Diabetes Survival Camp

1
Diabetes Survival Camp Session 3

• You can strive and thrive with diabetes

• Welcome

2
Survival Camp Topics

• Session 3
• Eating to thrive and survive
• Safely lifting Spirits
• Blood Pressure and Cholesterol Med
• Meters and Numbers - Surviving the Highs and
  Lows

3
Eating to Survive and Thrive

• Healthy Foods to nourish your
• lifetime journey
• Surviving thriving with everyday
• foods
• Building your Nutrition Survival
• tool kit

4
Dietary Fat and Diabetes

• Fat has little direct impact on blood glucose
  levels
• But fat does play a role in elevating blood
  glucose and can promote disease
• Increases insulin resistance
• Saturated fat and Trans fat intake greatly
  increase the incident of cardiovascular disease.

5
Fats - Aim for heart health

• Saturated fats (LIMIT)
• Solid
• Animal
• Tropical (palm, coconut)
• Trans fats (deep fried)
• Monounsaturated
• Olive canola oils
• Nuts
• Avocado
• Polyunsaturated
• veg oils canola, corn, walnut, safflower,
  soybean

• Serving sizes
• 1 tsp butter, margarine, oil, mayonnaise
• 1 Tbsp salad dressing, cream cheese, seeds
• 2 Tbsp avocado, cream, sour cream
• 1 slice bacon

6
Saturated Fats

• Makes the body produce more cholesterol
• Stimulates the production of LDL cholesterol
• Raise cholesterol levels and LDL-cholesterol
  levels more than dietary cholesterol itself
• Related to an increased risk of cardiovascular
  disease

7
Saturated Fats Raise Cholesterol

• Palm oil
• Coconut oil
• Cocoa butter
• Hydrogenated vegetable oil
• Poultry with skin
• Processed and fast foods

• Meat
• Cheese
• Egg yolk
• 2 or regular milk
• Ice cream
• Butter
• Cream cheese
• Sour cream

8
Meat and Chicken serving size Fat Content

• Serving size
  Kcal total fat saturated
  fat
• Ground Beef 3 oz 244 18
  gms 8 gms
• (21 fat)
• Ground Beef 3 oz 191 10
  gms 4 gms
• (9 fat)
  
• T-Bone 3 oz 174
  9 gms 3 gms
• Top Round 3 oz 153 4
  gms 1.5 gms
• Pork tenderloin 3 oz 140 4
  gms 1.5 gms
• Chicken breast 3 oz 140 3
  gms 1 gm

9
Cheese Serving Size Fat Content

• Serving Size Kcal
  gms/total fat gms/sat. fat
• Cheddar 1 oz 110 9
  gms 6 gms
• Swiss 1 oz 110
  9 gms 5 gms
• Blue 1 oz 100
  8 gms 5 gms
• Mozzarella 1 oz 70
  5 gms 3 gms
• Feta 1 oz 60
  5 gms 3 gms
• Parmesan 2 Tb 60 4
  gms 3 gms
• Romano 2 Tb 40 4
  gms 2 gms

10
WHAT IS A TRANS FAT

• Made when manufacturers add hydrogen to vegetable
  oil--a process called hydrogenation
• Turn liquid oils into solid fats like shortening
  and hard margarine
• Hydrogenation increases the shelf life and flavor
  stability of foods containing these fats

11
THE PROBLEM

• Trans fats cause
• lowering of HDL (good) cholesterol
• increase in LDL (bad) cholesterol
• make the arteries more rigid
• cause major clogging of arteries
• cause or contribute to type 2 diabetes
• cause or contribute to other serious health
  problems

12
Monounsaturated Fats

• Olive oil
• canola oil
• peanut oil
• olives
• avocado
• almonds
• peanuts
• cashews
• pecans

13
Polyunsaturated Fats

• Corn oil
• Safflower oil
• Soybean oil
• Sunflower oil
• Omega-3 polyunsaturated fats
• Walnuts
• Flaxseed
• Chia seeds
• Hemp seeds

