)

C  1 cup oatmeal with ½ cup low-fat milk (~30 grams)

C  ½ warm whole wheat pita with 1 tbsp peanut butter wrapped around ½ banana (30 grams)

C  1 whole wheat pita stuffed with hard boiled egg and sliced tomato (30 grams)

C  1 tbsp nut butter on apple slices with low fat yogurt (30-45 grams)

C  ¾ cup high fiber cereal with 1 cup low-fat or skim milk and small handful of mixed nuts (walnuts, almonds, pistachios or peanuts) (40 grams)

C  ½ cup low fat cottage cheese with ½ cup sliced fruit and 1/2 cup high fiber cereal (~50 grams)

Breakfast Parfait: layer 1 cup low-fat plain yogurt, ¾ cup high fiber cereal and small handful of mixed nuts (as noted above) (57 grams)

C  Even leftovers from dinner! (variable grams)

 

VERY LOW CARB SNACKS

(5 g carbs or less)

C   

¼ cup mixed NUTS (almond, peanuts, pistachios, walnuts)

C   

¼ cup SEEDS (sunflower, pumpkin)

C   

1 oz low-fat cheese (any soft or hard) with 2-3 baby carrots

C   

1 slice lean cold cuts (turkey, low fat ham) rolled up in a leaf of lettuce (optional: add mustard or a pickle)

C   

½ hard boiled egg (or just egg white) with light mayo

 

½ cup raw vegetables (baby carrots, celery, peppers, cucumber) with1/3 cup cottage cheese, low-fat ranch or sour cream dip

C   

½ cup low-fat cottage or sour cream with 2-3 sliced strawberries

 

1/3 cup Tuna, egg or chicken salad with light mayo

 (Instead of bread use a leaf of lettuce)

 

1 cup salad (mixed greens + raw veggies) with oil & vinegar

C   

3-4 celery sticks with 1 Tbsp NATURAL peanut butter (SMUCKERS)

 or cream cheese

 

1 serving sugar-free Jell-O with lite whipped cream

 

1 Dannon Light’n Fit CARB CONTROL Smoothie (4g of carbs)

 

1 Dannon Light’n Fit CARB CONTROL yogurt (3g of carbs)

 

1 Sugar Free PopsicleÒ

 

½ cup ricotta cheese with (cinnamon, vanilla extract, 4-5 nuts, splenda)

C   

3-4 Pickles or 5-6 olives with 1 oz low-fat cheese

C   

¼ cup edamme (soybeans)

Carb Counting Tips

1. Weigh and measure foods

  • Get a scale that indicates ounces clearly
  • Also use measuring cups, measuring spoons, and a ruler
  • Measure how much food your bowls and serving spoons hold

1. Get a good carbohydrate counting book

  • The Doctor’s Pocket Calorie, Fat & Carbohydrate Counter, by Allan Borushek (calorieking.com)
  • The Complete Book of Food Counts, by Corinne T. Netzer
  • Carbohydrate Gram Counter, by Corrine Netzer
  • Calories and Carbohydrates, by Barbara Kraus
  • Carbohydrate Guide to Brand Names and Foods, by Barbara Kraus
  • Food Values of Portions Commonly Used, by J. Pennington

2. Use caution when reading food labels

  • If you have an unexplained response to a food, double check by weighing or measuring the food next time
  • Be conscious of varying portion sizes on each label
  • Be aware if the information is indicating cooked or uncooked

3. Don’t ignore fat and protein

  • A portion size of protein is considered to be 3 oz of meat or meat substitute
  • (the size of the palm of your hand or deck of cards)
  • A portion of fat is 1 tsp oil or butter which has 5gm fat (the size of one die (dice))
  • A high fat meal (25 - 35 gm or more) can delay food from leaving the stomach for several hours
  • A high protein meal (6 - 12oz) (2-3 decks of cards) can also slow the carbohydrate from being digested and sometimes raise your blood sugar
  • If you are on a pump a dual wave bolus can be used to cover meals with extra protein and fat
  • Be aware that fat and protein can provide a lot of calories and can lead to weight gain

4. Be careful when eating out

  • Be familiar with typical restaurant foods and portion sizes
  • (e.g. restaurant size portion of pasta = about 4 cups)
  • Get take-out at favorite restaurants and measure the portion size at home
  • If you are on a pump use a dual wave for heavier meals like pizza and Chinese food
  • Be aware of hidden carbohydrates in soups, sauces, gravies, dressings, and condiments
  • Ask for sauces on the side

 

Below is a list of gluten-free flours, grains, and starches with the total carbohydrate and fiber content per serving. 

