Скачать презентацию Improving Diabetes Control with Carbohydrate Counting The University Скачать презентацию Improving Diabetes Control with Carbohydrate Counting The University

ed5a00edd6f1a5508bc205ee672e5c96.ppt

  • Количество слайдов: 49

Improving Diabetes Control with Carbohydrate Counting The University of Georgia Cooperative Extension Service Improving Diabetes Control with Carbohydrate Counting The University of Georgia Cooperative Extension Service

Carbohydrate Counting Advantages • Helps improve blood glucose – A 1 C goal: Less Carbohydrate Counting Advantages • Helps improve blood glucose – A 1 C goal: Less than 7% – Blood glucose goals (plasma) • Before meals: 90 -130 • After meals: less than 180 • Bedtime: 110 -150

Carbohydrate Counting Advantages • Easier - you only count carbohydrate • Allows you more Carbohydrate Counting Advantages • Easier - you only count carbohydrate • Allows you more flexibility in food choices – Virtually any food can be worked into your meal plan

What is Carbohydrate Counting? • Keeping track of the amount of carbohydrate eaten at What is Carbohydrate Counting? • Keeping track of the amount of carbohydrate eaten at meals and snacks • Keeping carbohydrate intake consistent at meals from day to day • Matching insulin injections to carbohydrate intake (for some)

Why Count Carbohydrate? Why Count Carbohydrate?

Why Count Carbohydrate? • Amount of carbohydrate eaten determines how high blood glucose will Why Count Carbohydrate? • Amount of carbohydrate eaten determines how high blood glucose will rise after a meal • Carbohydrate begins to raise blood glucose within 15 minutes of eating

Who Should Count Carbohydrate? People wanting to improve diabetes control who manage their diabetes Who Should Count Carbohydrate? People wanting to improve diabetes control who manage their diabetes with: • Balanced food intake and regular physical activity or. . . • Diabetes pills or. . . • Insulin injections

Nutrients in Foods • Carbohydrate • Protein • Fat (Vitamins, minerals, water) Nutrients in Foods • Carbohydrate • Protein • Fat (Vitamins, minerals, water)

What are Carbohydrates? bread, rice, cereal, potatoes, pasta, corn, peas, butter beans fruit, milk, What are Carbohydrates? bread, rice, cereal, potatoes, pasta, corn, peas, butter beans fruit, milk, regular sodas, candy, juices

Combination Foods That Contain Carbohydrate • Pizza • Spaghetti • Sandwiches • Casseroles • Combination Foods That Contain Carbohydrate • Pizza • Spaghetti • Sandwiches • Casseroles • Soups • Stews

Which Contain Carbohydrate? • Brunswick stew • Baked chicken • Brussels • Rice sprouts Which Contain Carbohydrate? • Brunswick stew • Baked chicken • Brussels • Rice sprouts • Orange juice • Sugar-free jello • Diet soda • Skim milk • Oreos • Fat-free frozen yogurt

Carbohydrate is Healthy • Most foods containing carbohydrate are among the healthiest foods to Carbohydrate is Healthy • Most foods containing carbohydrate are among the healthiest foods to eat: – grains, fruits, vegetables, low-fat milk and yogurt • Carbohydrates are the foundation of a healthy eating plan – contain many essential vitamins, minerals, and fiber

Does the Type of Carbohydrate Matter? • Various carbohydrates have slightly different effects on Does the Type of Carbohydrate Matter? • Various carbohydrates have slightly different effects on blood glucose – processing, cooking, fiber, mixed meals with fat or protein affect glucose response

The Amount of Carbohydrate is More Important Than the Type 1 frosted brownie = The Amount of Carbohydrate is More Important Than the Type 1 frosted brownie = 2 slices bread 1 cup ice-cream = 1 cup cereal (30 grams carbohydrate)

Use of Sugar in the Meal Plan • Can be used in moderation – Use of Sugar in the Meal Plan • Can be used in moderation – share desserts in restaurants – ask for child-sized portions of ice-cream – keep large portions of sweets out of the house • Substitute for other carbohydrate in the same meal • Check effect on your blood glucose

Use of Sugar in the Meal Plan Many high-sugar foods: • are also high Use of Sugar in the Meal Plan Many high-sugar foods: • are also high in fat • provide very little nutritional value (empty calories) • may replace more healthful foods

