1. Carbohydrates and Sweeteners Extension Educator Title or County
Dining with Diabetes
Carbohydrates and Sweeteners
Extension Educator
Title or County
Welcome back to Dining with Diabetes, session two
Today we will focus on carbohydrates and sweeteners in our diets.
Extension educator will introduce self and any assistants. Welcome any new participants.

2. Program Sessions: Session 1- Living Well with Diabetes
Session 2 – Carbohydrates and Sweeteners
Session 3 – Fats and Sodium
Session 4 – Putting it All Together
Three-month follow-up - optional
Carbohydrates and sweeteners - are at the heart of learning to adopt healthy eating patterns when you have diabetes.

3. Last Week:
Did the class last week increase your awareness of diabetes management techniques or tests?
What portion of your plate should be nonstarchy vegetables?
How did you do in accomplishing your SMART goals?
But before we begin, let’s review any changes that you might have made over the last week and your smart steps from last week.
As a result of last week’s lesson, were you more aware of diabetes management techniques or tests? Did you begin to think about what you were eating? And why?
Were you more aware of your surroundings…perhaps signs, billboards, media.
You each set a smart step or goal for this week. Were you able to work on it? How did you do? Was it a reasonable short term goal?
Last week, we talked about many important things we could do to start to help manage diabetes. Can you name three of them?
(BP, physical activity, blood glucose, cholesterol, eye exam, foot exam…managing meals were implied)
Try not to be overwhelmed with changing all three at one time. Perhaps just focus on one topic at a time and once you feel more confident, then you can move onto the next item. Medications may be out of your control but meals and physical activity are not.
Also last week, we talked about physical tests that can help you better manage your diabetes. Can you name a few?

4. Know Your Numbers A1c Blood Pressure Cholesterol and Triglycerides
Fasting Glucose
Also last week, we talked about physical tests that can help you better manage your diabetes. Can you name a few?
Hemoglobin A1C, test every 3-4 months
Blood pressure tests should be done during every doctor’s visit.
Cholesterol, LDL, HDL and triglyceride blood tests should be done annually.
eGFR (tests kidney function), once a year.
Individuals with Type 2 Diabetes should have a dilated eye exam annually.
You should do foot exams daily and during each office visit by your doctor.
It is important that you do home glucose testing as advised by your doctor.

5. We are surrounded by food choices!
We are surrounded by choices every single day….and the choices…both good and bad add up.
Today we are going to focus on carbohydrates and learn how to make the best choices to balance your blood sugar.

6. What is a Carbohydrate?
1 carbohydrate serving = 15 grams of carbohydrate
Food groups containing carbohydrates
Grain
Fruit
Vegetables
Milk/yogurt
You have no doubt heard the word “carbohydrate” a lot since learning that you have diabetes, but you may not have been told what they are or why they are important.
Carbohydrates are substances, found in certain kinds of food, that provide you with energy. Foods such as sugar and bread that contain these substances can also be referred to as carbohydrates. Carbohydrates are broken down to glucose during digestion, and then absorbed into the bloodstream.
When someone has diabetes, their body does not use glucose the way that it should. You can help your body use glucose better by having consistent amounts of carbohydrate-containing foods at regular intervals. Your health care team can help you determine how many servings you need per day and the timing of those servings.
Throughout this session, we will talk about carbohydrate servings. 1 carbohydrate serving is equal to 15 grams of carbohydrate.
Keep in mind that both starchy and sweet foods are rich in carbohydrates. Carbohydrates are an essential nutrient but too many carbohydrates, whether starchy or sweet, can cause hyperglycemia and damage your body.

7. How Do Carbohydrates Work in the Body?
Just as a car needs gas to run, blood glucose, or blood sugar, is the fuel that our bodies run on. Glucose, or blood sugar, is vital to life itself. Our bodies can make glucose from all foods that we eat, but some foods are better sources of glucose than others.
Can you name some foods that raise blood glucose? (bread, fruit juice, desserts, sweet beverages – actually all carbohydrates raise blood glucose following a meal or snack)
Glucose, or blood sugar, is the required fuel for the brain.
Carbohydrate-containing foods are the best and most available sources of glucose.

