Diabetes_lifestyle Counseling_as honarary

8/9/2019 Diabetes_lifestyle Counseling_as honarary

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DIET AND HEALTH DIRECTIVES

ea sympa y are no enoug

There is a need for righte an ea rec ons or

Indians living w ith diabetes

by Shivali & Shaily Chauhan, Nutritionist & DietitianDIET & HEALTH DIRECTIVES

, ,

SHIVALI SHAILY


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DiabetesDIET AND HEALTH DIRECTIVES

What is Diabetes?

Diabetes is a disease in which the bodydoes not produce or properly use insulin.

Insulin is a hormone that isneeded to convert sugar, starches, and

o er oo n o energy nee e or a y e.

, ,obesity, and lack of exercise appear to play roles.

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ypes o a e es

y : Pancreas doesnt produce insulin(juvenile diabetes). ~5-10% of population .

insulin is produced, strongly linked to obesity (adult

onset). Majority of population are diagnosed

Gestational Diabetes: occurs durin re nanc

.

~ 4% of the pregnant women per year.

Pre-Diabetes: Blood lucose levels are between normal &

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high levels ~ Affects 41 million population.


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SIGN & SYMPTOMS


y - excessive eating

Polyuria- excessive urination

Polydypsia - excessive fluid intake

Poor wound healing

Blurred vision

Irritability

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How do you know if you have

FASTING GLUCOSE LEVELS

Normo-glycemic: 70-110 mg/dl

-- Prediabetes: 100 -125 mg/dl

Hyperglycemic: >110 mg/dl

-- Diabetes: > 126 mg/dl

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Criteria for Diagnosiso re- a e es

- -

Fasting: 110- 126 mg/dL2-h: 140-200 mg/dL

Current Criteria for

Symptoms of diabetes and a casualplasma glucose 200 mg/dl

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Di a b e t e s M o d e l Ov e r v i e w



Burden of Diabetes

( P er person Diabetes)

Total Prevalence

( P eople with Diabetes )

n ea y ays( P er person Diabetes)

Prediabetes Diabetes

People withNormal

Blood sugar

People withDiabetes

People withundiagnosed

diabetes

People withdiagnoseddiabetes

onset agnos s Death

Obesity ineneral

Prediabetes Diabetes Diabetes

population

managementdetection

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Burden of Diabetes

This larger view takes us

( P er person Diabetes)

epidemiological models andmost intervention programs

Total Prevalence( P eople with Diabetes )

n ea y ays( P er person Diabetes)

Prediabetes Diabetes

People withNormal

Blood sugar

People withDiabetes

People withundiagnosed

diabetes

People withdiagnoseddiabetes

onset agnos s Death

Obesity ineneral

Prediabetes Diabetes Diabetes

population

managementdetection

Standard Boundary Ref NHIS, NHANES,CENSUS SHIVALI SHAILY


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Diet is an essential part of

Diabetes.

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Basic Principles of Diabetic DietDIET AND HEALTH DIRECTIVES

Ensure your regular meals

- ase mea s on comp ex car o y ra es:Brown Bread, Cereal

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ncourage g er w o e mea vers ons


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Aim for rec ommended 5 portionsDIET AND HEALTH DIRECTIVES

Spread fruit throughout day.

Limit fruit juice.

What is a portion?

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Cut down on sugar andDIET AND HEALTH DIRECTIVES

sugary oo s:

Aim for low sugar diet,.

Instead of sweet cakes/ biscuits offer plain ,

.

high fiber biscuits, fruit whole wheat Loaf.

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o no e ec oo g ucose eve s.


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Caution!

Fruit sugar (fructose) when used asa sweetener will still affectBlood Sugars in the same way as

normal sugar!!

Avoid Diabetic foods e.g. jams, chocolates and cream biscuits: Contain sweeteners such as sorbitol - laxative affect

Ex ensive and unnecessar

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Food Labeling

Nutrition InformationNUTRIENT PER SERVING PER 100 g

ENERGY 351 Kcal 234 Kcal

PROTEIN 100 g 7.0 g

. .

of which sugars 3.0 g 2.0 g

of which starch 25.2 g 16.8 g. g . g

of which saturates 7.6 g 5.1 g

of which mono- 10.9 g 7.3 g

saturatesof which poly unsaturates

2.7 g 1.8 g

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FIBRE 1.6 g 1.1 g

SODIUM 0.6 g 0.4 g


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Food Labeling

e o

2g SUGAR 10g

3 FAT 20

1g SATURATEDFATS

5g

FOOD ITEM NUTRIENT CONTENT vs. FOOD ITEM NUTRIENT CONTENT

.

Cocoa Sugars - 9.0g vs . Drinking Chocolate - Sugars 26.4gInstant Light Malted drink Sugar 11.3g vs. Malted drink Sugar 21.5g

. . .

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Steps to a healthier U DIET AND HEALTH DIRECTIVES

Weight loss is desirable

e.g. chips, pastry, crisps, cheese & fried foods

Encourage low-fat food options e.g. semi-skimmed milk, low-fat spread

Offer fruit/ diet yoghurt as pudding/ dessert

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Snacks not essential


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Caution with

Examples: Fortisip, Fortijuic e,

,

Milky supplements better choice

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Alcohol

Alcohol in moderation can be included ,no more than:

1-2 units / week for women

Never drink alc ohol on an empty stomac h

Remember to use diet mixers

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Caution with sweet liquors


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Key Points

Ensure regular meals

Aim f r r i n f fr i n v l

wn n r n r f

If in doubt read food label

SHIVALI SHAILY Encourage relatives to bring low sugar foods


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Standards of Care ABCsDIET AND HEALTH DIRECTIVES

-B - Blood PressureC - CholesterolD Diabetes /Dental Exam/DietE - Eye Exam/Exercise

F - Foot Exam

G - Glucose monitoringH - Heart HealthI - Indications for s ecialties

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K - Kidney


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Exercise

Examples of Exercise:

Aerobic: Walking, Swimming, Bicycling, Jogging

-- Strength: Weight/Resistance

Flexibility: Yoga

sugars and lower you risk of

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Three Key Parts To Any

FREQUENCY: Exerc ise at least 3-5 days per week

TIME: Exerc ise for at least 20-30 minutes

INTENSITY: This means how hard you work during exercise. You should feel like you are working harder than usual but

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Exercise Tips

Type 1: do not exerc ise if sug ars< 70 or > 300 or if ketones are present

T e 2: do not exerc ise if su ars < 70 or >350

several hours after exerc ise

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Sc hedule exerc ise 45-60 minutes after eating


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Further Guidelines

Keep a daily logWear Medic al ID

Modify Caloric Intake

Carry fast ac ting sug ar

Exerc ise with a partner Do NOT in ec t into area where exerc ise is involved

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You have ot to take anactive role inmonitoring &

health.

Waiting for the system to

help you just wont.

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Su ort

Family

Multi-disciplinary Team

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Summary for Success

KnowledgeIndividualizeS tart

S upport

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DIET AND HEALTH DIRECTIVES You will learn that

A nutrition messa e ismore than just 5 A Day

DIET DIRECTIVE

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HEALTH DIRECTIVE

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Resourc es/Referenc es

Americ an Diabetes Assoc iation:www.diabetes.org

Center for Disease Control :

www.c dc .g ov/diabetes

Clinic al Diabetes :http://clinical.diabetesjournals.org

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www.sddiabetes.net



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