2 Ways to Count Carbohydrate • Carbohydrate Choices Food Exchanges or Servings • Carbohydrate 2 Ways to Count Carbohydrate • Carbohydrate Choices Food Exchanges or Servings • Carbohydrate Grams Specific number of grams of carbohydrate per meal or snack

Carbohydrate Choices (servings) • Each food in fruit, starch, milk group contains about 15 Carbohydrate Choices (servings) • Each food in fruit, starch, milk group contains about 15 grams carbohydrate • One carbohydrate choice = 15 grams carbohydrate

Carbohydrate Choices • Lunch: Exchanges Carbohydrate Choices 2 1 1 3 2 starch fruit Carbohydrate Choices • Lunch: Exchanges Carbohydrate Choices 2 1 1 3 2 starch fruit milk meat fat = = = 2 1 1 0 0 carb carb choices choices

Each Carbohydrate Choice = 15 grams Carbohydrate Example: • • • Breakfast: Lunch: Snack: Each Carbohydrate Choice = 15 grams Carbohydrate Example: • • • Breakfast: Lunch: Snack: Dinner: Evening Snack: 3 2 1 3 carb choices = 45 grams choices = 30 grams choice = 15 grams choices = 45 grams 1 carb choice = 15 grams

How Much Carbohydrate Should You Have? • Depends on your: – calorie needs – How Much Carbohydrate Should You Have? • Depends on your: – calorie needs – height – weight – physical activity – level of fat in your blood (triglycerides) – usual food habits and schedule

Carbohydrate Needs (Example) 1500 Calories: 188 grams/day – 3 – 4 – 1 carb Carbohydrate Needs (Example) 1500 Calories: 188 grams/day – 3 – 4 – 1 carb choices at breakfast choices at lunch choices at dinner choice at bedtime

Resources for Counting Carbohydrate • Food package labels • Carbohydrate counting books • Food Resources for Counting Carbohydrate • Food package labels • Carbohydrate counting books • Food Exchange booklets

Nutrition Facts Label • Best resource for carbohydrate counting • Pay attention to: – Nutrition Facts Label • Best resource for carbohydrate counting • Pay attention to: – Serving Size – Total Carbohydrate

Food Label (Example 1) • Your meal plan: 2 carb choices (30 grams carb) Food Label (Example 1) • Your meal plan: 2 carb choices (30 grams carb) • Food label (ice-cream): Serving size = 1/2 cup Total carbohydrate = 15 grams How much ice-cream should you have?

Food Label (Example 2) If your meal plan at breakfast is: 45 grams carbohydrate Food Label (Example 2) If your meal plan at breakfast is: 45 grams carbohydrate Food label: Cereal Milk Serving size: 1/2 cup 1 cup Total Carb: 15 grams 12 grams How much cereal and milk should you have?

Carbohydrate Counting Books • Use for foods without a Nutrition Facts Label – Fresh Carbohydrate Counting Books • Use for foods without a Nutrition Facts Label – Fresh fruits – Fresh vegetables – Breads from a bakery or farmer’s market – Restaurant foods

Food Exchange Booklet • Gives average carbohydrate values for many foods • Pocket Guide Food Exchange Booklet • Gives average carbohydrate values for many foods • Pocket Guide available

Practice Counting Carbs #1 Breakfast Choices 1 large bagel (4 oz) 1 tsp. margarine Practice Counting Carbs #1 Breakfast Choices 1 large bagel (4 oz) 1 tsp. margarine 1/2 cup orange juice 1 cup skim milk Grams

Practice Counting Carbs #2 Dinner Choices Spaghetti noodles 1 cups Spaghetti sauce, cup Tossed Practice Counting Carbs #2 Dinner Choices Spaghetti noodles 1 cups Spaghetti sauce, cup Tossed salad with lettuce, tomato Garlic bread, 2 slices (2 oz) Diet Coke Grams

Matching Insulin to Carbohydrate Intake • Useful for people taking at least 3 -4 Matching Insulin to Carbohydrate Intake • Useful for people taking at least 3 -4 insulin injections per day or on insulin pump • Carbohydrate to insulin ratio is determined – Example: Ratio of 15: 1 means that 1 unit of insulin needed for every 15 grams carbohydrate • Insulin dose depends on planned carbohydrate intake at meal

