Diabetes diet calculations: choices and meal plan Flashcards
Why consume low GI foods?
It helps to: • decrease risk of type 2 diabetes and its complications • decrease risk of heart disease and stroke • feel full longer • maintain or lose weight
Should u avoid alcohol if you have diabetes?
As a general rule, there is no need to avoid alcohol because you have diabetes.You should not drink alcohol if you: • are pregnant or trying to get pregnant • are breastfeeding • have a personal or family history of drinking problems • are planning to drive or engage in other activities that require attention or skill • are taking certain medications. Ask your pharmacist about your medications.
What are the aspects that help individualize the program to your client?
- What do they know?
- What do they find difficult or challenging?
- What are their goals to manage their diabetes?
Examples of Individualized Goals
Ways of controlling type 2 or pre-diabtes
- Diet
- Excercise
Some T2DM patients can control their symtomps usign only these 2 methods
Ways of controlling type 2 diabtes
- Diet
- Exercise
- Meds (typically start with oral)
Ways of controlling type 1 or 2 diabtes
- Diet
- Exercise
- Meds, Insulin (insulin is obligatory in type 1)
Who is at risk for very high or low blood sugars?
not every diabetic person is at risk of such extreme conditions
- insulin or insulin secratogogue medication
- Illness: increases blood glucose-> increased risk of hyperglycemia
- Alcohol: lowers blood glucose as liver is busy neutralizing alcohol
- Diabetic ketoacidosis (DKA) in Type 1
- Hyperosmolar Hyperglycemic State (HHS) in Type 2
What causes a diabetic coma?
- Severe hypoglycemia - severely low blood sugar
- Deabetic ketoacidosis- extremely high blood sugars from a lack of insulin; more typical for T1DM
- Diabetice hyperosmolar syndrome- severy dehydration and high blood sugar; more often in T2DM
What % of diabetics use insulin?
- Within 5 - 10 years or less of diagnosis, many Type 2 diabetics will need insulin to optimize control, especially if their blood glucose was very high at the time of diagnosis
- Approximately 14% use insulin alone (this would include Type 1’s and Type 2’s). Type 1 represents 5 – 10%.
- 13% use insulin and oral medication (Type 2)
- 57% take oral medication only (Type 2)
- 16% control blood sugar with no medications (diet and exercise alone) (Type 2)
Why insulin for Type 2
- Eating right, exercise, + oral meds may not be enough
- Insulin works. It is the closest to our normal body function- > thus, patients should not be scared about using insulin
What might be the benefits of giving type 2 pateitns insulin sooner?
Starting insulin sooner for a Type 2 may give:
- Feel better sooner
- Better mood, better outlook
- Better control of blood glucose sooner
• Avoid complications developing
The Effect of Alcohol on Blood Sugar
The effects are unpredictable
- Can cause blood sugars to go low (effect can last up to 24 hours)
- Symptoms of low blood sugar could be confused with drunkenness, thus might go unnoticed, which is bad and dangerous
When driniking alcohol, Diabetics need to make sure to->
- Consume a meal or snack while drinking alcohol to provide glucose since alcohol lowers glucose
- Wear a medic-alert ID
What are the alcohol intake recommendations in diabetes?
Same as for peoplw w/o diabetes
What are the recommendations for insulin administration when drinking?
If you are carbohydrate counting, do not take insulin for the carbohydrate content of alcoholic drinks
Which alcoholic beverages should be avoided by diabetics? Why?
Which drinks are ok?
Liquers and Cordials, Wine, Coolers, Mixes should be avoided due to high CHO content
Beer, spirits/hard liquor are OK
1 Regular Beer = 140 kcalories, with 10 g of Carbohydrate, 0 g fat, 1 g protein.
• How many kcalories does the carbohydrate + protein provide?
What is the source of other calories?
How many kcalories does the carbohydrate + protein provide? (10 x 4) + (1 x 4) = 44
96kcal are coming from alcohol
How long does it usually take to digest carbs?
Does it take less or more time to digest fat/protein
2h
Takes longer to digest fat/protein
GI category of white bread. whole wheat bread
both are medium GI
Is flour a simple carb? What is its GI?
flour is a starch complex, but it is still digested fairly quickly
• High glycemic inde
Does low sugar= low GI? give an example
White Bread often has no sugar in it, but has a high GI-> thus low sugar doesn’t equal low GI
Are unsweetened juices a “free to go” item?
