Transcript powerpoint - Kovler Diabetes Center

Nutrition and Exercise
Julia Socke RD, LDN, CDE
Diabetes Educator and Outreach Coordinator
Kovler Diabetes Center
University of Chicago
What Affects Blood Sugar?
 Carbohydrates
 Quantity of
carbohydrates at one
time
 Protein, fat, and fiber
content of the meal
 Overall volume of
meal
 Timing of insulin dose
or other medication
 Physical activity
 Stress levels
 Illness
 Site absorption
 Excitement
How Fast Foods Breakdown
• Carbohydrate:
-2 hours
• Protein:
-7-8 hours
• Fat:
-20 hours
Percentage Of Nutrients Changed
To Blood Glucose
100% Carbohydrates
50-60% Proteins
Less than 10% Fats
Glucose
Total Carbohydrates Count!
• The amount of carbohydrate at one time
has the most significant impact on
blood sugar
Starches
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1 slice of bread
½ pita bread
1/3 c rice
1/3 c pasta
6” flour tortilla
4” corn tortilla
¾ c unsweetened cereal
½ c unsweetened hot
cereal (made with water)
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1 small potato
½ c mashed
½ c corn
1 c winter squash
½ c beans
½ english muffin
3 c popcorn
6 saltine crackers
Fruit
• ½ banana
• 1 small apple, pear,
peach, orange, kiwi
(5oz)
• 1 c whole
strawberries
• 15 grapes
• 1c cubed watermelon
• 1/3 c cantaloupe
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12 cherries
¾ c blueberries
3 prunes
2 tbsp raisins
½ c orange juice
¾ c fresh pineapple
½ small mango or
papaya
• 2 figs
Milk and Yogurt
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1c (8oz) milk
1c buttermilk
6-8oz yogurt (plain)
6-8oz yogurt using artificial sweetener
6-8oz yogurt without added sugar
1/3 c nonfat dry milk powder
½ c evaporated skim milk
Carbohydrate Counting and
Coverage
• Do your best and utilize carb counting tools
available
• Use past experiences to help guide you
• When at a gathering, bring a dish and/or dessert
from home
• Look ahead at menus
• Can carbs in recipes be reduced?
• If possible, give insulin lead time to start working
before eating
• Check 2 hours after meals
Consider Extended Bolus
• Meals high in fat, protein, and carbs may break down
much slower
• The end result is an elevated BG 4-5 hours post meal
even though the 2 hr pp sugar is normal
• Try giving 50% upfront and then the other 50% over 2-4
hour time span
• Check prior to meal + every 2 hours for 6 hours
• Goal to be within 30-50 points at each interval
Food Labels
Carbohydrate and Recipe
Resources
American Diabetes Association
www.diabetes.org
Jewish Diabetes Association
www.jewishdiabetes.org
SELF Nutrition Data
http://nutritiondata.self.com/
Smart Phone Apps
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Carb counting with Lenny
Fooducate
Calorie King
ChooseMyPlateSuperTracker
EveryoneEat!
GoMeals
MyFitnessPal
Sugar Alcohols
• A type of reduced calorie sweetener
• Their effects on blood sugar can vary
• Rule: 5g or more per serving then subtract
½ from total carb
• Can have a laxative effect
Fiber
• Part of the plant that your body cannot
digest
• Slows the digestion of carbohydrates
• If greater than 5g, 1/2 can be subtracted
from total carb
Glycemic Index
Determine how quickly a food will raise
blood sugar
Low glycemic foods can promote fullness
for a longer period of time
Remember basic healthy eating principles
when interpreting low/high glycemic foods
2011 MyPlate
Balanced Meal Planning:
The Plate Method
How Does Summer Vacation
Impact Diabetes?
• Children may be out of their typical routine
• Different foods are often consumed
• Larger quantities of higher carbohydrate
foods available
• Changes in physical activity level
• Travel
Summer Eating Tips
• Your child can still eat their favorites!
• Encourage your child to focus on carb
foods that are most desired
• Limit snacking between meals or
encourage non-carb foods
• Plan ahead!
Travel Tips
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Obtain letter from healthcare team
Allow enough time for TSA to check bags
Bring prescriptions and insurance cards
Medical ID is a must
Check BG often
Consult with healthcare team if travelling across time
zones
• Avoid exposing insulin to extreme temperatures
• If in foreign country, insulin strength is different than in
the U.S.
Travel Supplies
IN CARRY-ON BAG
 Glucometer and test strips
 Medication
 Batteries
 Glucose Tabs
 Glucagon
 Ketone strips
 Insulin and needles
 Snacks in case of delays
 Pack at least twice the amount of supplies
you think will be needed!
Get Moving!
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Physical activity can help to control BG
Exercise lowers insulin need
Use caution if blood sugar is >250
Please contact your healthcare team if
lows often occur as a result of exercise
• Avoid injecting insulin into an active site
Exercise and Blood Sugar
• Sulfonylurea and insulin both work to
lower sugar
• Consider a decrease in medication prior to
exercise or eat a snack before
• Take note of differences in sugar with
different activities
• Sometimes there is a delayed effect on
blood sugar hours later
Thank you!
[email protected]