Part 2 Nutrition Therapy for Diabetes Management How

Part 2: Nutrition Therapy for Diabetes Management

How Do You Control Blood Sugar With Food? Meal Planning • Consistent meal times • Consistent carbohydrates • Combine protein foods with carbohydrates Why does it matter? • Maintains normal/near normal blood sugar levels

How Nutrients Affect Blood Sugar CARBOHYDRATE PROTEIN FAT

Total Carbohydrates Count Carbohydrates give energy ENERGY But too much carbohydrate or the wrong carbohydrate can raise blood sugar above your target range

Total Carbohydrates Count Men 45 -60 grams per meal 15 -30 grams per snack Women 30 -45 grams per meal 15 -30 grams per snack

Carbohydrates (CHO) in Each Food Group

Breads, Cereals, Grains & Starchy Vegetables Have CHO Each serving has about 15 grams carbohydrates One serving is: • 1 slice of bread • ¼ bagel • 1/3 cup cooked rice, pasta or oatmeal • ½ cup starchy vegetables – potatoes, beans, peas, corn

Fruits Have CHO Each serving has about 15 grams carbohydrates One serving is: • 1 small fruit (size of tennis ball) • ½ cup fruit • ½ large banana • 17 small grapes • 2 Tbsp raisins or dried fruit

Non-starchy Vegetables Have Very Few CHO Each serving has about 5 grams carbohydrates One serving is: • 1 cup raw vegetables • ½ cup cooked vegetables

Dairy Products Have CHO Each serving has about 15 grams carbohydrates One serving is: • 8 oz cow’s milk • 6 – 8 oz plain yogurt – Flavored yogurt = 18 – 45 g! Check the label!

Meats & Protein Alternatives Have No CHO • Meats, eggs and cheeses have very little CHO but can be high in fat and cholesterol • Beware of breading and sugary sauces • Protein alternatives have very little CHO: – Nuts, nut butters, seeds, soy & tofu – Veggie burgers DO have CHO – check the label!

Sweets & Sugars Have CHO • Count towards total carbohydrates • ‘Sweets’ have little nutritional value but can be high in fat and calories, which can cause an increase in weight and triglycerides • Sugar free products still have CHO • Limit ‘sweets’ to 1 -2 servings each week

Portion Sizes • • • 3 oz of meat = size of deck of cards 1 cup = size of baseball ½ cup = ice cream scoop 1 serving of fruit = size of baseball 1 Tbsp of fat = thumb tip 1 serving of bread = size of CD

Use the Plate Method every meal ½ Plate Veggies ¼ Plate Protein ¼ Plate Starches, Grains, Fruit or Milk

Reduce Saturated Fat Roasting Baking Broiling Grilling • Remove skin from poultry & choose white meat • Choose lean proteins – chicken, turkey, fish, tofu or pork tenderloin • Eat fewer high-fat foods – cold cuts, hot dogs, sausage, bacon & fried food • Use less fat in cooking or use cooking sprays

Meal Planning: Timing • Eat every 3 -5 hours • Do NOT skip meals • Try to eat at the same time every day • Eat a snack if meal is delayed

Reading a Label Always check the serving size! Look for total CALORIES Check the FAT Nutrition Facts Serving Size 1 cup (236 g) Servings Per Container 2 Amount Per Serving Calories 230 Calories from fat 120 % Daily Value* Total Fat 14 g 22% Saturated Fat 7 g 35% Trans Fat 1 g Cholesterol 40 mg 13% Sodium 950 mg 40% Total Carbohydrate 16 g 5% Dietary Fiber 2 g 8% Sugars 3 g Protein 11 g Vitamin A 20% Calcium 2% Vitamin C 0% Iron 6% Check for CARBS *Check the first 3 items on the ingredients list for hidden fats and sugars

Water & Non-Calorie Liquids = 8 cups per day Sugar-free drinks do count, but water is best! SF Tang Diet Soda Herbal Tea Crystal Light Flavored Water Coffee or Tea

Your Meal Plan: Deciding What to Eat Lunch Sample 2 slices whole wheat bread 2 oz of turkey 1 slice of 2% cheese 1 Tbsp lite mayo Lettuce/tomato 1 small piece of fruit Noncalorie beverage Total Carbohydrates 30 grams 0 -2 grams 15 grams 0 grams = 45 grams

Exercise Therapy for Diabetes Management

Total Carbohydrates Count Good News About Physical Activity Lose weight Gain energy Lower risk of heart disease Increase well-being Possibly reduce the need for some medications Improve overall health

Keep It Fun! Add Variety to Your Daily Routine Choose Enjoyable Activities Enjoy Activities with Friends

Blood Sugar & Exercise Blood Glucose Level Guidelines Lower than 100 mg/d. L (5. 6 mmol/L) Your blood sugar may be too low to safely exercise. Eat a carbohydrate containing snack. You're good to go! This is a safe pre-exercise zone. 100 to 250 mg/d. L (5. 6 to 13. 9 mmol/L) > 250 mg/d. L (13. 9 mmol/L) or higher Your blood sugar may be too high to exercise safely. Postpone your workout until your blood sugar drops to a safe pre-exercise range.

Diabetes & Exercise • Exercise only when feeling well • Become familiar with blood glucose patterns • Know the symptoms of highs and lows • Keep snacks with you; 15 -20 gm sugar to prevent low episodes

Diabetes & Exercise • 30 – 45 minutes of exercise is safe when diabetes is under good control • Eat a meal 1 – 3 hours before exercise • Insulin – Administer insulin more than 1 hour before exercise – Administer insulin in abdomen – Avoid extremity injection

Diabetes & Exercise • • During exercise, drink plenty of fluids Remember: sports drinks contain sugar After exercise, monitor your blood glucose Wear shoes and socks at all times Always wear properly fitted footwear Check your feet after every session Consult your physician if any symptoms develop during or after exercise

Where Can You Find Shoes & Socks for Exercise? • Pharmacies • Podiatrists – Wilmington Foot & Ankle • Omega Sports (Oleander Dr) • Diabetic socks can be purchased at the EFC, most pharmacies and large retail stores – Dr. Scholl’s brand

What is Exercise? • Exercise is anything you want it to be – walking the dog, cleaning, taking the stairs, working out at the Employee Fitness Center • Focus on duration over intensity – three 10 min sessions or one 30 min session; every minute counts!! • Adding to your normal, daily activity is important – if you walk all day at work, you still need planned exercise or additional physical activity in your routine

Time to Get Started Want to get started now? Your safety is very important to us. Follow the guidelines we have provided, and remember that you can always contact a trainer at the EFC for more specific advice on physical activity and exercise. Always seek help with each new exercise. Can’t start the 12 to. Life just yet? Try a group exercise class offered at the EFC, take a walk with some friends or coworkers during lunch, take the stairs, or even contact a trainer for an appointment. Not sure if you can participate in any of the NHRMC EFC programs? Remember our guidelines, and seek help when needed. Your team is here to help you. For more information on outdoor resources for exercise and physical activity in your area, contact a member of the Diabetes Health Plan Team or an EFC staff member! Even if you live farther away, always remember that you are not alone.