ALWAYS check the product Nutrition Facts label.

 

For comparison only (NOT gluten free!):

Whole wheat flour

¼ c    

4

4

White wheat flour

¼ cup

24

<1

**All servings are for uncooked product unless otherwise noted

Starch

Serving Size

Total Carbs (grams)

Fiber

(grams)

Almond meal

¼ c     

6

3

Amaranth grain

¼ cup

26

0

Arrowroot starch

¼ cup

28

1

Beans, whole

½ cup cooked

20—22

6—8

Black bean flour

¼ cup

22

5

Brown rice flour

¼ cup

31

1

Buckwheat grain

¼ cup

21

5

Buckwheat flour

¼ cup

21

4

Corn, kernel

½ cup cooked

16

2

Cornstarch

1 tbsp

7

0

Cornmeal

¼ cup

27

2

Flaxseed

3 tbsp

11

9

Flaxseed meal

2 tbsp

4

4

Garbanzo beans

½ cup cooked

22

6

Garbanzo flour

¼ cup

18

5

Guar Gum

1 tbsp

6

6

Millet grain

½ cup cooked

20

1

Millet flour

¼ cup cooked

22

4

Peas, green

½ cup cooked

12

4

Pea, green, flour

1 ½ tbsp

9

4

 

 

 

 

Starch

Serving Size

Total Carbs (grams)

Fiber (grams)

Potato flour

3 tbsp

27

2

Potato starch

1 tbsp

10

0

Potato, russet

3.5 oz baked

21

2

Potato, red

3.5 oz baked

20

2

Potato, sweet

3.5 oz baked

27

4

Quinoa grain

¼ cup raw

23

3

Sorghum flour

¼ cup

22

3

Tapioca flour

¼ cup

26

0

White bean flour

¼ cup

20

8

White rice grain

½ cup cooked

22

0

White rice flour

¼ cup

32

1

 

 

Carbohydrate Content of Foods

 

BREADS / CRACKERS / GRAINS/ STARCHY VEGETABLES

* carbohydrate content may vary from brand to brand, always read the food label!

 

Starches                                                Amount                                                Carb grams

 

BREADS

Bread, white or wheat                        1 slice (1 oz)                                                15 g

Light bread                                                1 slice (1 oz)                                                7-8 g

Low Carb bread                                    1 slice (1 oz)                                                9 g

Challah                                                1 oz                                                             15 g

Lawash, plain                                    2 oz                                                            30 g

Pita bread, all types                        2 oz                                                            30 g

            Mini/Pocket                                    1 oz                                                            15g

Turkish/Middle Eastern                        1 oz                                                            15 g

Hamburger or Hot dog bun            1 bun                                                            20 g

Dinner rolls                                                1 small                                                15 g

Sandwich roll                                    1 medium (2 oz)                                    30 g

Bagel                                                 1 (Deli style)                                                60-70g

Mini bagel                                                1 (1 oz)                                                15 g           

Croissant, plain                                    1 mini (1 oz)                                                15 g

                                                            1 medium (1 ½ oz)                                    20 g

                                                            1 large (2 ½ oz)                                    35 g

Danish, fruit                                                1 regular                                                30 g

Doughnut                                                1 medium                                                25 g

Pancake or waffle, frozen            1 small                                                15 g

English muffin, plain                        1                                                            30 g

Muffin, blueberry                                    1 small (2 oz)                                    30 g

            Dunkin Donuts                        1 regular                                                75 g

Tortilla, corn, 6”                                    1.2 oz, each                                                10 g

            Soft Taco                                    1                                                            15 g

            Flour Tortilla                                    1 (1.7 oz)                                                30 g

Burritos Tortilla                        1                                                             30 g

Wraps, plain

            Regular size                                    1                                                            75 g

            Large size                                    1                                                            120 g

 

CRACKERS

            Saltine                                    1 cracker                                                2 g

            Cheese                                     1 crackers                                                2 g

            Graham                                    1 cracker                                                5 g

            Wheat Thins                                    1 cracker                                                1 g

            Soda                                                1 cracker                                                10 g

