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 health.com/Pages/Default.aspx

Smudge Breakfast Tues Grey Diet Kit (4g carb) 1 each Syrup (13 g carb) 1 serv Margarine (0g carb) 1 serv Low Chol Eggs (1g carb) 1 serv Turkey Sausage (0g carb) 1 each Pancakes (27 g carb) 2 each Coffee 1 cup Cheeri 1 ind Apple J 1 each 2% Mil 1 serv Name: _________________________ DOB: Room: Diet: Regular with Diabetic Features

Hypoglycemia is defined as a blood sugar less 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. 4 th edition.