8. MyPlate
USDA created a guide to help us choose healthy food. It was introduced in 2010 and contains all the food groups that we need to eat each day. This food guide is called My Plate and has a wonderful website, ChooseMyPlate.gov with a wide array of resources. You may have seen MyPlate on food packaging and in the media.

9. A Tool for Diabetes Meal Planning
The Plate Method:
A Tool for Diabetes Meal Planning
Fruit
Milk
Meat
Starches
Another tool, known as the Idaho Plate Method was designed to assist in diabetic meal planning. This Plate Method differs from MyPlate because this plate is HALF full of vegetables and the fruit is outside the plate. You might be saying to yourself, “how can I eat that many vegetables
What are some examples of how we can fill half our plate with vegetables?
Suggestions:
Mixed green salad
Spaghetti squash (Use this instead of spaghetti)
Your favorite non-starchy vegetable (broccoli)
Filling half your plate with vegetables can also lower the caloric content of your meal and may lead to weight loss.
A “9” plate is a good size dinner plate. (Show different sizes of plates to demonstrate the point). Balancing your food group choices is a good way to start balancing your diabetes.
Activity suggestion : - pass out a variety of plastic food models or cardboard food models from each group. As you go through the lesson, ask participants to hold up foods from the food group being discussed. Then ask them to hold up foods from that group that contain carbohydrate.
Vegetables

10. No Measuring Cup? No Problem!
Serving sizes are very important for everyone…but what does one serving mean? When we talk about carbohydrates in diabetic meal planning, we often talk about carbohydrate “servings”. As mentioned earlier, a carbohydrate serving is 15 grams. Carbohydrate servings include starchy foods like grains and starchy vegetables, dairy, non starchy vegetables, fruit and desserts.
One serving of a starchy food is one slice of bread or half of a bun or bagel. If the starchy food is cooked, like rice, potatoes, pasta, corn or green peas, then one serving is 1/3 cup. It is also approximately the amount a person can hold in one cupped hand.
A serving of fruit is one small piece of fresh fruit or ½ cup of canned or frozen fruit or fruit juice. which is 4 ounces.
One 8 ounce cup of milk is one serving. If the milk is made into pudding or a frozen dessert, the serving size is ½ cup.
Each of these serving sizes of starch, fruit, and milk raise blood sugar about the same amount.
Activity: Display 2 boxes of ready-to-eat cereal on the table. Ask for 2 volunteers to come up and pour what they think is a 1 cup serving into the bowl provided. Then measure what they have poured into an actual measuring cup to see if their “eyeballed” estimate was correct. Encourage participants to use measuring cups to keep themselves on-track at home.
1 Tablespoon

11. No Measuring Cup? No problem!
Serving sizes are very important for everyone…but what does one serving mean? When we talk about carbohydrates in diabetic meal planning, we often talk about carbohydrate “servings”. As mentioned earlier, a carbohydrate serving is 15 grams. Carbohydrate servings include starchy foods like grains and starchy vegetables, dairy, non starchy vegetables, fruit and desserts.
One serving of a starchy food is one slice of bread or half of a bun or bagel. If the starchy food is cooked, like rice, potatoes, pasta, corn or green peas, then one serving is 1/3 cup. It is also approximately the amount a person can hold in one cupped hand.
A serving of fruit is one small piece of fresh fruit or ½ cup of canned or frozen fruit or fruit juice. which is 4 ounces.
One 8 ounce cup of milk is one serving. If the milk is made into pudding or a frozen dessert, the serving size is ½ cup.
Each of these serving sizes of starch, fruit, and milk raise blood sugar about the same amount.
Activity: Display 2 boxes of ready-to-eat cereal on the table. Ask for 2 volunteers to come up and pour what they think is a 1 cup serving into the bowl provided. Then measure what they have poured into an actual measuring cup to see if their “eyeballed” estimate was correct. Encourage participants to use measuring cups to keep themselves on-track at home.
1-2 Tablespoon

12. Other Serving Size Visuals
4 stacked dice = 1 oz. of cheese
Deck of cards = 3 oz. of meat
Baseball = medium potato or fruit
1 cup cold cereal
Compact disk = pancake
Remember: LARGE portions add up!
100 Extra calories per day = 10 pounds of weight gain per year!
Some other guides to help estimate serving sizes are listed on this slide. While it is important to choose healthy foods, large portions can add up as you can see on this slide extra calories per day = 10 pounds of weight gain per year.