            Peanut Butter                        1 cracker                                                4 g

CEREALS

            Check the label!                        1 serving (1 cup)                                    15-45g

Oatmeal                                     1 cup (cooked)                                    30 g

Farina                                                1 cup (cooked)                                    25 g

 

GRAINS

            Rice, white or brown            1 cup (cooked)                                    45 g

            Spaghetti                                    1 cup (cooked)                                    40 g

            Elbows/spirals                        1 cup (cooked)                                    40 g

            Small Shells                                    1 cup (cooked)                                    30 g

            Mac & Cheese                        1 cup (cooked)                                    30 g

            Grits                                                1 cup (cooked)                                    30 g

 

STARCHY VEGETABLES

Corn                                                             ½ cup                                                15 g

Corn on the cob                                    1 medium                                                20 g

Popcorn                                                 3 cups                                                15 g

Potatoes

            Plain, baked                        small (3 oz)                                                15g

            Wendy’s, baked                        large                                                            60-70g

            Mashed                                    ½ cup                                                15g

Plantain                                                1 medium                                                30 g

Yam                                                            ½ cup (mashed)                                    15 g

Yucca                                                ½ cup (mashed)                                    15 g

Hash brows                                                ½ cup (mashed)                                    10 g

French Fries

            McDonald’s                                    small                                                            25 g

                                                            medium                                                60 g

                                                            large                                                            70 g

            Restaurant style                        15 fries                                                25 g

Ku(Wendy’s)gel                                    5 oz                                                            25 g

 

BEANS

Beans, dry:

            Black-eyed peas                        1 cup (cooked)                                    30 g

            Lentils or peas                        1 cup (cooked)                                    40 g

            Navy beans                                    1 cup (cooked)                                    45 g

            Pinto or Black beans            1 cup (cooked)                                    45 g

Beans canned:

            Backed in sweet sauce            1 cup                                                            50 g

            Black or Kidney beans            1 cup                                                            40 g

            Chili with beans                        1 cup                                                 30 g

            Garbanzo beans                        1 cup                                                            50 g

            Lima beans                                    1 cup                                                            30 g

            Refried beans                        1 cup                                                            40 g

 

FRUIT/ FRUIT JUICES

* Use a Food Scale to measure carbohydrate content of fruit per amount (oz.)

 

Food                                                            Amount                                                Carb grams

 

FRESH FRUIT

Apple            

            Small                                                4 oz *                                                            15 g

            Medium                                    6 oz                                                            25 g

            Large                                                8 oz                                                            35 g

Apricots                                                1 medium (2oz)                                    6 g

Applesauce                                                ½ cup unsweetened                        15g

Banana           

            1 medium                                    5 oz                                                            20 g

            1 large                                    7 oz                                                            25 g

Berries                                                1 cup                                                            20 g

Cantaloupe/Honeydew                                               

            Flesh/no skin                        1 oz                                                            2 g

                                                            1 cup (cubes)                                    15 g

Cherries                                                10 pieces                                                10 g

Clementine                                                1 medium (3 oz)                                    15 g

Grapefruit                                                ½ fruit                                                            15 g

Grapes                                                15 pieces                                                15 g

Kiwifruit                                                1 medium (3 oz)                                    10 g

Mandarin                                                1 small (3 oz)                                    6 g

Oranges

            Small                                                1 (5 oz with skin)                                    12 g

            Medium                                    1 (7 oz)                                                18 g

Papaya                                                ½ cup (cubed)                                    8 g

            Medium                                    1 (with skin)                                                30 g

Peaches                                                1 medium (4 oz)                                    8 g

Plum                                                            1 small (2 oz)                                    6 g

Pear                                                             1 medium (6 oz)                                    22 g

Pineapple                                                1 thick slice (3 oz)                                    10 g

Strawberries                                                1 cup (sliced)                                    10g

                                                            3 large (2 oz)                                    3 g

Watermelon                                                1 cup cubes                                    12 g

 

CANNED FRUIT

            (check the label!)

