NLO

Define diabetes Discuss dietary basics Identify carbohydrate containing

foods and servings Review documentation of

carbohydrates consumed Review signs/symptoms of

hypoglycemia

Diabetes is a metabolic disease resulting in elevated blood glucose levels caused by the body’s complete lack of insulin production, or the cell’s resistance to the circulating insulin. Insulin is needed to transport glucose into the cells for energy.

Three main types of diabetes: • Type 1- body does not produce insulin• Type 2- body’s cells are resistance to insulin• Gestational- high blood glucose during pregnancy

The three main nutrients= macronutrients• Carbohydrates• Fats• Proteins

Why count carbs?• 100% of carbohydrates convert to glucose• Protein and fat have very little effect on glucose

levels What foods contain carbs?

• Fruits, starchy vegetables, grains, legumes, dairy, and sweets

15 grams is the standard unit of measurement for carbs

What does 15 grams of carbs look like?• 1 slice bread• ½ cup grain, beans, or starchy vegetables• 1/3 cup cooked rice or pasta• 1 small piece fruit• 4 oz. fruit juice• 8 oz milk• 2 small cookies

No such thing as a diabetic diet

No such thing as a sugar free liquid diet

Simply limiting sugar does not improve glycemic control

The nurse will administer insulin based on how many carbs the patient consumes, so we need to be as accurate as possible : )

Carb documentation is very important! (documentation responsibilities are unit specific)

Can document as a “task” or as a “ad hoc” charting

If you are not sure how many carbs certain food items are worth, you can go to the Inside page, Clinical Hotspots, then the nutritional table for your facility

https://insideintegris.corp.integris-health.com/Pages/Default.aspx

Smudge

Breakfast TuesGrey Diet Kit (4g carb) 1 each

Syrup (13 g carb) 1 servMargarine (0g carb) 1 serv

Low Chol Eggs (1g carb) 1 servTurkey Sausage (0g carb) 1 eachPancakes (27 g carb) 2 each

Coffee 1 cupCheeri 1 indApple J 1 each2% Mil 1 serv

Name: _________________________DOB:Room:Diet: Regular with Diabetic Features

Hypoglycemia is defined as a blood sugarless than 70. Symptoms include: Hunger Nervousness and shakiness Sweating Light-headedness Sleepiness Confusion Anxiety

Notify your nurse for any blood sugar less than 70 or a patient with symptoms!

The patient should be treated and have their blood sugar rechecked every 15 minutes until the patients blood sugar is greater than 70.

It is a good idea to notify your nurse with all blood sugar reading you take.

Remember to dock/upload the meter for all results as soon as possible.

It is the nurse’s responsibility to determine treatment of hypoglycemia!!!

Taking care of patients with diabetes is a team effort! : )

American Diabetes Association and American College of Cardiology (2011). Choose to live: your diabetes survival guide.

American Diabetes Association (2009). Life with Diabetes: A series of teaching outlines by the Michigan Diabetes Research and Training Center. 4th edition.