Diabetes Survival Camp – Session 3

1. Diabetes Survival Camp –Session 3 • You can strive and thrive with diabetes Welcome

2. Survival Camp Topics Session #3 • Eating to thrive and survive • Safely lifting “Spirits” • Blood Pressure and Cholesterol Med • Meters and Numbers - Surviving the Highs and Lows

3. Eating to Survive and Thrive • Healthy Foods to nourish your lifetime journey • Surviving & thriving with everyday foods • Building your Nutrition Survival tool kit

4. Dietary Fat and Diabetes • Fat has little direct impact on blood glucose levels • But fat does play a role in elevating blood glucose and can promote disease • Increases insulin resistance • Saturated fat and Trans fat intake greatly increase the incident of cardiovascular disease.

5. Fats - Aim for heart health • Saturated fats(LIMIT) • Solid • Animal • Tropical (palm, coconut) • Trans fats (deep fried) • Monounsaturated • Olive & canola oils • Nuts • Avocado • Polyunsaturated veg oils: canola, corn, walnut, safflower, soybean Serving sizes • 1 tsp butter, margarine, oil, mayonnaise • 1 Tbsp salad dressing, cream cheese, seeds • 2 Tbsp avocado, cream, sour cream • 1 slice bacon

6. Saturated Fats • Makes the body produce more cholesterol • Stimulates the production of LDL cholesterol • Raise cholesterol levels and LDL-cholesterol levels more than dietary cholesterol itself • Related to an increased risk of cardiovascular disease

7. Saturated Fats Raise Cholesterol • Meat • Cheese • Egg yolk • 2% or regular milk • Ice cream • Butter • Cream cheese • Sour cream • Palm oil • Coconut oil • Cocoa butter • Hydrogenated vegetable oil • Poultry with skin • Processed and fast foods

8. Meat and Chicken serving size & Fat Content Serving size Kcal total fat saturated fat • Ground Beef 3 oz 244 18 gms 8 gms (21% fat) • Ground Beef 3 oz 191 10 gms 4 gms (9% fat) • T-Bone 3 oz 174 9 gms 3 gms • Top Round 3 oz 153 4 gms 1.5 gms • Pork tenderloin 3 oz 140 4 gms 1.5 gms • Chicken breast 3 oz 140 3 gms 1 gm

9. Cheese: Serving Size & Fat Content Serving Size Kcal gms/total fat gms/sat. fat • Cheddar 1 oz 110 9 gms 6 gms • Swiss 1 oz 110 9 gms 5 gms • Blue 1 oz 100 8 gms 5 gms • Mozzarella 1 oz 70 5 gms 3 gms • Feta 1 oz 60 5 gms 3 gms • Parmesan 2 Tb 60 4 gms 3 gms • Romano 2 Tb 40 4 gms 2 gms

10. WHAT IS A “TRANS FAT” • Made when manufacturers add hydrogen to vegetable oil--a process called hydrogenation • Turn liquid oils into solid fats like shortening and hard margarine • Hydrogenation increases the shelf life and flavor stability of foods containing these fats

11. THE PROBLEM • Trans fats cause: • lowering of HDL (good) cholesterol • increase in LDL (bad) cholesterol • make the arteries more rigid • cause major clogging of arteries • cause or contribute to type 2 diabetes • cause or contribute to other serious health problems

12. Monounsaturated Fats • Olive oil • canola oil • peanut oil • olives • avocado • almonds • peanuts • cashews • pecans

13. Polyunsaturated Fats • Corn oil • Safflower oil • Soybean oil • Sunflower oil Omega-3 polyunsaturated fats • Walnuts • Flaxseed • Chia seeds • Hemp seeds

14. Fish and Shell Fish Serving & Fat Content • Salmon 3 oz 155 7 gms 1 gm 1500 mg Omega 3 • Trout 3 oz 128 5 gms 1 gm 1500 mg Omega 3 • Scallops 3 oz 122 1 gm 0 gm 200 mg Omega 3 • Snapper 3 oz 109 1 gm 0 gm 200 mg Omega 3 • Shrimp 10 lg 54 1 gm 0 gm 150 mg Omega 3

15. Limit Hypertension Limit Weight loss desired Alcohol and Your Health • Avoid • High triglycerides • Avoid • Neuropathy

16. AlcoholCarbohydrate content and calories Serving Size Carbohydrate Calories • 12 oz Beer 15 gms 150 • 4 oz Dry Wine 5 gms 85 • 4 oz Dessert Wine 14 gms 150 • 1 oz distilled alcohol 0 gms 65 • 12 oz Smirnoff Ice 32 gms 228 • 1 oz Kahlua 13 gms 100 * Liqueurs or Cordials = 50% Sugar and 20-50% Alcohol*

17. ALCOHOL RULES • Moderation (1-2 drinks) • Never drink on an empty stomach • Never drink alone • Inform others • Carry treatment for a low • Wear diabetes ID • Caution with exercise • Experiment