 

DRIED FRUIT

Apricots                                                8 halves (1 oz)                                    15 g

Prunes                                                3 medium                                                15 g

Raisins                                                2 Tbsp.                                                15 g

 

FRUIT JUICE

Apple juice                                                4 oz (1/2 cup)                                    15 g

Grape juice                                                4 oz (1/2 cup)                                    20 g

Orange juice                                    4 oz (1/2 cup)                                    12 g

Vegetable juice                                    4 oz (1/2 cup)                                    6 g

 

 

MILK / YOGURT

Food                                                            Amount                                                Carb grams

 

MILK

Whole, low-fat or skim                        8 oz (1 cup)                                                12 g

Chocolate milk                                    8 oz                                                            26 g

Soymilk (plain)                                    8 oz                                                            8-10 g

 

YOGURT

Yogurt (plain)                                    8 oz (1 cup)                                                12-14 g

Yogurt (light)                                    8 oz                                                            16-20 g

Yogurt with fruit                                    8 oz                                                            32-40 g

 

 

CONDIMENTS / SWEETENERS

Food                                                            Amount                                                Carb grams

 

SUGARS

Table sugar                                                1 Tbsp                                                15 g

Honey                                                1 tsp                                                            6 g

Jam or preserve                                    1 Tbsp                                                15 g

Syrup, Regular                                    1 Tbsp                                                15 g

Syrup, Light                                                1 Tbsp                                                7 g

 

CONDIMENTS

BBQ sauce                                                1 Tbsp                                                6 g

Ketchup                                                1 Tbsp/ 1 pkt                                    5 g

Spaghetti sauce                                    ½ cup                                                10 g

Cranberry sauce                                    ¼ cup                                                25 g

 

FAST FOODS

* Ask for nutritional information where you buy/eat fast food

 

New York style pizza                        1 slice                                                            45 g           

           

 

 

Where can I get some tips about losing weight or maintaining weight loss?

12 Steps to Attain Your Healthy Weight
by Alisa Scherban RD, CDE

 

1. Set Realistic Goals…Losing 5-10% of your body weight through diet and exercise is a realistic goal.

2. Find Out What Motivates You…Keep reminding yourself each day of all the benefits of losing weight.

3. Downsize Portions…By cutting portions sizes by a third or a half you cut calories. It takes 3500 calories to lose a pound of fat. If you cut out 500 calories per day you should lose 1 pound per week.

4. Be a Label Detective…Look for calories, fiber and fat grams on the Nutrition Facts panel. Pay close attention to the servings size. Beware every package is different!

5. Slim Down on Fat…Limit added fats like butter, oil, salad dressing, cheese, nuts, and high fat meats. Fat has more than double the calories of carbohydrates and protein. Look for foods with 3 grams or less per serving.

6. Fit in Fiber…Focus on fresh vegetables, fruits, and whole grains. These foods will keep you fuller and they may help lower your cholesterol as well. Look for 3-5 grams on the label.

7. Eat Frequently…Consuming small meals and snacks every 3-4 hours will provide consistent energy while fueling your metabolism.

8. Stay Hydrated…Shoot for at least 8-8oz glasses per day of water! Try to carry a water bottle with you at all times.

9. Listen to Hunger Cues…Before eating between meals ask yourself, "Do I feel hungry". If the answer is no avoid the snack. It is important to get in touch with your body’s hunger and satiety signals.

10. Chew Your Food…By eating slowly you will be able to enjoy your food longer and you will give your brain a chance to sense that you are full.

11. Write it Down…Keeping a record of what you are eating will help identify the problem areas of your diet. It also may make you a little more careful of what you decide to put in your mouth.

12. Get Moving…Aim for 20-30 minutes 3-5 times per week of any cardiovascular exercise (like walking) and continue to increase each week.

 

Estimating Portion Sizes

A FIST = ONE CUP

Your fist is about the same size as one cup. A half cup serving of hot cereal, pasta, potato, corn, peas and beans, fruit and vegetable is equal to one serving. Rice is less (about 1/3 cup) and cold cereal is more like _ cup. Compare the size of your fist to the amounts of these foods that you are eating.

A HANDFUL = ONE OR TWO OUNCES OF SNACK FOOD

One handful equals an ounce of foods such as nuts. For bulkier snacks such as chips and pretzels, two handfuls equals one ounce which is the serving size listed on most snack-food labels. If you do not have measuring spoons, two tablespoons of liquid fits in your cupped hand.

A THUMB = ONE OUNCE OF CHEESE

In general one thumb-size chunk, is about one ounce of cheese. (Very hard cheeses such as aged parmesan, with very little water content, will weigh more than soft cheeses such as Mozzarella, which has more moisture).

