Nutrition & Diabetes

1. Nutrition & Diabetes Elva McNurlin, RD, LD, CDE – SLMV Diabetes Educator Wendy Rice, MS, RD, LD – SLMV Chief Clinical Dietician Slide Design & Inspiration by: Becky McCarver, MS, RD, LD – SLWR Clinical Nutrition & Diabetes Education Manager

2. Pre-Test

3. Sugar & Diabetes • Our cells depend on a single simple sugar, glucose, for most of their energy needs. • The body has intricate mechanisms in place to keep glucose levels constant.

4. We are What we Eat • Carbohydrates eaten turn into glucose • Glucose is carried in the blood to the body • Glucose must move from blood into cells • Cells needs glucose as energy to function

5. How Cells get Energy • Insulin is the key hormonal substance that unlocks the cell wall to let glucose into the cell

7. Pillars of Management for Diabetes • Diabetes Education • Increased activity levels • Meal planning • Blood Glucose Monitoring • Medication • Stress reduction

8. Meal Planning -Mythbuster • “Eating too much sugar causes diabetes” • No • Diabetes is caused by a combination of genetic and lifestyle factors

9. Meal Planning -Mythbuster • “People with diabetes should eat special ‘diabetic’ or ‘dietetic’ foods” • A healthy meal plan for people with diabetes is the same as for everyone: • Low in fat, salt & sugar • Meals based on whole grains, vegetables and fruit.  • Diabetic and “dietetic” versions of sugar-containing foods offer no special benefit. • Raise blood glucose levels • Usually more expensive • Can also have a laxative effect if they contain sugar alcohols.

10. Meal Planning -Mythbuster • “Diabetics should not eat carbohydrates or eat less than the recommended amount of carbohydrates, or a ‘low carb’ diet.” • Carbohydrates are the BEST source of energy for the cells. • The body prefers 50% - 60% of energy from carbohydrates. • There is no standard definition of a ‘low carb’ diet. • Without carbohydrates the body will : • Use less efficient sources of energy • Use energy sources that are less healthy for the body • In time excess protein & fat may be damaging.

11. Meal Planning “I’m going to put you on a low carb diet”

12. Meal Planning -Mythbuster • “Just look at the food label to see how much sugar is in a product to know if you can eat it or not.” • Reading food labels is important • Grams of carbohydrate is more important than the listed amount of sugars when deciding the appropriate amount to eat.

13. Meal Planning • GOAL:Balance carbohydrates through meal planning • Why? • Macronutrients provide Energy & Nutrients • Fats • Proteins • Carbohydrates or ‘carbs’ • Carbs are the only macronutrient digested to glucose (sugar) • Consistent intake of carbs promotes blood glucose control • Meal Plans need to be tailored to individual needs

14. “Control my diet, control my lifestyle, control my carbs… What are you, some kind of freak?”

15. Meal Planning - Simplified • ~50% Caloric needs from Carbs • ‘No concentrated Sweets’ • AKA Reduced concentrated sweets • AKA Low concentrated sweets • Plate Method • Group Activity • Diets in the Hospital

16. Meal Planning - Individualized • ADA diets • Calorie controlled • Exchanges • Carbohydrate Counting To • Portion Size is Key • 1 carb = 15 grams of carbohydrate • Reading a Food Label n that contain carbohyt = eGrains (e=reads, cck ers, rice, cereals)

17. Meal Planning – Reading Labels

18. “Don’t worry about your dietitian finding out, Allison. What happens in Baskin Robbins stays in Baskin Robbins.”

19. SLMV Diabetes Screening

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