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If you or someone you know has diabetes, you may be worried about what the future holds. Diabetes is likely to cause changes in your life, but with proper care, most diabetics can live much as they did before developing the disease. Diabetes is a condition whereby the body does not make enough insulin or use it properly. Without insulin, the body cannot utilize food for energy. People with diabetes have high blood glucose levels and many have high blood cholesterol and triglyceride levels. The two main types of diabetes are: ● Type 1 or insulin-dependent ● Type 2 or non-insulin-dependent Type 1 is treated with daily insulin injections, regular exercise, and a balanced meal plan. The daily meal plan is tailored to an individual’s needs. It is likely to include three meals and two or three snacks eaten at set times each day. Arkansas Is Our Campus Visit our web site at: http://www.uaex.edu
Living Healthy with Diabetes As people get older, their risk for type 2 diabetes increases. In fact, in the United States about one in four people over the age of 60 has diabetes. If you already have diabetes, you may find that you need to adjust how you manage your condition as the years go by. This booklet provides information to help you take care of your diabetes over the long term, so that you can avoid or delay complications and live a long, happy, and active life. Diabetes Basics What is type 2 diabetes? When you eat, your food is broken down into a sugar called glucose. Glucose gives your body the energy it needs to work. But to use glucose as energy, your body makes insulin, which “unlocks” your body’s cells so they can receive the glucose they need.
Food Exchange Lists The following pages separate foods into these seven groups: - Starches Fruits and Fruit Juices Milk, Yogurt, and Dairy-like foods Non-Starchy Vegetables Sweets, Desserts, and Other Carbohydrates Meats and Meat Substitutes Fats At the top of each section you will find the amount of carbohydrate, protein, fat and calories found in each selection. These food lists can be used for: • • • • counting carbohydrates counting calories counting grams of fat counting grams of protein DTC - UCSF To help you make healthy food choices: • milk products are separated by fat and calorie content • meats and protein foods are separated by fat and calorie content • dietary fats are divided into unsaturated and saturated sources Compiled from: Choose Your Foods: Exchange Lists for Diabetes American Dietetic Association and American Diabetes Association, 2008 1 Starches Breads and Flours Each Serving = 15 g carbohydrate, 3 g protein, 0-1 g fat, 80 calories Bagel Biscuit Bread Reduced-calorie White, whole-grain, pumpernickel, rye, unfrosted raisin Bun (hotdog or hamburger) Chapatti, small Cornbread English muffin Flour, corn meal, wheat germ Naan Indian Bread Pancake, 1/4 inch thick Pita bread Roll, plain, small Stuffing, bread Taco shell or tostada shell Tortilla Corn or flour, 6 inches across Flour, 10 inches across Waffle
The Joslin Clinical Nutrition Guideline For Overweight and Obese Adults With Type 2 Diabetes, Prediabetes or at High Risk for Developing Type 2 Diabetes is designed to assist primary care physicians, specialists, and other healthcare providers in individualizing the care of and set goals for adult, non-pregnant patients with type 2 diabetes or individuals at high risk for developing type 2 diabetes. This guideline focuses on the unique needs of those individuals, and complements the 2010 Dietary Guidelines for Americans, which is jointly developed by the Department of Health and Human Services and the Department of Agriculture. It is not intended to replace sound medical judgment or clinical decision-making and may need to be adapted for certain patient care situations where more or less stringent interventions are necessary. The objectives of the Joslin Clinical Diabetes Guidelines are to support clinical practice and to influence clinical behaviors in order to improve clinical outcomes and assure that patient expectations are reasonable and informed. Guidelines are developed and approved through the Clinical Oversight Committee that reports to the Joslin Clinic Medical Director of Joslin Diabetes Center. The Clinical Guidelines are established after careful review of current evidence, medical literature and sound clinical practice. These Guidelines will be reviewed periodically and the Joslin Diabetes Center will maintain, upgrade or downgrade the rating for each recommendation when new evidence mandates such changes.
Gestational Diabetes Meal Plan Gestational diabetes is a form of diabetes that occurs during pregnancy. If you have gestational diabetes, you and your developing baby are likely to have high blood glucose (too much glucose — or “sugar” — in the blood). This can cause problems for both of you during the pregnancy, at birth, and in the years to come. Fortunately, there’s a lot you can do to help control your blood glucose and lower health risks. Following a meal plan is one of the most important parts of your treatment. Your doctor or other healthcare provider (registered dietitian or diabetes educator) will work with you to develop a personalized meal plan. This handout provides a blank plan for you to complete and use — and the information you need to make the most of it. Meal plan basics Meal plans for gestational diabetes are built around a few basic ideas: •• Carbohydrates matter. All foods contain some combination of carbohydrate, fat, and protein. Fat and protein affect your blood glucose over many hours, but carbohydrate affects it much faster. For this reason, you’ll need to regulate your intake of foods that are rich in carbohydrate (“carbs”). Your healthcare provider will show you how — and your meal plan will help you stay on track.