14
Fish and Shell Fish Serving Fat Content

• Salmon 3 oz 155
  7 gms 1 gm 1500 mg Omega 3
• Trout 3 oz 128
  5 gms 1 gm 1500 mg Omega 3
• Scallops 3 oz 122
  1 gm 0 gm 200 mg Omega 3
• Snapper 3 oz 109
  1 gm 0 gm 200 mg Omega 3
• Shrimp 10 lg 54
  1 gm 0 gm 150 mg Omega 3

15
Alcohol and Your Health

• Avoid
• High triglycerides
• Avoid
• Neuropathy

• Limit
• Hypertension
• Limit
• Weight loss desired

16
AlcoholCarbohydrate content and calories

• Serving Size Carbohydrate
  Calories
• 12 oz Beer 15 gms
  150
• 4 oz Dry Wine 5 gms
  85
• 4 oz Dessert Wine 14 gms
  150
• 1 oz distilled alcohol 0 gms
  65
• 12 oz Smirnoff Ice 32 gms
  228
• 1 oz Kahlua 13 gms
  100
• Liqueurs or Cordials 50 Sugar and 20-50
  Alcohol

17
ALCOHOL RULES

• Moderation (1-2 drinks)
• Never drink on an empty stomach
• Never drink alone
• Inform others
• Carry treatment for a low
• Wear diabetes ID
• Caution with exercise
• Experiment

18
Fiber Goals

• Same as for general population
• 25 grams for women per day
• 38 grams for men per day
• Choose a variety of fiber-containing foods
• whole grains
• fruits
• Vegetables

19
Fiber

• Made up of complex carbohydrates that cannot be
  broken down
• Provide vitamins, minerals, fiber and
  phytonutrients that are important for good health
• There are two types of fiber
• Soluble
• Insoluble

20
Soluble Fiber

• Forms a gel when liquid
  mixed with
• Good sources
• flesh of fresh fruits (especially apples and
  citrus), certain grains
• (oatmeal, barley and rye), legumes seeds
• Dried fruits have the highest concentration of
  soluble fiber
• Delays glucose absorption
• Lowers cholesterol
• Decreases the speed at which food moves through
• your intestines

21
Insoluble Fiber

• Does not mix with water
• Found in all fruits, vegetables, legumes, and
  seeds
• Delays glucose absorption
• Slows the breakdown of starch
• Increases the speed at which food moves through
  the intestines

22
Carbohydrate and Fiber Content of Several High
Fiber foods

• Legumes Srvg size CHO Fiber
• Kidney 1/2 c 15 6
  
• Black 1/2 c 15 8
  
• Pinto 1/2 c 15 7
  
• Fruit
• Blackberries 3/4 c 15 6
  
• Boysenberries 1 c 15 7
  
• Pear w/ peal 1 Med 15 4
  
• Raspberries 1 c 15 8
  
• Avocado 1/2 7 5

23
Reviewing your Nutrition Survival Tool Kit

• Controlling portions
• Healthy carbohydrates
• Healthy fats
• Go lean with protein
• Food and activity records
• Blood sugar monitoring

24
Diabetes Management Plan
25
Survival Strategies for Blood Vessels Big and
Small
26
Hyperglycemia Can Cause Serious Long-Term Problems
27
Take Steps to Reduce Risk Factors for Heart
Disease
28
The ABCs of Diabetes Control

• A - A1c less than 7
• B - Blood pressure less than 140/80
• C Cholesterol
• LDL less than 100 (70 with heart disease)
• HDL more than 40
• Triglycerides lt 150

29
Keeping Big Blood Vessels Healthy

• Lower Blood Sugar, Cholesterol and Blood Pressure
• How?
• Healthy Eating
• Activity
• Quit Smoking
• Medications