A THUMB TIP = ONE TEASPOON

A smear of butter, peanut butter, and mayonnaise add to your fat calories and servings can add up quickly! If the amount you have eaten matches the size of the top part of your thumb, it's a teaspoon. If you eat three thumb-tip-size, you've eaten a tablespoon. The top part of your index finger is about a half teaspoon.

PALM = THREE OUNCES

A serving of meat is a lot less than you think. A serving is about 2-3 ounces. We should have 2-3 servings of meat and meat alternatives per day. After being cooked, the size of your palm - minus fingers and thumb — meets half your day's requirement.


Permission to use information and pictures has been granted by Kim Babcock RD, BA, CDE, Maureen Thornton, RN, CDE and Laurie Mark of Sugarbytes.com

 

 

Low Calorie, Low Fat Snacks

Choose snacks with 100-150 calories and 3 grams of fat or less

  • 1 piece of fresh fruit
  • ½  cup of unsweetened applesauce
  • 1 small box of raisins
  • 1 cup of baby carrots or celery with 2 Tbsp low fat dressing
  • 1 cup of salad with fat-free salad dressing
  • 8 oz vegetable juice
  • 3 graham crackers
  • 1 low fat granola bar
  • 2 fig bars
  • 4 ginger snaps or vanilla wafers
  • 6 Saltines or whole grain crackers with 1 oz low fat cheese or ½ cup nonfat cottage cheese
  • 3/4 cup of unsweetened cereal and 1 cup skim milk
  • Sugar free hot cocoa with 1 cup skim milk
  • 1 cup of dry cereal chex mix
  • 2 rice cakes with sugar free jam
  • 1 handful of pretzels
  • 1 handful of baked tortilla chips and salsa
  • 1 handful of baked potato chips or fat free Pringles™
  • 1 handful of Glenny’s™ Pirates Bootie or Potato Flyers
  • 20 Soy Crisps™
  • 3 cups of light microwave popcorn
  • 1 cup of soup
  • ½  cup of sugar free, nonfat pudding
  • 1 cup of nonfat, light yogurt
  • 1 cup of sugar-free jello™ with fat free whipped topping
  • 1 stick of light mozzarella string cheese
  • 1 English muffin, 1 slice raisin toast or ½ lender’s™ bagel with light cream cheese
  • ½  sandwich with low fat tuna or turkey breast

 

Simple Substitutions
For Cutting Fat and Cholesterol 

 

When a recipe

Calls for:

………

Use this instead:

Sour cream

 ¼ cup of plain low fat yogurt, 0% or 2% greek yogurt

Whipped cream

Chilled, whipped evaporated skim milk, or a nondairy whipped topping

Cream

Evaporated skim milk

Whole milk

Skim, 1 % or 2 % milk

Full-fat cheese

Low fat, skim milk cheese, cheese with less that 5 grams of fat

Ricotta cheese

Low fat or fat-free cottage cheese or non-fat or low-fat ricotta cheese

Ice cream

Low fat or non-fat ice cream, or frozen or non-fat yogurt

Ground beef

Extra lean ground beef, or lean ground turkey or chicken

Bacon

Canadian bacon or lean ham

Sausage

Lean ground turkey or 95% fat-free sausage

Whole egg

Two egg whites, or ¼ cup cholesterol-free liquid egg product

One egg yolk

One egg white

Mayonnaise

Low fat or fat-free mayonnaise or plain low fat yogurt combined with low-fat cottage cheese

Salad dressings

Low-calorie dressing or homemade dressing made with olive oil, water and vinegar or lemon juice

Cream soups

Broth-based or skim milk based soups

Nuts

Dried fruit such as raisins, dried cranberries, or chopped dried apricots

1 oz baking chocolate

3 tablespoons cocoa powder and 1 tablespoon oil

Butter or lard

Soft tub margarine, olive oil or canola oil

 

 

 

Why do patients participate in clinical research studies?

Participating in a research study has many benefits. By participating, you may help us find answers to important research questions, such as what causes diabetes, or what treatments work to prevent diabetes or to treat diabetes. In addition, by participating in a research study you may be able to get new treatments for diabetes that are not yet available in pharmacies. At the Berrie Center, patients also have rapid access to translational research studies, protocols that test recent discoveries made in the laboratory.