13. The Plate Method and Meal Planning
Fruit
Milk
Meal planning for people with diabetes is not easy. And there is no “one-size-fits-all” when it comes to a diabetic meal plan.
Using the Plate Method, no more than one-fourth of the plate should be covered by starchy foods such as bread, grains, or potatoes.
For Heart Healthy eating, no more than one quarter of the plate should be covered by something from the meat group.
Non-starchy vegetables should cover the rest of the plate.
The small circles represent single servings of milk and fruit.
Since milk, fruit, and starches raise blood sugar in the same way, they can be exchanged sometimes to match your taste and nutrition needs. All three provide about the same amount of carbohydrates per serving (~15 grams). .

14. Fill ½ Your Plate with Non-starchy Vegetables
Broccoli
Cauliflower
Carrots
Cucumbers
Green beans
Mushrooms
Peppers
Spinach Starchy Vegetables
Lettuce corn, peas, potatoes
Milk
Fruit
Meat
Starches
Vegetables
Meal planning is important for diabetes, but it takes time at first. It is very important to separate starchy vegetables from non-starchy vegetables. Starchy vegetables, such as corn, peas, lima beans and potatoes should be included in the “starchy” quarter of your plate. Remember that starchy vegetables are high in carbohydrates and will raise your blood glucose level.
Non-starchy vegetables, such as broccoli, tomatoes, spinach, and cucumbers, are a great choice because they help fill you up, but do not have as great of an impact on blood glucose. Fill half your plate with non-starchy vegetables. Note that while non-starchy vegetables are an excellent source of many nutrients and fiber, they are not a completely “free” food. Since they do contain small amounts of carbohydrate (up to 5 grams of carbohydrate per serving) large portions (i.e. a triple portion) can still affect blood glucose.
As a point of reference, the MyPlate recommendation ranges from a 2 to 3 cup equivalent per day, depending upon caloric need. A half-cup equivalent is ½ cup of dense uncooked vegetables (i.e. chopped celery or raw broccoli), ½ cup of a cooked vegetable (regardless of whether initially a dense or leafy vegetable), 1 cup of a raw, leafy vegetable, or 6 baby carrots.

15. Fill ¼ of Plate with Meat or Other Proteins
Examples of 1 oz. meat equivalents:
1 oz. meat, poultry or fish
½ cup dried beans, peas, or tofu
1 egg
1 oz. cheese
¼ cup cottage cheese
1 tablespoon peanut butter
Milk
Fruit
Meat
Vegetables
Starches
Protein is a very important part to any diet. ¼ of the plate is equivalent to ~2-3ounces of meat equivalents.
Meats such as beef, chicken, pork, eggs and fish do not contain carbohydrates. This might encourage you to include large portions of animal protein in your meal but most meat contains saturated fat which increases the risk for heart disease.
Plant proteins like dried beans, peas and tofu are healthy choices. They do contain carbohydrates so must be included in the carbohydrate count for a meal. Nut butters and soy products can be good protein options, too. Seeds and nuts contain protein, but in diabetic meal planning these foods are often considered a fat rather than a protein. These plant proteins are cholesterol free.
As a point of reference, the MyPlate recommendation ranges from a 5.5 to 6.5 ounce equivalent per day, depending upon caloric need. 1-ounce equivalents include 1-ounce of cooked meat, 1 egg, 1 Tablespoon of peanut butter or almond butter, ½ cup of tofu, 1/3 cup hummus
Beans and peas count as 1 protein, plus 1 starch. Equivalents include ½ cup of cooked beans (such as black, kidney, pinto, or white beans, refined beans), ½ cup of cooked peas (such as chickpeas, cowpeas, lentils, or split peas), 1/3 cup of baked beans.
Remember that cheese is considered a protein food for purposes of diabetic meal planning. Equivalents include 1 ounce cheese, ¼ cup cottage cheese. Low-fat choices (those with 3 grams fat or less per ounce) should be encouraged.

