DM Nutritional Management

Question 1

What are some key priorities when making a diet plan for a diabetic?

Answer 1

Want to adjust goals according to life status + sustained CHO delivery throughout the day
- consider that growth, fetal development, quality of life, healthy weight is not compromised

Question 2

How much of a diabetic diet is composed of protein

Answer 2

15-20%

Question 3

how much of a dm diet is CHO based on?

Answer 3

45-60%
oR
40-45% if tighter control

what type of cho are we considering here?

Question 4

Compare GI vs GL

Answer 4

GI- idea of CHO quality and how quickly it changes blood glucose levels
GL- idea of cho quality and quantity - relative to the serving

Question 5

Low GI vs High GI ranges?

Answer 5

low= less than 55% of the value of glucose
high = 70% or more

Question 6

benefits of fibre

Answer 6

1. slow digestion and absorption
2. satiety
3. less energy density

Question 7

how much % of sugar in diabetic diet? sugar alchohols?

Answer 7

sugar = 10% total energy
sugar alchohol aim for less than 10g/day to avoid gi issues

Question 8

what is a key point to remember when designing a low cho diet?

Answer 8

see what patient prefers, values and goals are
adjust accordingly
make sure culturally appropriate

Question 9

how much % of total energy should come from fats?

Answer 9

20-35%

Question 10

of the total fat intake, how much should be SFA? PUFA? MUFA?

Answer 10

SFA = less than 7%
MUFA = 10-15%
PUFA = less than 10%

Question 11

How do SFA, MUFA and PUFA affect TG and LDL-chol levels?

Answer 11

SFA = increase LDL
PUFA = decrease LDL
MUFA = doesnt affect LDL but decreases TG

Question 12

what are things you have to consider regarding micronutrients for low cho diet?

Answer 12

Not much different than a normal population unless trying to lose weight or pregnant

but make sure no added sodium in diet bc lots of T2D patients have hypertension

Question 13

Whats the order of priorities when building a low cho diet plan?

Answer 13

1. control CHO/glucose which should also lower LDL levels
2. lower SF if LDL levels still high
3. Reduce Na+ if high blood pressure
4. Alchohol is usually same for T2D but make sure no hypoglycemia for T1D

Question 14

What are the distributions of CHO amount for meals?

Answer 14

1/5 break, 2/5 Lunch, 2/5 dinner
or
1/6 break, 2/6 lunch, 2/6 dinner, 1/6 snack

Question 15

What are some teaching tools and methods for cho diet planning

Answer 15

1. Just the basics
2. BTB
3. advanced cho counting

Question 16

Summarize the gist of “just the basics” method

Answer 16

-3 meals a day, regular timing, 6 hours max spaced out with snacks
-Limit processed sugars and high fat foods
-more high fibre foods
- drink water when thirsty
- add PA

Question 17

Summazrize the gist of BTB plan

Answer 17

-focus on the quan and qual of CHO
-conversion of glucose to body from macros
-15g of CHO per portion size
-aimed to limit risk of related disorder

Question 18

summarize the gist of advanced cho counting method

Answer 18

-count the actual cho intake using food lists and labels
-you have to have good understanding of food, estimates of portions
-calc grams of cho consumed
-necessary for type 1 patient meal plans

Question 19

basic cho counting vs advanced?

Answer 19

basic = you set a CHO goal for each meal and eat to goal

advanced = CHO will vary for each meal so you calculate the insulin you need to handle CHO

Question 20

what is the ratio for insulin: CHO calculations

Answer 20

1: 15

1 unit of rapid insulin covers 15g of cho

Question 21

Things to consider for insulin:CHO dose adjustments?

Answer 21

rapid acting insulin = only account for the cho in the meal, not snacks

slow acting insulin = account for cho in meal and any snack afterwards before the next meal

Question 22

What are CHO factors?

Answer 22

the cho concentration per gram of food
-useful for advanced cho counting method