Transcript DiabetesandNutrition - Diabetes Education & Camping Association

Diabetes and
Nutrition
Julie Thilges, RD, LD
Mercy Medical CenterNorth Iowa
Many thanks to our friends at Camp Hertko
Hollow for providing this presentation.
Camp Hertko Hollow
101 Locust St.
Des Moines, IA 50309
Ann Wolf, Executive Director
515-471-8523
[email protected]
Vivian Murray, Camp Director
352-750-6759 or 888-437-8652 (Toll free)
[email protected]
This presentation is intended to be a general guide that will help you create a thorough staff
training tool for your camp. It is not intended to be a comprehensive resource or to fully cover
the topic. We hope you will take this presentation and adapt it so that it fits your camp’s
specific needs and meets the guidelines established for the safe and effective operation of your
program.
Each diabetes camp operates under detailed policies and procedures that follow Board of
Health and national accreditation standards that ensure the health and safety of children with
diabetes. It is essential that camp staff be trained according to your camp’s policies and
procedures. Staff should be encouraged to carefully review materials before arriving at camp,
participate fully in pre-camp training, ask questions and use good judgment as they provide
diabetes management supervision and educate youth with diabetes at camp.
While doing so, it is equally important that camp staff not lose focus – camp is a place for
youth to have fun with peers – to feel supported and understood, and to feel part of a
passionate community. Good luck!
Nutrition
Food greatly impacts blood sugars
 Diabetes diet is a healthy diet, all
people benefit from following this
 Different nutrients impact your child and
family’s growth and health
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Nutrients
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Carbohydrates
 Proteins
 Fats
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Vitamins and
Minerals
 Water
 Fiber
Carbohydrates
Main energy source for the body
 Sugar and starch is a type of
carbohydrate
 It is not believed certain types of carbs
are any worse than another
 HOW MUCH, WHEN, and WITH WHAT
the carbohydrate is eaten with will
impact blood sugars
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Carbohydrates
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Breads
Crackers
Fruits
Beans (baked, refried, black, kidney)
Starchy vegetables (corn, peas, potatoes,
squash)
Milk and Yogurt
Most desserts
Proteins
Important for muscle and bone growth
 Eating extra will not mean increased
muscle growth
 Complete proteins come from animal
products- may be higher in fat
 Proteins may help keep blood sugars
from going too low when consumed with
carbs
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Proteins
Beef
 Pork
 Eggs
 Peanut butter
 Cheese
 Chicken
 Fish
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Fats
Fat is essential, however it provided
more energy/ gram than other
macronutrients
 High fat diets may lead to heart disease
 Fat consumption in large amounts tend
to impede blood sugars coming down to
a normal level

Vitamins and Minerals
Essential for healthy growth
 Not significant for calories
 Most people with a balanced diet get
adequate amounts
 A multivitamin may be beneficial for
someone not getting a balanced diet
(not liking milk or vegetables)

Water
Water makes up two thirds of the body
 Recommend 6 cups/ day
 Especially important with increased
activity and hot days (when your body is
more likely to lose fluids)

Fiber
Dietary fiber is a type of carbohydrate
that is not digested
 May be subtracted from total carbs on
food labels
 Is thought to help control blood sugars
 Aids in digestion
 Helps body feel satisfied longer
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Sweetners

(Non-nutritive) Provide no calorie or
carbohydrate
 (Nutritive) sucrose and fructose
– High fructose corn syrup is a combo of both and
raises blood sugars more quickly than both
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Sugar alcohols
– They provide a smaller amount of carbs (2 grams./
Tsp) and are absorbed more slowly
– Found in sugar free candy
Non-Nutritive Sweetners
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Saccharin- found in some soft drinks
 Aspartame-contains phenylalanine, found in
many products
– It has been suggested the breakdown product
(formaldehyde) could be bad for health- THIS HAS
NEVER BEEN SCIENTIFICALLY SUPPORTED
IN HUMANS
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Acesulfame- K- used in chewing gums,
desserts, and soft drinks
 Sucralose- Splenda, most heat stable
 Stevia- natural alternative from a herb,
– Not approved by the FDA
Reading Labels

Serving size shown
on top
 Total fat- may
impact blood sugars
and its importance
r/t heart disease
 Total carbs (15g = 1
carb choice)
 Dietary Fiber
Objectives of Food Management
Balance insulin and carb intake to keep
blood sugars close to normal
 To keep blood fats and lipoproteins at
desired levels
 Improve overall health by maintaining
nutrition
 Attain normal growth and development
 Prevent severe hypoglycemia
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Three Common Meal Plan
Approaches
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Constant Carbohydrate Meal Planning
– Carbs may vary from meals, but stay the same
from day to day
– Food eaten my vary d/t exercise, insulin taken, BS
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Carbohydrate Counting Meal Plan
– Involves counting grams to match insulin
– Assumes variation (provides more flexibility and
safety from hypoglycemia)
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Exchange Meal Plan
– Protein and fat exchanges used
Glycemic Index
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Ranks carbohydrates based on how quickly
these foods will raise blood sugars
Not suggesting any foods are good or bad
Important to be aware of
Not recommended to solely control food
intake
May see more of this in the future
Glycemic Index- continued
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Low GI diets help people lose and
control weight
Low GI diets increase the body's
sensitivity to insulin
Low GI carbs improve diabetes
control
Low GI carbs reduce the risk of
heart disease
Low GI carbs reduce blood
cholesterol levels
Low GI carbs can help you manage
the symptoms of PCOS
Low GI carbs reduce hunger and
keep you fuller for longer
Low GI carbs prolong physical
endurance
High GI carbs help re-fuel
carbohydrate stores after exercise
Glycemic Index Examples
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High glycemic index foods include many
carbohydrates such as these:
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Pasta
Rice
Cereal
Baked goods
Low glycemic index foods include these:
– Fruits and vegetables
– Whole grains
– Legumes
www.webmed.com
Ketoacididosis and Nutrition
Nutrition mostly used as a tool for
prevention
 Stay hydrated- will replace lost fluid
from urine
 Orange juice and bananas are good for
replacing potassium
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Sick days
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It is important to keep track of consumption
and fluid intake
Drink out of a 1 L water bottle to keep track
May need to consume foods normally
avoided to meet carb needs (Regular pop or
gelatin)
May need extra snacks
Check BS often
If vomiting avoid solid foods, gradually start
liquids (if vomiting is frequent may need med
such as Phenergan)
Discussion