16. Fill 1/4 Plate with Grains/Starchy Veggies
Examples:
1 slice bread
½ cup cooked cereal
¾ cup dry cereal
½ cup beans
⅓ cup cooked pasta or rice
½ cup starchy vegetables
Potatoes, peas, corn, lima beans
1 serving = 15 grams of carbohydrate
Milk
Fruit
Meat
Starches
Vegetables
Foods in the grain groups are high in carbohydrate, so be mindful of the serving size and learn what a serving of carbohydrate is. Carbohydrates add up quickly! For example, a serving of rice or pasta is one-third of a cup. (Hold up the one-third measuring cup as you speak).
Educator may want to show other examples of carbohydrates (1 piece of bread, ½ cup cooked cereal, etc.)
A serving of grains has roughly 15 grams of carbohydrates (discuss 15 gram carbohydrate equivalents). These may include breads, cereals, pasta, starchy vegetables, beans and rice.
While desserts should not take the place of healthy foods, it is important to note that they should be included in this portion of the plate as well. Studies show us that sugar and sweets do not raise blood glucose more than other foods rich in carbohydrates. Desserts should not be looked at as a separate category but carefully considered within a balanced meal plan.
Talk with your health care team to determine the number of carbohydrate servings you need. A general recommendation would include 45 – 60 grams/meal for women (3-4 CHO servings) and 60 – 75 grams for men (4-5 CHO servings)

17. Option: Add a Serving of Fruit
Contain carbohydrates
1 serving (1/2 cup) = 15 grams of carbohydrate
Note these ½ cup equivalents:
½ cup canned fruit, canned in its own juice
1 small fresh fruit
½ cup cut fresh fruit
¼ cup dried fruit
½ cup fruit juice
Milk
Fruit
Meat
Vegetables
Starches
Fruits contain carbohydrates. Check with your health care team to determine the specific amount of fruit you need in your diet daily.
You may choose fresh fruit, fruit canned in its own juice, or dried fruit. Whole fruit is preferred over juices, but 100% fruit juices may be used in the diet (discuss fruit servings).
As a point of reference, the MyPlate recommendation ranges from a 1.5 to 2 cup equivalent per day, depending upon caloric need. A half-cup equivalent is 1 small piece of fruit, ½ cup of cut fruit, a 4-ounce “snack size” serving of canned fruit, ¼ cup dried fruit, ½ cup fruit juice.
Note: carbohydrate levels vary widely among different fruit. Participants should be encouraged to use the MyPlate Super Tracker or other tool to find out the specific carbohydrate content of fruits they eat on a regular basis.

18. Option: Add a Serving of Milk
Contain carbohydrates
1 cup milk = 15 grams of carbohydrate
Choose low fat and fat free options
Note these equivalents:
8 fluid ounces milk
1 cup yogurt (plain)
Milk
Fruit
Meat
Vegetables
Starches
Did you know that milk and yogurt contain carbohydrate? Again, you need to add these into your total carbohydrate intake.
Fat-free and low-fat milk are good choices because they contain fewer calories and are lower in saturated fat. They contain the same amount of other vitamins and minerals as milk with higher fat contents contain – and the same amount of carbohydrates.
Notice, 1 cup of plain, low-fat yogurt contains approximately 15 grams of carbohydrates. Check the carbohydrate content if you select varieties that contain fruit or have special preparations, such as “whipped”, as these yogurts tend to have much higher carbohydrate levels.
As a point of reference, the MyPlate recommendation is 3 cups per day, regardless of caloric need. One cup equivalents include 8 ounces of fluid milk or 1 cup of yogurt. While dairy foods are encouraged due to the important combination of nutrients they contain, 1 cup of calcium-fortified soymilk is a suitable substitution for individuals who are lactose intolerant.
Note: cheese is typically counted as a protein since it contains little carbohydrate but is a good source of protein.

