Shelby Polk DNP, FNP-BC, CDEApril 21, 2010

2

Exercise

LegalRights

Health&

Learning

Nutrition

InsulinAdministration

Hypoglycemia &

Hyperglycemia

Ketones

MonitoringBlood Glucose

Glucagon Administrati

on

Management of children with diabetes Asked to do more with less staff

◦ Monitoring blood glucose◦ Recording results◦ Carbohydrate counting◦ Calculate insulin needs◦ Check urine for ketones◦ Treat low blood sugar◦ Administer glucagon

7 hours/day – 5 days/week = 35 hours/week

YOU ARE VITAL!!!!!

WHY COUNT CARBOHYDRATES

HOW DO CARBOHYDRATES AFFECT BLOOD SUGAR?

WHAT IS A CARBOHYDRATE?◦ Protein◦ Fat◦ Carbohydrate

◦ Brussel sprouts◦ Skim milk◦ Oreos◦ Orange Juice◦ Fat free frozen yogurt◦ Sugar free cookies◦ Diet Coke◦ Mayonnaise◦ Ketchup◦ Butter

Do we need carbohydrates? Good versus bad?

The amount of carbohydrate is more important than the type◦ 1 frosted brownie = 2 slices bread◦ 1 cup ice cream = 1 cup of cereal

30 grams carbohydrates

1 serving = 15 grams

Meals◦ 3 – 4 carb servings

45 – 60 grams carbohydrates

Snacks◦ 1 – 2 carb servings

15 – 30 grams carbohydrates

1st – Serving Size 2nd – Total Carbohydrates

◦ ?? Deduct fiber from total carbohydrates if > 4grams

◦ ?? Deduct ½ of sugar alcohol from the total carbohydrates

3rd – Count Carbohydrates for each food item for a Total Carbohydrate amount for the meal/snack

Serving Size

Total Carbohydrate

Total Fat

Fresh fruit1 cup, 1/2 banana, 15 grapes, 1/8 cantaloupe, tennis-ball size piece

Canned fruit1/2 cup

100% fruit juice 4 ounces

Dried fruit 2 Tablespoons

Starches 1 slice bread, 1/3 cup rice, 1/2 cup pasta, 1/2 cup cereal, 1 small roll, 1/2 bun

Starchy vegetables 1/3 cup corn, ½ cup potatoes, dried beans, peas

Milk 8 ounces

Yogurt 1 cup

Pudding & ice cream1/3 - 1/2 cup

BREAKFAST◦ 1 large bagel (4 oz)◦ 1 tsp margarine◦ ½ cup orange juice◦ 1 cup skim milk

DINNER◦ Spaghetti noodles 1 cup◦ Spaghetti sauce ½ cup◦ Tossed salad with lettuce, tomato◦ 2 Tbs salad dressing◦ Garlic Bread 2 slices (2 oz)◦ Coke