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
Nutrition at School for Kids with Diabetes
Lisa Emmert, MS, RD, LD, CDEArkansas 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• 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
Nutrition Education• Day 2
– Starchy/non-starchy vegetables– Protein and fats– Free foods– Sweets
• Day 3:– School lunch/breakfast– Snacking– Resources
Education Materials• Our own departmental handbook• Calorie King books• “Pink Panther Book” from the Barbara
Davis Center (in Denver, CO)
Carbohydrate Counting• Can be counted using exchanges, carb choices, or
grams of carbohydrate. • We most often use grams of carbohydrate.
Food Labels
• Focus on 2 things: total carbohydrate and serving size.
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
Carb Counting Resources• Check with your food service director
or dietitian• Network with other school nurses• Google search
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
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
What About Fat?
• Do not need to count carbs for fats
• However, some fat-free items (such as salad dressing) DO have carbohydrate.
Condiments
• Do count the following:– Ketchup– Barbecue sauce– Honey mustard– Sweet and sour sauce
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.
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
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.
Meal Plan for Type 1 DiabetesBks Snack Lunch Snack Dinner Snack
Grams of carbo-hydrate
60 15 60 30 60 30
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
Thank You!