Diabetes and Nutrition

Julie Thilges, RD, LD

Mercy Medical Center- North Iowa

Many thanks to our friends at Camp Hertko Hollow for providing this presentation.

Camp Hertko Hollow101 Locust St.Des Moines, IA 50309 Ann Wolf, Executive Director515-471-8523a.wolf@camphertkohollow.com

Vivian Murray, Camp Director352-750-6759 or 888-437-8652 (Toll free)v.murray@camphertkohollow.com

This presentation is intended to be a general guide that will help you create a thorough staff training tool for your camp. It is not intended to be a comprehensive resource or to fully cover the topic. We hope you will take this presentation and adapt it so that it fits your camp’s specific needs and meets the guidelines established for the safe and effective operation of your program.

Each diabetes camp operates under detailed policies and procedures that follow Board of Health and national accreditation standards that ensure the health and safety of children with diabetes. It is essential that camp staff be trained according to your camp’s policies and procedures. Staff should be encouraged to carefully review materials before arriving at camp, participate fully in pre-camp training, ask questions and use good judgment as they provide diabetes management supervision and educate youth with diabetes at camp.

While doing so, it is equally important that camp staff not lose focus – camp is a place for youth to have fun with peers – to feel supported and understood, and to feel part of a passionate community. Good luck!

Nutrition

Food greatly impacts blood sugars Diabetes diet is a healthy diet, all

people benefit from following this Different nutrients impact your child and

family’s growth and health

Nutrients

Carbohydrates Proteins Fats

Vitamins and Minerals

Water Fiber

Carbohydrates

Main energy source for the body Sugar and starch is a type of

carbohydrate It is not believed certain types of carbs

are any worse than another HOW MUCH, WHEN, and WITH WHAT

the carbohydrate is eaten with will impact blood sugars

Carbohydrates

Breads Crackers Fruits Beans (baked, refried, black, kidney) Starchy vegetables (corn, peas, potatoes,

squash) Milk and Yogurt Most desserts

Proteins

Important for muscle and bone growth Eating extra will not mean increased

muscle growth Complete proteins come from animal

products- may be higher in fat Proteins may help keep blood sugars

from going too low when consumed with carbs

Proteins

Beef Pork Eggs Peanut butter Cheese Chicken Fish

Fats

Fat is essential, however it provided more energy/ gram than other macronutrients

High fat diets may lead to heart disease Fat consumption in large amounts tend

to impede blood sugars coming down to a normal level

Vitamins and Minerals

Essential for healthy growth Not significant for calories Most people with a balanced diet get

adequate amounts A multivitamin may be beneficial for

someone not getting a balanced diet (not liking milk or vegetables)

Water

Water makes up two thirds of the body Recommend 6 cups/ day Especially important with increased

activity and hot days (when your body is more likely to lose fluids)

Fiber

Dietary fiber is a type of carbohydrate that is not digested

May be subtracted from total carbs on food labels

Is thought to help control blood sugars Aids in digestion Helps body feel satisfied longer

Sweetners

(Non-nutritive) Provide no calorie or carbohydrate

(Nutritive) sucrose and fructose– High fructose corn syrup is a combo of both and

raises blood sugars more quickly than both

Sugar alcohols– They provide a smaller amount of carbs (2 grams./

Tsp) and are absorbed more slowly– Found in sugar free candy

Non-Nutritive Sweetners

Saccharin- found in some soft drinks Aspartame-contains phenylalanine, found in many

products – It has been suggested the breakdown product

(formaldehyde) could be bad for health- THIS HAS NEVER BEEN SCIENTIFICALLY SUPPORTED IN HUMANS

Acesulfame- K- used in chewing gums, desserts, and soft drinks

Sucralose- Splenda, most heat stable Stevia- natural alternative from a herb,

– Not approved by the FDA

Reading Labels

Serving size shown on top

Total fat- may impact blood sugars and its importance r/t heart disease

Total carbs (15g = 1 carb choice)

Dietary Fiber

                          

Objectives of Food Management

Balance insulin and carb intake to keep blood sugars close to normal

To keep blood fats and lipoproteins at desired levels

Improve overall health by maintaining nutrition

Attain normal growth and development Prevent severe hypoglycemia

Three Common Meal Plan Approaches Constant Carbohydrate Meal Planning

– Carbs may vary from meals, but stay the same from day to day

– Food eaten my vary d/t exercise, insulin taken, BS Carbohydrate Counting Meal Plan

– Involves counting grams to match insulin– Assumes variation (provides more flexibility and

safety from hypoglycemia) Exchange Meal Plan

– Protein and fat exchanges used

Glycemic Index

Ranks carbohydrates based on how quickly these foods will raise blood sugars

Not suggesting any foods are good or bad Important to be aware of Not recommended to solely control food

intake May see more of this in the future

Glycemic Index- continued

Low GI diets help people lose and control weight

Low GI diets increase the body's sensitivity to insulin

Low GI carbs improve diabetes control

Low GI carbs reduce the risk of heart disease

Low GI carbs reduce blood cholesterol levels

Low GI carbs can help you manage the symptoms of PCOS

Low GI carbs reduce hunger and keep you fuller for longer

Low GI carbs prolong physical endurance

High GI carbs help re-fuel carbohydrate stores after exercise

                   

                         

Glycemic Index Examples

High glycemic index foods include many carbohydrates such as these:– Pasta– Rice – Cereal– Baked goods

Low glycemic index foods include these:– Fruits and vegetables– Whole grains– Legumes

www.webmed.com

Ketoacididosis and Nutrition

Nutrition mostly used as a tool for prevention

Stay hydrated- will replace lost fluid from urine

Orange juice and bananas are good for replacing potassium

Sick days

It is important to keep track of consumption and fluid intake

Drink out of a 1 L water bottle to keep track May need to consume foods normally avoided to

meet carb needs (Regular pop or gelatin) May need extra snacks Check BS often If vomiting avoid solid foods, gradually start

liquids (if vomiting is frequent may need med such as Phenergan)

Discussion