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Nutrition at School for Kids with Diabetes

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19 diapositives · 535 Views · Jul 19, 2014

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.

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  1. Nutrition at School for Kids with Diabetes Lisa Emmert, MS, RD, LD, CDE Arkansas Children’s Hospital

  2. Nutrition Education • Inpatients: • 3 day inpatient education • Involves nutrition education, social work, diabetes educator, 4 Adolescent nursing staff, and child life

  3. 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

  4. Nutrition Education • Day 2 • Starchy/non-starchy vegetables • Protein and fats • Free foods • Sweets • Day 3: • School lunch/breakfast • Snacking • Resources

  5. Education Materials • Our own departmental handbook • Calorie King books • “Pink Panther Book” from the Barbara Davis Center (in Denver, CO)

  6. Carbohydrate Counting • Can be counted using exchanges, carb choices, or grams of carbohydrate. • We most often use grams of carbohydrate.

  7. Food Labels • Focus on 2 things: total carbohydrate and serving size.

  8. 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

  9. Carb Counting Resources • Check with your food service director or dietitian • Network with other school nurses • Google search

  10. 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 = 3.8 Round to 4 units

  11. 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

  12. What About Fat? • Do not need to count carbs for fats • However, some fat-free items (such as salad dressing) DO have carbohydrate.

  13. Condiments • Do count the following: • Ketchup • Barbecue sauce • Honey mustard • Sweet and sour sauce

  14. 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.

  15. 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

  16. 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.

  17. Meal Plan for Type 1 Diabetes

  18. Meal Plan for Type 2 Diabetes

  19. Thank You!