1. DIABETES Nutrition Education for Diet Clerks October 2012
Presented by Kristen Estima, Sodexo Dietetic Intern
Beth Chiodo,RD,LDN, and Nicole Michael,RD,LDN
Lower Bucks Hospital

2. What is Diabetes?
Is a metabolic disease characterized by Hyperglycemia (High Blood Sugars)
Hyperglycemia results from:
- Insufficient insulin secretion
- Defect in the action of Insulin

3. Prevalence of Diabetes?
Diagnosed people: 18.8 million
Undiagnosed: 7 million
Total: 25.8 million

4. Types of Diabetes
Type 1 – Insulin deficiency (requires insulin every day)
Type 2 – Resistance to insulin.
Gestational Diabetes – Glucose intolerance.

5. Diagnostic Criteria Type 1 and Type 2 Glucose of 126 mg/dL- Fasting
Glucose of 200 mg/dL- 2hours after meal 75g OGTT
A1C of >6.5%

6. Recommended Diet Carbohydrates: 5 servings of fruits and vegetables
3 servings of whole grains
2 to 4 servings of milk or milk products
Examples of 1 serving: 1 slice of bread; ½ cup of fruit; 1 cup of fat-free milk; ½ cup sherbet.

7. Recommended Diet Protein: 4-6 ounces of meat, or other protein foods.
Protein does not affect blood glucose levels too much.

8. Recommended Diet Fat: Saturated fat should be limited (<7%)
Cholesterol should be limited to <200mg/day
- Healthy fats such as olive oil, canola oil, and nuts are encouraged.

9. Recommended Diet Sodium: Should be limited to <1500
- Type 2 diabetics are usually more sodium sensitive.
Examples of High Sodium foods are canned foods, cheese, salt.

10. Carbohydrate Counting
Estimating Needs:
In a 1800 calorie diet
50% calories should come from Carbs.
1800 x .5 = 900 calories from Carbohydrates.
900calories/4grams= 225g per day
225g/15g= 15 exchanges per day.
15ex./4 meals= 3.75 exchanges per meal.
Conclusion: On a 1800cal diet, pt should be eating 3-4 exchanges of carbs distributed in 4 meals.

11. Breakfast sample On a 1800 calorie CHO-controlled diet
If patient picks 1 Bagel = 4 carbs
-Having eggs, orange juice and a banana would total 6 carbohydrates.
-Patient is only allowed 5 servings for breakfast so suggesting only ½ a bagel would leave room for more carbohydrate choices.
- See attached form for carbohydrate exchanges.

12. Carbohydrate Counting
Hand Guides:
Fist = 1cup
Handful = ½ cup
Palm = 3 oz
Thumb = 1 oz
Thumb tip = 1 tsp.

13. Carbohydrate Counting
Food labels:
- Look at the total grams of carbohydrates.
- Next, confirm the number of servings.
Ex: If total carbohydrate grams is 30g but the serving size is 2. Multiple 30g by 2 which means that there are actually 60 g of carbohydrates in that food package.
- Lastly, divide 60 by 15g which will yield 4 carbohydrates exchanges.

14. Conclusion
Moderation and consistency is the key factor in controlling blood sugars.

15. References
"Diabetes Basics." - American Diabetes Association. N.p., n.d. Web. 03 Oct
N.p., n.d. Web. 03 Oct < Care>.