Breakfast Lunch 1 whole wheat English muffin 1 Tbsp. sugar free jam 1 poached egg 1 Tbsp. “0g trans-fat” butter spread 1 small apple Total: 51g Carbs tuna salad sandwich with 4oz tuna 2 slices whole wheat bread 4 oz. low-fat yogurt ½ cup sliced strawberries 5 baby carrots 2 Tbsp. low fat Ranch Total: 46g Carbs 2 slices turkey deli meat 2 slices whole wheat bread 2 Tbsp. mustard 1 slice American cheese 1 small bag baked potato chips (1 oz.) Total: 48g Carbs Frozen entrée with less than 300 calories & 30g Carbs 1 small pear ½ cup cherry tomatoes 1 Tbsp. low fat ranch dressing Total: 54g Carbs 3 oz. roasted chicken breast 1 cup baked winter squash ½ cup cooked spinach 1 small whole wheat roll ½ Tbsp. “0g trans-fat” butter spread Total: 53g Carbs 4 oz. salmon ½ baked potato ½ Tbsp. “0g trans-fat” butter spread 1 cup carrots 1 small chocolate chip cookie
Eating healthy is an important part of managing your diabetes. The food in your meal plan will provide the calories and nutrients you need each day to manage your blood glucose and to give you the energy you need for healthy living. You can use the following guidelines to estimate how many calories are needed per day to help maintain your weight. For every pound of weight, calculate: • 10 calories for an adult who is obese, very inactive, or always dieting • 13 calories for an adult over 55 years of age, an active woman, or an inactive man • 15 calories for a very active woman or an active man • 20 calories for a very active man or an adult athlete To lose weight, you’ll need to eat fewer calories. To gain weight, you’ll need to eat more calories. You and your healthcare provider will develop a healthy meal plan that is right for you. The Exchange Lists for Meal Planning The Exchange Lists offer a large selection of foods grouped together because they have approximately the same nutritional content. Each serving of a food has about the same carbohydrate, protein, fat, and calories, as the other foods in that list. Any food within a list can be “exchanged” for another food in the same list. Ask your healthcare provider for a copy of the Changing Life With Diabetes booklet, Carb Counting and Meal Planning from Novo Nordisk. It includes the Exchange Lists for Meal Planning and other useful information on healthy eating. Use the Exchange Lists in Carb Counting and Meal Planning with this meal planning information. To become a member of Changing Life With Diabetes, a free program for people who take insulin, enroll on line at ChangingDiabetes-us.com. Another program that will help you manage your diabetes is the free Novo Nordisk Tip Line at 1-800-260-3730.
National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-KDOQI™) Did you know that the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI™) develops guidelines that help your doctor and health care team make important decisions about your medical treatment? The information in this booklet is based on the National Kidney Foundation's KDOQI™ recommended guidelines for diabetes, and it's very important for you to know. What is your stage of kidney disease? There are five stages of kidney disease. They are shown in the table below. Your doctor determines your stage of kidney disease based on the presence of kidney damage and your glomerular filtration rate (GFR), which is a measure of your level of kidney function. Your treatment is based on your stage of kidney disease. Speak to your doctor if you have any questions about your stage of kidney disease or your treatment.
Diabetes Treatment & Diet • Blood glucose (BG) control is the foundation of treatment for diabetes mellitus. High BG increases the risk of infections during illness, slows healing, and can lead to long-term complications. • Blood glucose levels are often elevated during illness and after injury because of stress. Many patients with diabetes come to the hospital with high BG levels, or their BG levels become elevated during hospitalization. Certain medications and decreased physical activity during hospital stay contribute to elevated BG levels. • The American Diabetes Association recommends that a consistent carbohydrate (CHO) diet be provided to patients with diabetes during hospitalization. The Consistent CHO diet doesn’t have a specific calorie level. Instead, it provides a specific amount of CHO. • “Calorie level diabetic diets” are no longer recommended for patients during hospitalization. VUH is phasing out “calorie level diabetic diets.” • The diet order for patients with diabetes in VUH (except on 4 East) is “Diabetic Diet– Consistent CHO.” • On 4 East, a slightly different version of the diet is provided. This diet is known as “the OB Diabetic Diet.”
Good meal planning can help you better control your blood sugar Eating healthy foods and adding variety to your menus is easier than you think. Your doctor or healthcare provider can help you develop a meal plan that helps control tour blood sugar. This sheet can help you make that plan more interesting by providing substitution options, so you don’t have to eat the same foods all the time. It also helps if you eat a balanced diet, eat meals at the same time every day, avoid skipping meals and eat food portions that are indicated by your individual meal plan. The American Diabetes Association recommends good eating habits along with being physically active as the primary part of any good type 2 diabetes management plan. Here’s how you can easily choose foods that fit your type 2 diabetes meal plan: · Find your total daily calorie level on the chart below. · Using the chart, plan your menus for the day with serving amounts from each group. · Look at the sample meal plan below to see how you can do this. · Give your meals variety by choosing other items from the same food groups.