Participating in a research study is voluntary. We will always tell you all of the details about a study you might be eligible for, and you will have the opportunity to ask as many questions as you like. If you’re not interested, simply tell us right away. You may take the consent form home to read and discuss with your family. If you decide to participate and then change your mind, that’s fine, too. It’s up to you to decide whether or not to join a clinical diabetes study.

How do I find out more about the diabetes trials underway at the Berrie Center?

We have an updated list of current trials listed on this website. If you’d like more information about type 1 diabetes trials, please contact lead research coordinator, Ellen Greenberg at emg25@columbia.edu or at (212) 851-5425. If you’d like more information about type 2 diabetes trials, please contact lead research coordinator, Patricia Kringas, RN at mpk40@columbia.edu or (212) 851-5489

Where can I get more information about the insulin pump?

Insulin pump therapy is an effective method used to manage type 1 diabetes. At the Naomi Berrie Diabetes Center and nationally, the pump population is growing rapidly. Here are some commonly asked questions and answers about pump therapy.

How does the insulin pump work?
An insulin pump is approximately the size of a pager. It has a compartment to hold a small container of rapid-acting insulin (often aspart or lispro insulin). A small plastic catheter is inserted under the and changed every 2-3 days. Leaving the pump site in for longer may cause higher risk of infection and poor insulin absorption. The catheter is soft and flexible. A needle is required to help insert the catheter, but the needle is removed after insertion. There are devices that can help the patient insert the catheter. Most people feel that the insertion is similar to an injection of insulin. In most pumps, clear plastic tubing carries the insulin from the pump to the insertion site.

Basal (background) insulin doses provide a continuous low-dose insulin infusion based on individual needs. Some patients need higher basal rates early in the morning (3-8am) and decreased basal rates in the afternoon. When a patient is going to eat a snack or a meal, they check their blood sugar and determine how much additional insulin to give through the pump (called a bolus) based on the blood sugar and the amount of carbohydrate about to be eaten.

What can the pump do?

Improve glucose control by allowing the patient to have normal pre-meal blood sugars without the use of long-acting insulin. In people who do not have diabetes, the pancreas is continuously making low levels of insulin. It then gives bursts of insulin whenever it detects elevations of blood sugar levels. The insulin pump helps mimic how our body provides insulin by providing a combination of continuous low-dose insulin (the basal rate) and extra doses of insulin to cover the meal-related increase in blood sugar. Importantly, the patient still needs to check the blood sugar and “tell” the pump what to do.

Improve flexibility in timing and amounts of meals

When using a pump, patients can choose when to eat rather than eating when insulin is peaking and can more precisely match the bolus insulin to the food. Patients using a pump do not have to draw up insulin in a syringe or use a pen when injecting insulin. They merely “press the button” on the pump and administer the insulin through the pump.

Improve flexibility in timing and amount of exercise

The pump allows for greater flexibility in exercise. Without the use of long-acting insulin, hypoglycemia is less of a problem. The insulin pump allows patients to decrease the basal insulin temporarily during exercise; the pump can also be “turned off” or even disconnected during exercise

Reduce hypoglycemia (low blood sugars)
Many patients experience hypoglycemia related to the use of long-acting insulin. The pump uses only very short acting insulin and the basal rate can be altered according to individual situation such as travel, exercise, stress, or illness. This same flexibility is not possible with injected long-acting insulin.

What can’t the pump do?
It’s important to recognize what the pump can and cannot do. Patients may be able to obtain good glucose control from insulin injections or from an insulin pump. The pump cannot automatically give patients excellent diabetes control without effort. Patients still need to monitor their blood sugars and count carbohydrates.

Who is a good pump candidate:
Most of our patients find that the insulin pump requires as much attention as multiple daily injections, even more in the beginning. We expect that patients interested in the pump are currently approaching their diabetes management in an intensive manner. This means that the patient should be monitoring their blood sugar 4-6 times a day, counting carbohydrates well, and have demonstrated their ability to work well with the diabetes team. Good pump candidates should also be adjusting their insulin doses related to carbohydrate intake and/or activity and then evaluating the effectiveness of those adjustments. This approach to diabetes management is beneficial for all patients, even those not considering pump therapy.