No, Avoid Juice, even if unsweetened
• Pure unsweetened fruit juice has no added sugar but does contain carbohydrate which is rapidly absorbed
what can Juice or sweetened beverages be used for?
Juice or sweetened beverages can be used to treat a Low blood sugar.
What is recommended instead of juice? Why>
real fruit is better than juice
lower Gi plus less is usually consumed
Name a milk/alternative item with high GI
rice milk
What GI group do milk/alternative usually belong to? Why
Usually below to low GI as there’s usually fat and protein content
7 tips form Just the Basics and reasons
What is important about CHO and meal intakes for people with diabetes?
Consistency in spacing and intake of carbohydrate and in spacing and regularity in meal consumption may help control blood glucose and weight
Is milk a seprate food group in diabetes canada guide? In food guide?
Food guide- no longer a separate food group
Diabetes guide- still a separate food group
How can hands be used to determine a portion?
What is the weigth of CHO in one serving
1 serving of CHO= 15g
What are the Foods that have Little or No Carbohydrate
- MEAT & ALTERNATIVEs- 0 grams (except for legumes)
- VEGETABLES- 0 grams (except for some vegetables)
- FATS- 0 grams
How many g of CHO per meal and per snack?
- 45 to 75g (3-5 exchanges) per meal
- 15 to 30g per snack
the amount though depends on various factors, such as age, gender, height, weight, and level of physical activity
What are the recommended blood sugar levels before and 2h after meals
- 4 to 7 mmol/l before meals
- 5 and 10 mmol/L 2 hours after meals
How to read to carb labels for people with diabetes? for carb exchange calculations
General easy guide:
Fibre should be subtracted from total carbohydrate because it does not raise blood glucose
36g – 6g = 30g-> 2 carb choices
Does sugar high up in the ingredient list= bad?
No! calculate carb exchange to see whether the item is appropriate or not
Health Canada Label Reading “a little” vs “a lot”
<5%-> a little
>15%-> a lot
What shoudl we eat less and more of?
Less of: fat, saturated and trans fats, sodium
More of : fibre, Vit A, calcium, iron
Who might benefit from a more complex meal plan?
- Those who would benefit from a more precise meal plan and who are able and motivated to understand the plan
- Type 1 on a conventional insulin plan (one or two injections per day)
- Type 2 who needs to control portion sizes, trying to lose weight
Who might not benefit from a more complex meal plan?
- Diabetic who has difficulty following basic principles or complex
- instructions (ex: less motivated, lower literacy…)
- Vegan
- Athlete or person with higher energy needs
- Person not needing to lose weight or control portions
- Person with multiple insulin injections per day (match insulin to carbohydrate) Clinical Nutrition 3
Nutritional Value of one exchange
When would a pateint use exact labels or nutritional analysis tables?
- have time
- trying a new product
- less common food
• not sure
What does 1 starch exchange equal to?
15g carbs
3g prot
0 fat
legumes are found both in __ and __
legumes are found both in starch and meat
Do canadians eat enough veggies?
No
Which veggies shoudl be counted as a source of cal/macronutrients
the starchy ones
1 Milk and Alternatives exchange =
12 to 15 g carbohydrate
8 g protein
0 to 9 g fat
Cheese and plain Greek yogurt are listed in the __ group because they are l__
Cheese and plain Greek yogurt are listed in the Meat and Alternatives group because they are low in carbohydrates and high in protein.
recommendationsf for added sugar intake
Adults with diabetes may substitute added sugars (sucrose, high fructose corn syrup, fructose, glucose) with other carbohydrates as part of mixed meals up to a maximum of 10% of total daily energy intake, provided adequate control of BG, lipids, and body weight is maintained
1 Meat and Alternatives exchange =
0 g carbohydrate
8 g protein
3 g fat
One Fats exchange =
0 g carbohydrate
0 g protein
5 g fat
Which food group do Nuts and Seeds belong to?
• Small amounts are included and mentioned mainly in the Fats section due to their high fat content
If you have a client who is vegetarian and regularly consuming nuts and seeds as their protein source, then you could count them as Meat and Alternatives
45 – 60 ml whole nuts/seeds = 1 Very High Fat Meat and Alternative
are people with diabetes required to consume sugar substitures
no
AMDR recommendations
CHO: 45-60%
Prot: 15-20% (or 1-1.5g /kg BW)
Fat: 20-35%