30
Medications for Blood Pressure and Cholesterol

• See handouts
• Circle the medications you are taking
• Doses need changes over time
• Keep a medication log to track changes

31
Blood Pressure Goal 140/80

• Medications for Blood Pressure
• Ace Inhibitors (ils)
• ARBs (sartans)
• Beta Blockers (olols)
• Calcium Channel Blockers
• Diuretics and others
• May need 3 or more different types of pills to
  control blood pressure

32
Cholesterol - Blood Fats

• Lipid Goals as outlined by ADA
• LDL lt 100, less than 70 with heart disease
• HDL gt 40 for men, 50 for women
• Triglycerides lt 150
• Medications
• Most people with diabetes should be on a drug
  class called Statins

33
Aspirin A Day? Ask your Doctor

• Aspirin can help reduce your risk of heart
  attack and stroke.
• Usual dose - Baby aspirin to adult aspirin daily.
• Can use enteric coated to protect your stomach.
• Ask you doctor if you should start!

34
Tips for Safe Medication Use
35
Peaks and Valleys Surviving the Highs and Lows
36
Glucose Monitoring Getting the Most from your
Numbers

• Monitoring puts the control in your hands
• Knowing your goals
• When to get help

37
Knowing Your Goals - Blood Sugar

• Blood sugar goals
• Always greater than 70
• Before meals 70-130
• 1- 2 hours after meal less
• than 180

38
Blood Glucose Monitors
39
Blood Glucose Testing Gives You a Picture of Your
Diabetes Control
40
Hermione Witchwand Blood Sugars - Takes no meds

• Day Before Break Lunch Dinner Bedtime
• Mon 128 119 126 102
• Tues 118 112
• Day After Break Lunch Dinner Bedtime
• Wed 191 174 225 142
• Thursday 186 214

41
Julio Iglesias Blood Sugars - Takes Glyburide 5
mg AM/PM

• Day Before Break Lunch Dinner Bedtime
• Mon 68 119 126 102
• Tues 118 69
• Day After Break Lunch Dinner Bedtime
• Wed 124 84 117 79
• Thursday 112 113

42
Keep a Log of Your Blood Glucose Readings
43
Monitor Care and Storage Tips
44
Meter Maintenance

• Control solutions - use with each new bottle of
  strips.
• Solutions expires in 3 months, need new bottle.
• Batteries - know the type and when low - keep
  extras on hand
• Avoid temp extremes for meter / strips
• Questions? Call 800 number on meter.

45

• Safe Disposal of Lancets
• Place lancets sharps container or bleach bottle.
• Take to Hazardous Waste Collection Site
• In Paradise - 920 American Way (near Clark Rd.)
• Monday- Friday, Hours-8am 5pm. Phone [phone]
• In Chico - 1101 Marauder Street (near the
  airport)
• Hours 9am 1pm on Friday and 9-4pm on Saturday
  
• More info - Call [phone]

46
Figuring out the Highs and Lows
47
Understanding Hypoglycemia
48
Symptoms of Hypoglycemia
49
Preventing Hypoglycemia
50
Treating Hypoglycemia
51
Causes of Hyperglycemia (High Blood Glucose)
52
Managing Hyperglycemia
53
Sick-Day Management
54
When Illness Occurs Follow Your Sick-Day Plan
55
Sick Day Management

• Continue taking your diabetes pills and insulin.
  
• Test blood sugar every 4 hours.
• If you cant get blood sugar below 300, call
  doctor.
• Make sure to eat and drink plenty of fluids.

56
During Illness, Call Your Care Team If You Have
57
Jackie G. Blood Sugars - On Advandia/Glucophage/In
sulin

• Day Before Break Lunch Dinner Bedtime
• Mon 212 154 182 311
• Tues 198 270
• Day After Break Lunch Dinner Bedtime
• Wed 248 172 244 298
• Thursday 236 218

58
You Survived Camp Session 3

• You can strive and thrive with diabetes

• See you next week