Why must you count carbohydrates to use an insulin pump?
To be successful with the insulin pump. it is very important to understand how much insulin you need to “cover” all the foods that you eat. In order to do this, you must know how much carbohydrate, the main nutrient in food that affects blood sugar, is contained in the foods you eat. Carbohydrates are found in foods such as bread, cereal, rice, pasta, potatoes, fruit, and milk. The carbohydrates in food are measured in grams. You can find out how many grams are in the foods you eat by reading food labels, weighing foods with a scale, or measuring foods with measuring cups and spoons. It is also helpful to get a carbohydrate-counting book that lists foods and their carbohydrate content.You will need to take a specific amount of insulin for the amount of carbohydrate grams that you eat throughout the day. This is called an insulin bolus. Each person requires a different amount of insulin for the carbohydrates they consume. You will need to keep detailed records of your food intake, carbohydrate grams, insulin doses and blood glucose levels for several weeks before starting the pump. Keeping records will help you learn how to count carbohydrates and it will help to determine how much insulin you need per gram of carbohydrate. This is referred to as your insulin to carbohydrate ratio (e.g. 1 unit of insulin for 15 grams of carbohydrate = 1:15).

Are you ready for the pump?
We recommend that you come to the “Considering the Pump” class and then meet individually with your diabetes educator. Once you and the team agree that you are a good candidate for the pump – you test your blood sugar frequently, count carbohydrates, self-adjust insulin based on food and blood sugar and other factors, and work well with the team, we will order the pump that you’ve chosen.

What is involved in starting the pump?
Pump starts are usually done in 2 long office visits. The first visit is a pump start without insulin. The patient inserts the pump and learns all the basic features then uses the pump for a week with saline, while continuing the usual insulin regimen by injection. Patients spend the first week practicing pump site insertions, trouble-shooting, and making changes and adjustments in basal and bolus doses. The second visit is for the pump start with insulin. This visit is done in the morning. The long acting insulin is held the night before and insulin is initiated by pump is the office. Patients usually spend at least through lunch at the Berrie Center on their first day of pump therapy. Patients are in close contact with the educator for several weeks after initiation of pump therapy.

What to do if the insulin pump fails?

Prepare for pump failure in advance while your pump is working!

Contact your insulin pump company IMMEDIATELY, so that a replacement pump can be shipped to you.

•  Animas Corporation: 877-937-7867
•  Medtronic MiniMed: 800-MINIMED (800-646-4633)
•  OmniPod (Insulet Corporation): 800-591-3455

In the event of a pump failure, you will need to take long-acting insulin (glargine or lantus) and short-acting insulin (novolog or humalog) by injection.  Make sure you have at least 1 vial of lantus and syringes and/or pens available.  Don’t forget to have emergency prescriptions for lantus and syringes available even when you travel.

  1. Keep an index card with your current insulin pump settings in several places including your home and work place.  Write down your basal rates, insulin:carbohydrate ratios and insulin correction factors.  Update the cards monthly.
  2. Calculate your lantus dose by adding up the total basal rate for 24 hours.  Your lantus dose will be ______ units.  Continue to give the same doses of pre-meal short-acting insulin bolus now by injection.
  3. Once your replacement insulin pump arrives, you will need to program your settings from your old pump into your replacement pump. If you need assistance with programming the doses into your replacement pump, please contact the customer service department of your pump company.
  4. Lantus lasts for 24 hours so restart the basal rate 24 hours after the last Lantus dose is given.

Where do I get more information about diabetes?

Diabetes Organizations

American Diabetes Association

1707 North Beauregard Street

Alexandria, VA

800-DIABETES (342-2383)

800-232-6733 (to order publications)

Website: www.diabetes.org

Children with Diabetes, Inc.

5689 Chancery Place

Hamilton, OH 45011

Website:  www.childrenwithdiabetes.com

 Diabetes Exercise & Sports Association

310 West Liberty, Suite 604

Louisville, KY  40202

800-898-4322

Website: www.diabetes-exercise.org

 Diabetes Education and Camping Association (DECA)

PO Box 385

Huntsville, AL  35804

Website: www.diabetescamps.org

Juvenile Diabetes Research Foundation

120 Wall Street

New York, NY 10005-4001

800-533-CURE (2873)

Website: www.jdrf.org

Diabetes Identification

American Medical ID

Phone: 800-363-5985

Website:  www.identifyyourself.com

Lauren’s Hope

Phone: 800-360-8680

Website:  www.laurenshope.com

The Beadin’ Beagle

Phone:  561-737-8325

Website:  www.beadin-beagle.com