Write down: • Carbohydrate eaten • Times of meals • Blood glucose results • Write down: • Carbohydrate eaten • Times of meals • Blood glucose results • Diabetes pills or insulin • Physical activity/exercise

What Else Affects Your Blood Glucose? • Portions sizes – Large portions of carbohydrate What Else Affects Your Blood Glucose? • Portions sizes – Large portions of carbohydrate increase blood glucose

What Else Affects Your Blood Glucose? • Timing of food intake – Space food What Else Affects Your Blood Glucose? • Timing of food intake – Space food throughout day – Eat at regular times – Don’t skip meals

Measuring and Weighing Foods • You can’t accurately count carbohydrate without weighing and measuring Measuring and Weighing Foods • You can’t accurately count carbohydrate without weighing and measuring • Weigh at least once a week • Practice, practice!

What to Weigh and Measure • Weigh: Bread, rolls, bagels, some fruits, baked potatoes What to Weigh and Measure • Weigh: Bread, rolls, bagels, some fruits, baked potatoes • Measure: mashed potatoes, popcorn, pasta, rice, vegetables, fruit juice

Mixed Foods Containing Carbohydrate • Macaroni & Cheese • Soups • Casseroles • Lasagna Mixed Foods Containing Carbohydrate • Macaroni & Cheese • Soups • Casseroles • Lasagna • Subs • Beef Stew • Spaghetti and Meatballs

Restaurant Dining • Dining Out in Restaurants – Use books on restaurant eating – Restaurant Dining • Dining Out in Restaurants – Use books on restaurant eating – Estimate carbohydrate content • Check blood glucose 2 hours after meal • Take-out (Example: Chinese) – Measure food at home to determine carbohydrate content

Fast Foods Get carbohydrate information from: • Web site or toll-free number for chain Fast Foods Get carbohydrate information from: • Web site or toll-free number for chain restaurants – i. e. www. mcdonalds. com • Extension web site for fast foods • Carbohydrate counting books

Fast Food Restaurants #1 Subway® Carb Exchanges Classic Italian 43 g Tuna - 6” Fast Food Restaurants #1 Subway® Carb Exchanges Classic Italian 43 g Tuna - 6” 42 g 2 starch 2 meat, 1 veg, 1 fat 2 1/2 starch 1 meat, 1 veg 5 fat 1/2

Fast Food Restaurants #2 Mc. Donalds® Carb Exchanges Hamburger 34 g meat, 6 -pc Fast Food Restaurants #2 Mc. Donalds® Carb Exchanges Hamburger 34 g meat, 6 -pc Chicken 15 g meat, Mc. Nuggets French Fries 57 g medium 2 starch, 1 1/2 fat 1 starch, 2 1 1/2 fat 4 starch, 3 fat

Other Factors to Consider • Fat – Slows down time your stomach takes to Other Factors to Consider • Fat – Slows down time your stomach takes to empty – Delays rise in blood glucose – High in calories

Other Factors to Consider • Protein – Very little effect on blood glucose – Other Factors to Consider • Protein – Very little effect on blood glucose – Usually combined with fat

Weight Gain and Carbohydrate Counting You can gain weight if you: • Count carbohydrate, Weight Gain and Carbohydrate Counting You can gain weight if you: • Count carbohydrate, but ignore fat content of foods • Eat more high-calorie foods

Fiber and Carbohydrate Counting • Included in total carbohydrate • Does not convert to Fiber and Carbohydrate Counting • Included in total carbohydrate • Does not convert to glucose • For more than 5 grams insoluble fiber per serving: subtract amount of fiber from the Total Carbohydrate

Fiber and Carbohydrate Counting • For example: 1 cup cereal = 30 gm Total Fiber and Carbohydrate Counting • For example: 1 cup cereal = 30 gm Total Carbohydrate - 7 grams insoluble dietary fiber 23 grams Count as 23 grams carbohydrate

So, enjoy the increased variety and flexibility with Carb Counting. . . but watch So, enjoy the increased variety and flexibility with Carb Counting. . . but watch the fat and calories!

Activity Activity