Shelby Polk DNP, FNP-BC, CDE April 21, 2010
2 Exercise Legal Rights Health & Learning Nutrition Insulin Administration Hypoglycemia & Hyperglycemia Ketones Monitoring Blood Glucose Glucagon Administration
Management of children with diabetes Asked to do more with less staff ◦ Monitoring blood glucose ◦ Recording results ◦ Carbohydrate counting ◦ Calculate insulin needs ◦ Check urine for ketones ◦ Treat low blood sugar ◦ Administer glucagon 7 hours/day – 5 days/week = 35 hours/week YOU ARE VITAL!!!!!
WHY COUNT CARBOHYDRATES HOW DO CARBOHYDRATES AFFECT BLOOD SUGAR? WHAT IS A CARBOHYDRATE? ◦ Protein ◦ Fat ◦ Carbohydrate
◦ Brussel sprouts ◦ Skim milk ◦ Oreos ◦ Orange Juice ◦ Fat free frozen yogurt ◦ Sugar free cookies ◦ Diet Coke ◦ Mayonnaise ◦ Ketchup ◦ Butter
Do we need carbohydrates? Good versus bad? The amount of carbohydrate is more important than the type ◦ 1 frosted brownie = 2 slices bread ◦ 1 cup ice cream = 1 cup of cereal 30 grams carbohydrates
1 serving = 15 grams Meals ◦ 3 – 4 carb servings 45 – 60 grams carbohydrates Snacks ◦ 1 – 2 carb servings 15 – 30 grams carbohydrates
1 st – Serving Size 2 nd – Total Carbohydrates ◦ ?? Deduct fiber from total carbohydrates if > 4grams ◦ ?? Deduct ½ of sugar alcohol from the total carbohydrates 3 rd – Count Carbohydrates for each food item for a Total Carbohydrate amount for the meal/snack
Serving Size Total Carbohydrate Total Fat
Fresh fruit 1 cup, 1/2 banana, 15 grapes, 1/8 cantaloupe, tennis- ball size piece Canned fruit 1/2 cup 100% fruit juice 4 ounces Dried fruit 2 Tablespoons
Starches 1 slice bread, 1/3 cup rice, 1/2 cup pasta, 1/2 cup cereal, 1 small roll, 1/2 bun Starchy vegetables 1/3 cup corn, ½ cup potatoes, dried beans, peas
Milk 8 ounces Yogurt 1 cup Pudding & ice cream 1/3 - 1/2 cup
BREAKFAST ◦ 1 large bagel (4 oz) ◦ 1 tsp margarine ◦ ½ cup orange juice ◦ 1 cup skim milk DINNER ◦ Spaghetti noodles 1 cup ◦ Spaghetti sauce ½ cup ◦ Tossed salad with lettuce, tomato ◦ 2 Tbs salad dressing ◦ Garlic Bread 2 slices (2 oz) ◦ Coke