nutrition at school for kids with diabetes
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Nutrition at School for Kids with Diabetes. Lisa Emmert, MS, RD, LD, CDE Arkansas Children’s Hospital. Nutrition Education. Inpatients : 3 day inpatient education Involves nutrition education, social work, diabetes educator, 4 Adolescent nursing staff, and child life. Nutrition Education. - PowerPoint PPT PresentationTRANSCRIPT
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Nutrition at School for Kids with Diabetes
Lisa Emmert, MS, RD, LD, CDEArkansas Children’s Hospital
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Nutrition Education• Inpatients:
– 3 day inpatient education– Involves nutrition education, social work, diabetes
educator, 4 Adolescent nursing staff, and child life
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Nutrition Education• Day 1:
– Which foods are carbohydrates?– Why count carbohydrates?– Insulin to carbohydrate ratio– Reading labels– Resources for carb amounts
• www.calorieking.com• www.dlife.com/nutrition• www.nutritiondata.com (recipe evaluation)
– Emphasize measuring portions
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Nutrition Education• Day 2
– Starchy/non-starchy vegetables– Protein and fats– Free foods– Sweets
• Day 3:– School lunch/breakfast– Snacking– Resources
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Education Materials• Our own departmental handbook• Calorie King books• “Pink Panther Book” from the Barbara
Davis Center (in Denver, CO)
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Carbohydrate Counting• Can be counted using exchanges, carb choices, or
grams of carbohydrate. • We most often use grams of carbohydrate.
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Food Labels
• Focus on 2 things: total carbohydrate and serving size.
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Carb Counting Resources• Websites:
– www.calorieking.com– www.dlife.com/nutrition– www.nutritiondata.com– www.allrecipes.com– www.cookinglight.com
• Cell Phone Apps– GoMeals– Carb Counting with Lenny– SparkPeople– Calorie King
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Carb Counting Resources• Check with your food service director
or dietitian• Network with other school nurses• Google search
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Insulin to Carb Ratio
If ratio is:1 unit of insulin (novolog) per 15gms carbohydrate
And patient eats:• Ham & cheese sandwich 30gms• Medium orange 15gms• 8 oz. Whole milk 12gms
57 gms
57 ÷ 15 = 3.8Round to 4 units
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What About Protein?
• Meat, cheese, eggs, cottage cheese
• Do not have to count, unless breaded
• Meals should contain a source of protein to help stabilize blood sugars
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What About Fat?
• Do not need to count carbs for fats
• However, some fat-free items (such as salad dressing) DO have carbohydrate.
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Condiments
• Do count the following:– Ketchup– Barbecue sauce– Honey mustard– Sweet and sour sauce
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Free Foods
• Free foods have less than 5 gm CHO and 20 calories per serving.
• Examples are sugar free jello, dill pickles, and sugar free popsicles.
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Snacking
• Not usually required with pumps or MDI
• If snack is desired give insulin only for snacks that go over the insulin to carb ratio
• For example, if ratio is 1:15, snacks of 15 gm or more require insulin, those less than 15, do not require insulin
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Meal Patterns• Some kids with type 1 may have a specific
meal pattern.• This is usually related to their insulin
regimen• Important to be consistent with carbohydrate
intake and meal timing• May need snacks to prevent hypoglycemia.
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Meal Plan for Type 1 DiabetesBks Snack Lunch Snack Dinner Snack
Grams of carbo-hydrate
60 15 60 30 60 30
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Meal Plan for Type 2 Diabetes
Bkst Lunch Snack Dinner
Grams of Carbohydrate
45 45 15 45
Ounces of protein
1 3 XX 3
Fat Servings
1 1 XX 1
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Thank You!