Used at Camp Nejeda for Type One Diabetes to educate children and their families on counting carbohydrates

1. Carbohydrate Counting

2. What is Carbohydrate Counting? Meal planning approach to diabetes Easy to learn & follow Adds variety & flexibility to meal/snack choices Achieve better glucose control

3. Carbohydrate (CHO) Main nutrient raises glucose levels Foods that contain starch and sugar 90% digestible CHO turns into glucose Insulin needs to cover the amount of CHO ingested

4. CHO Counting Basics Two methods for counting CHO CHO gram counting: add exact number of grams of CHO in each meal 2) CHO exchange system: uses food groups called “exchanges.” One portion/exchange of each food containing CHO=15g CHO

5. Carbohydrates Starches/Bread Fruits Milk Vegetables Most glucose will enter bloodstream between 15min to 2 hours after eating these foods

6. Protein and Fats Less effect on blood glucose. Appears to have an effect hours later after eating. Can potentially slow down rate that CHO turns to glucose

7. Foods That Contain CHO Cereal, Breads, Grains Pasta, Rice and Crackers Fruit and Fruit Juices Honey, Table Sugar, Syrup Yogurt and Milk Vegetables (starchy/nonstarchy) Cakes, pies, cookies, candy

8. Cereals, Breads & Grains ¾ cup unsweetened cereal ½ cup sweetened cereal ½ cup oatmeal 1 slice (1oz) bread ¼ large bagel 6 inch tortilla ½ hamburger or hot dog bun 1-4 inch pancake

9. Pasta, Rice, & Crackers 1/3 cup cooked pasta/rice 3 cups air popped popcorn 15 small pretzels 1 ½ graham crackers 4-5 vanilla wafers 5-6 saltine crackers 7-8 animal crackers 15 potato or corn chips

10. Fruit & Fruit Juices Apple or Orange juice (1/2 cup) Grape juice (1/3 cup) 1 small banana 1 small apple, orange, pear or peach 17 seedless grapes 2 T. raisins ½ cup mixed fruit in light syrup 1 cup watermelon

11. Yogurt, Milk & Ice cream Milk (1cup) Chocolate milk (1/3 cup) Plain Yogurt (1 cup) Fruited Yogurt (1/3 cup) Ice cream (1/2 cup or 1 scoop) Sherbet (1/3 cup)

13. 3 oz small potato Non-Starchy Vegetables: -1/2 cup cooked or 1cup raw= 5 grams CHO (e.i. lettuce, carrots, broccoli, cucumbers, spinach)

14. Cakes, Pies, Cookies & Candies Angel food cake (4oz)= 35g CHO Chocolate cake plain (4oz)= 30g CHO Chocolate cake w/frosting (4oz)= 50g CHO 2 Sugar cookies= 15g CHO Donut plain= 20g CHO ½ cup Pudding= 20g CHO Chocolate Candy Bar (1 ½ oz)= 12g CHO Hard candy (1oz)= 25g CHO Fruit pie (1/8 slice)= 35-40g CHO

15. Sugar, Honey & Syrup Regular Jelly/Jam (1T) Brown Sugar (1T) Honey (1T) Chocolate Sauce (1oz) Syrup (1 T)

16. Beverages Diet Soda=Free Regular Soda (12oz can)= 40-50g CHO Gatorade (8oz)= 15g CHO

17. Balanced Meals 10-20% Calories from Protein -high protein diet harmful to kidneys 50-60% Calories from Carb -rich source of carbs (fruits, vegetables, whole grains) 25-30% Calories from Fat -excess animal fat may result in greater risk for heart disease later in life

18. Balanced Meals Cont… Eat meals & snacks around same time each day Need to be flexible Never skip a meal or wait more than 4-5hr without eating Solid snack containing protein, fat, and carbs is best before bedtime

19. Hypoglycemia Signs: sweating, nauseas, dizzy, confused, irritable, tired Check blood sugar level right away. If below 100 mg/dl give 15g CHO (ei. 1/2c orange juice or 3 glucose tablets) Wait 15 minutes and test blood sugars again. Repeat steps if not above 100 mg/dl

20. Encourage Increase Fiber Intake Fiber: roughage in our food that is not absorbed into the body Fiber may slow the rise in blood sugar levels Apple juice vs Raw Apple Examples: raw fruits, vegetables, legumes, high-fiber cereals, and whole wheat breads

21. Avoid Added Salt High blood pressure is important risk factor for both eye and kidney complications of DM & heart attacks Rec. less than 3000 mg salt/d= 1 1/4tsp salt Foods high in salt content: canned soups, fast foods, many snack foods, frozen veg. in sauces

22. Important Points No difference in the effect of a simple sugar compared with a starch in raising FSBG levels A diabetic can eat almost any food in moderation if it is worked into meal plan Nutritious carbs should be encouraged Frequent FSBG testing is encouraged (2hrs post eating) to determine how a given food affects an individual

23. Last but not least! Food management for diabetics does not mean a restrictive diet, but rather a healthy eating regimen