Diabetes and Carbohydrate Counting

1. Diabetes andCarbohydrate Counting NLO

2. Objectives Define diabetes Discuss dietary basics Identify carbohydrate containing foods and servings Review documentation of carbohydrates consumed Review signs/symptoms of hypoglycemia

3. What is Diabetes? • Diabetes is a metabolic disease resulting in elevated blood glucose levels caused by the body’s complete lack of insulin production, or the cell’s resistance to the circulating insulin. Insulin is needed to transport glucose into the cells for energy. • Three main types of diabetes: • Type 1- body does not produce insulin • Type 2- body’s cells are resistance to insulin • Gestational- high blood glucose during pregnancy

4. Dietary Basics • The three main nutrients= macronutrients • Carbohydrates • Fats • Proteins • Why count carbs? • 100% of carbohydrates convert to glucose • Protein and fat have very little effect on glucose levels • What foods contain carbs? • Fruits, starchy vegetables, grains, legumes, dairy, and sweets

6. Identifying Carbs • 15 grams is the standard unit of measurement for carbs • What does 15 grams of carbs look like? • 1 slice bread • ½ cup grain, beans, or starchy vegetables • 1/3 cup cooked rice or pasta • 1 small piece fruit • 4 oz. fruit juice • 8 oz milk • 2 small cookies

8. Identify carbs:

9. Identify carbs:

10. Identify carbs:

11. Identify carbs:

12. Meal Planning No such thing as a diabetic diet No such thing as a sugar free liquid diet Simply limiting sugar does not improve glycemic control The nurse will administer insulin based on how many carbs the patient consumes, so we need to be as accurate as possible : )

13. Documentation https://insideintegris.corp.integris-health.com/Pages/Default.aspx Carb documentation is very important! (documentation responsibilities are unit specific) Can document as a “task” or as a “ad hoc” charting If you are not sure how many carbs certain food items are worth, you can go to the Inside page, Clinical Hotspots, then the nutritional table for your facility

14. Exercise Breakfast Tues Grey Diet Kit (4g carb) 1 each Syrup (13 g carb) 1 serv Margarine (0g carb) 1 serv Low Chol Eggs (1g carb) 1 serv Turkey Sausage (0g carb) 1 each Pancakes (27 g carb) 2 each Coffee 1 cup Cheeri 1 ind Apple J 1 each 2% Mil 1 serv Name: _________________________ DOB: Room: Diet: Regular with Diabetic Features Smudge

15. Hypoglycemia Hypoglycemia is defined as a blood sugar less than 70. Symptoms include: • Hunger • Nervousness and shakiness • Sweating • Light-headedness • Sleepiness • Confusion • Anxiety

16. Hypoglycemia Notify your nurse for any blood sugar less than 70 or a patient with symptoms! The patient should be treated and have their blood sugar rechecked every 15 minutes until the patients blood sugar is greater than 70. It is a good idea to notify your nurse with all blood sugar reading you take. Remember to dock/upload the meter for all results as soon as possible.

17. Hypoglycemia It is the nurse’s responsibility to determine treatment of hypoglycemia!!!

18. Conclusion Taking care of patients with diabetes is a team effort! : )

19. References American Diabetes Association and American College of Cardiology (2011). Choose to live: your diabetes survival guide. American Diabetes Association (2009). Life with Diabetes: A series of teaching outlines by the Michigan Diabetes Research and Training Center. 4th edition.