1 / 24

Diet Teaching For the Diabetic Patient

Diet Teaching For the Diabetic Patient. Elva McNurlin, RD, LD, CDE – SLMV Diabetes Educator Sarah Renaldi, MS, RD, LD – SLMV Clinical Dietitian Original Slides/Presentation By: Kate Waltz, RD, CDN, CDE; Clinical Nutrition Bassett Healthcare. Eating!.

mckile
Download Presentation

Diet Teaching For the Diabetic Patient

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Diet Teaching For the Diabetic Patient Elva McNurlin, RD, LD, CDE – SLMV Diabetes Educator Sarah Renaldi, MS, RD, LD – SLMV Clinical Dietitian Original Slides/Presentation By: Kate Waltz, RD, CDN, CDE; Clinical Nutrition Bassett Healthcare

  2. Eating! • Can’t live with it, can’t live without it! • Constant opportunity for change • Major factor in health, wellness, & happiness. • Can be a major stressor! • Focus on the positive

  3. Objectives • List diet and nutrition goals for patients with both Type 1 and Type 2 diabetes. • Explain role of carbohydrate, protein, and fat in meal planning and glucose control. • Explain basic concept of consistent carbohydrate diet and use of carbohydrate counting. • Identify additional diet modifications to address cardiac risk reduction.

  4. Type 1 Diabetes • Use of daily insulin • Goals for diet education: • Coordinate meal plan with insulin treatment • Use of carbohydrate counting for intensive insulin therapy programs • Alter intake as needed for activity level • Identify/reduce risk of hypoglycemia

  5. Type 2 Diabetes • May be diet and exercise controlled, using oral medications, or insulin treated. • Goals for diet education: • Weight control or weight loss • Use of carbohydrate counting for consistent carbohydrate diet or insulin program • Address co-morbid conditions and risk factors

  6. The Basics • Carbohydrate • Digests quickly, from 15 minutes to 2 hours • Has direct effect on postprandial blood glucose levels, more carbs = higher glucose • Should provide about 50% of total calories • Sources: grains, beans, vegetables, milk, fruit, sweets and added sugars

  7. The Basics • Protein • Digests more slowly, 3-5 hours • Can aid in prolonged post-meal satiety • May help prevent between meal and nocturnal hypoglycemia • Sources: meat, fish, poultry, eggs, cheese, nuts/peanut butter, soy products

  8. The Basics • Fat • Digests the most slowly- several hours • Promotes prolonged satiety • Type of fat consumed affects cardiac risk • Should be less than 30% total calories • Sources: butter, margarine, oils, mayo, salad dressing, cream cheese, nuts, seeds, gravy

  9. The Idaho Plate Method

  10. Carbohydrate Counting • Identify carbohydrate sources • Estimate or measure portion size • Quantify carbohydrate intake for that meal or snack in either carbohydrate servings or grams of total carbohydrate • There are no “good carbs” or “bad carbs”

  11. What is one serving of carbohydrate?(one serving = 15 grams carbohydrate) • 1 slice bread • 1/2 hamburger bun or English muffin • 1/2 cup potato, corn, peas, cooked cereal • 1/3 cup rice or pasta • 1 small fresh fruit, 1/2 cup canned fruit or juice • 1 cup milk or yogurt • 1 tablespoon sugar, honey, jam, maple syrup

  12. Sample Meal Example • 1/2 cup oatmeal • 1 hard boiled egg • 1 slice whole wheat toast • 1 teaspoon margarine • 1/2 cup orange juice Which are the carbs? How many servings? How many grams total carbohydrate?

  13. Sample Meal Example • 1/2 cup oatmeal = 1 serving (15 g) • 1 hard boiled egg = protein • 1 slice whole wheat toast = 1 serving (15 g) • 1 teaspoon margarine = fat • 1/2 cup orange juice = 1 serving (15 g) Total is 3 servings or 45 grams carbohydrate

  14. Sample Meal Example 2 • 3 ounces roast chicken • 1 cup cooked rice • 1/2 cup green beans • 1 cup tossed salad • 1/2 cup applesauce • 1 cup 1% milk

  15. Sample Meal Example 2 • 3 ounces roast chicken = protein • 2/3 cup cooked rice = 2 servings (30 g) • 1/2 cup green beans = 1/3 serving (5 g) • 1 cup tossed salad = 1/3 serving (5 g) • 1/2 cup applesauce = 1 serving (15 g) • 1 cup 1% milk = 1 serving (15 g) Total is 4 2/3 servings or 70 grams total carb

  16. Using a label to Count Carbs 1. Serving size, # of servings 2. Total grams of carbohydrate

  17. How much carbohydrate to eat? • 1200 kcal = 150 grams = 10 servings • 1500 kcal = 187 grams = 12-13 servings • 1800 kcal = 225 grams = 15 servings • 2000 kcal = 250 grams = 16-17 servings *Amounts and types of protein and fat can greatly affect total calorie intake.

  18. Not only how much, but when... • Goal is to spread carbohydrate servings out consistently over the day • 3-5 servings per meal • 1-2 servings per snack • Patient has freedom to change food choices and amounts eaten while staying within recommended carbohydrate intake

  19. Example of 1500 kcal diet(Total of 12-13 carb servings or 187 g per day) • Breakfast: 4 carb servings (60 g) • 1 cup oatmeal, 1 cup skim milk, 2 Tbs raisins • Lunch: 3 carb servings (45 g) • sandwich, small salad, 1 small fresh fruit • Dinner: 4 carb servings (60 g) • chicken, 1 cup pasta, broccoli, 1 cup skim milk • Snack: 1 carb serving (15 g) • 1 cup low fat yogurt

  20. Weight Loss • Weight loss of just 7-10% of a patient’s current weight can help lower glucose • Slow and steady wins the race! • Helpful modifications are low fat intake and high fiber intake • Exercise: 5-7 days/week with goal of 150 minutes/week or 10,000 steps per day

  21. High Fiber Intake • Can increase satiety, slow carbohydrate digestion and modify postprandial glucose • Intake of at least 25 grams/day, up to 35 grams/day to optimize cardiac benefits • Can subtract from total carbohydrate grams • Sources of fiber: whole grains, beans, nuts, seeds, fruits, vegetables

  22. Low Fat Intake • All patients with diabetes are at increased cardiac risk- more aggressive with cholesterol and blood pressure control • Total fat <30% kcal, sat fat <10%, trans fat 0% • Decrease added fats- 100 kcal/tablespoon • Opt for unsaturated fat- oils, nuts, margarine

  23. “Let nothing that can be treated by diet be treated by any other means.” Maimonides

More Related