18. Fiber Goals • Same as for general population • 25 grams for women per day • 38 grams for men per day • Choose a variety of fiber-containing foods • whole grains • fruits • Vegetables

19. Fiber • Made up of complex carbohydrates that cannot be broken down • Provide vitamins, minerals, fiber and phytonutrients that are important for good health • There are two types of fiber • Soluble • Insoluble

20. Soluble Fiber • Forms a gel when liquid mixed with • Good sources • flesh of fresh fruits (especially apples and citrus), certain grains (oatmeal, barley and rye), legumes & seeds • Dried fruits have the highest concentration of soluble fiber • Delays glucose absorption • Lowers cholesterol • Decreases the speed at which food moves through your intestines

21. Insoluble Fiber • Does not mix with water • Found in all fruits, vegetables, legumes, and seeds • Delays glucose absorption • Slows the breakdown of starch • Increases the speed at which food moves through the intestines

22. Carbohydrate and Fiber Content of Several High Fiber foods • LegumesSrvg size CHO Fiber Kidney 1/2 c 15 6 Black 1/2 c 15 8 Pinto 1/2 c 15 7 • Fruit Blackberries 3/4 c 15 6 Boysenberries 1 c 15 7 Pear w/ peal 1 Med 15 4 Raspberries 1 c 15 8 Avocado 1/2 7 5

23. Reviewing your Nutrition Survival Tool Kit Controlling portions Healthy carbohydrates Healthy fats Go lean with protein Food and activity records Blood sugar monitoring

24. Diabetes Management Plan

25. Survival Strategies for Blood Vessels – Big and Small

26. Hyperglycemia Can Cause Serious Long-Term Problems

27. Take Steps to Reduce Risk Factors for Heart Disease

28. The ABC’s of Diabetes Control • A - A1c less than 7% • B - Blood pressure less than 140/80 • C – Cholesterol • LDL less than 100 (70 with heart disease) • HDL more than 40 • Triglycerides < 150

29. Keeping Big Blood Vessels Healthy • Lower Blood Sugar, Cholesterol and Blood Pressure • How? • Healthy Eating • Activity • Quit Smoking • Medications

30. Medications for Blood Pressure and Cholesterol • See handouts • Circle the medications you are taking • Doses need changes over time • Keep a medication log to track changes

31. Medications for Blood Pressure Ace Inhibitors (il’s) ARB’s (sartans) Beta Blockers (olol’s) Calcium Channel Blockers Diuretics and others May need 3 or more different types of pills to control blood pressure Blood Pressure Goal 140/80

32. Lipid Goals as outlined by ADA LDL < 100, less than 70 with heart disease HDL > 40 for men, 50 for women Triglycerides < 150 Medications: Most people with diabetes should be on a drug class called Statins Cholesterol - Blood Fats

33. Aspirin A Day? Ask your Doctor • Aspirin can help reduce your risk of heart attack and stroke. • Usual dose - Baby aspirin to adult aspirin daily. • Can use enteric coated to protect your stomach. • Ask you doctor if you should start!

34. Tips for Safe Medication Use

35. Peaks and Valleys: Surviving the Highs and Lows

36. Glucose Monitoring: Getting the Most from your Numbers • Monitoring puts the control in your hands • Knowing your goals • When to get help

37. Knowing Your Goals - Blood Sugar • Blood sugar goals • Alwaysgreater than 70 • Before meals 70-130 • 1- 2 hours after meal less than 180

38. Blood Glucose Monitors

39. Blood Glucose Testing Gives You a Picture of Your Diabetes Control

40. Hermione Witchwand Blood Sugars - Takes no meds Day Before Break Lunch Dinner Bedtime Mon 128 119 126 102 Tues 118 112 Day After Break Lunch Dinner Bedtime Wed 191 174 225 142 Thursday 186 214

41. Julio Iglesias Blood Sugars - Takes Glyburide 5 mg AM/PM Day Before Break Lunch Dinner Bedtime Mon 68 119 126 102 Tues 118 69 Day After Break Lunch Dinner Bedtime Wed 124 84 117 79 Thursday 112 113

42. Keep a Log of Your Blood Glucose Readings

43. Monitor Care and Storage Tips

44. Meter Maintenance • Control solutions - use with each new bottle of strips. • Solutions expires in 3 months, need new bottle. • Batteries - know the type and when low - keep extras on hand • Avoid temp extremes for meter / strips • Questions? Call 800 number on meter.

45. Safe Disposal of Lancets • Place lancets sharps container or bleach bottle. • Take to Hazardous Waste Collection Site • In Paradise - 920 American Way (near Clark Rd.) Monday- Friday, Hours-8am – 5pm. Phone 876-3340 • In Chico - 1101 Marauder Street (near the airport) Hours – 9am – 1pm on Friday and 9-4pm on Saturday • More info - Call (866) 429-2288

46. Figuring out the Highs and Lows

47. Understanding Hypoglycemia

48. Symptoms of Hypoglycemia

49. Preventing Hypoglycemia

50. Treating Hypoglycemia