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

CARBOHYDRATE PROTEIN FAT

How Nutrients Affect Blood Sugar

Total Carbohydrates Count

Carbohydrates give energy

But too much carbohydrate can raise blood sugar above your target range

ENERGY

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 carbohydratesOne 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 carbohydratesOne 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 carbohydratesOne serving is:• 1 cup raw vegetables• ½ cup cooked vegetables

Dairy Products Have CHO

Each serving has about 15 grams carbohydratesOne 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

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

Nutrition FactsServing Size 1 cup (236 g)Servings Per Container 2

Amount Per ServingCalories 230 Calories from fat 120 % Daily Value*Total Fat 14g 22% Saturated Fat 7g 35% Trans Fat 1gCholesterol 40mg 13%Sodium 950mg 40%Total Carbohydrate 16g 5% Dietary Fiber 2g 8% Sugars 3gProtein 11 g

Vitamin A 20% Vitamin C 0%Calcium 2% Iron 6%

Reading a LabelAlways check the serving size!

Look for total CALORIES

Check the FAT *Check the first 3 items on the ingredients list for hidden fats

and sugars

Check for CARBS

Water & Non-Calorie Liquids = 8 cups per day

Sugar-free drinks do count, but water is best!

SF TangDiet SodaHerbal Tea

Crystal LightFlavored WaterCoffee or Tea

Your Meal Plan: Deciding What to Eat

Lunch Sample2 slices whole wheat bread2 oz of turkey1 slice of 2% cheese1 Tbsp lite mayoLettuce/tomato1 small piece of fruitNoncalorie beverage

Total Carbohydrates30 grams

0 grams0 grams0 grams

0-2 grams15 grams

0 grams = 45 grams

Exercise Therapy for Diabetes Management

Total Carbohydrates Count

Lose weight

Lower risk of heart disease

Possibly reduce the need for some

medications

Gain energy

Increase well-being

Improve overall health

Good News About Physical Activity

Keep It Fun!

Choose Enjoyable Activities

Enjoy Activities

with Friends

Add Variety to Your Daily

Routine

Blood Sugar & Exercise Blood Glucose Level Guidelines

Lower than 100 mg/dL (5.6 mmol/L)

Your blood sugar may be too low to safely exercise. Eat a carbohydrate

containing snack.

100 to 250 mg/dL (5.6 to 13.9 mmol/L)

You're good to go!This is a safe pre-exercise zone.

> 250 mg/dL (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

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

• 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

Where Can You Find Shoes & Socks for 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

What is Exercise?

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 12toLife 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.

Time to Get Started