19. Nutrition Facts Labels
Total Carbohydrate g 10% Dietary Fiber g Sugar g
Total Carbohydrate = Fiber + Sugar + Starch
If you are carbohydrate counting as a meal planning method, or if you just want to know how many carbohydrates are in your food, you need to be able to read the Nutrition Facts label.
This is a picture of the nutrition label found on almost all packaged foods sold in this country. Look at the portion of the label that tells how much Total Carbohydrate is in the food in order to decide how much it might raise your blood glucose. Total carbohydrate is the sum of the fiber, sugar and starch in the food. However, only sugar and starch break down to glucose and can affect blood glucose. Be sure to check the Serving Size on this label and see if it is close to amount you ate. If you ate more, you must include the extra carbohydrates in your meal count.
A serving of this macaroni and cheese has 31 grams of total carbohydrate and does not have any fiber. It has 5 grams of sugar so the other 26 grams are starch. How many carbohydrate servings is this? (2)
Be sure to look at Total Carbohydrate and not just at Sugars to see if a food will raise your blood sugar.
For Educators:
If you get questions about counting carbohydrates and how fiber is counted, you can refer to this statement from the American Diabetes Association:
“The grams of sugar and fiber are counted as part of the grams of total carbohydrate. If a food has 5 grams or more fiber in a serving, subtract the fiber grams from the total grams of carbohydrate for a more accurate estimate of the carbohydrate content.”

20. Types of Artificial Sweeteners
Aspartame
Stevia
Saccharin
Artificial sweeteners are used often by those who want to reduce the calories and carbohydrates in food. There are many artificial sweeteners on the market. Let’s discuss some of the most common ones available at this time. If you have a handout on artificial sweeteners, include this at this slide.
Aspartame, also known as NutraSweet™ or Equal™ has very little aftertaste but it tends to denature or lose its sweet taste, when it is heated.
It is 200 times sweeter than sugar.
Saccharin, sold as Sweet n’ Low™ and as a brown sugar substitute, Sugar Twin, and Sweet Thing are very stable for baking, but it has a noticeable aftertaste when used in large quantities.
It is 300 times sweeter than sugar.
Acesulfame potassium, sold as Sweet One™ has less aftertaste than saccharin and is more stable when heated than aspartame.
It is 200 times sweeter than table sugar.
Sucralose, also known as Splenda™, is made from sugar with certain chemical changes. It has the same volume and taste as sugar and it is stable when heated. Brown sugar blends are also available.
It is 600 times sweeter than table sugar.
Stevia may be sold under the approved names of Only Sweet, PureVia, SweetLeaf, and Truvia. It is stable for baking. Check packaging as may vary from one brand to another and depending upon form (liquid, packet, loose powder). Generally substitute ¼ tsp. or ½ packet stevia for every 1 tsp. in a recipe.
Other types of sugars:
SUGARS
Sucrose, fructose, lactose
SUGAR ALCOHOLS
Sorbitol Mannitol Xylitol
Malitol Lactitol Isomalt Erythritol
Hydrogenated starch hydrolysate
Sucralose
Acesulfame
Potassium

21. Functions of Sugars vs. Sweeteners
Traditional home recipes for desserts may contain large portions of sugar. Sugar does more than just make a recipe sweet. Sugar helps a recipe to be tender and moist. It also helps make the familiar golden brown color of baked desserts and breads. Sometimes sugar makes up a lot of the volume of a recipe as it does in cakes and cookies. When it does, replacing sugar entirely with artificial sweeteners may produce a cake that is tough, flat, and dry, as well as gray in color. Remember that artificial sweeteners only make a recipe sweet.
Recipes which usually do well with sugar substitutes include beverages, frozen desserts, pie fillings, sauces, gelatins, and puddings. Cakes, cookies, and meringues depend on large amounts of sugar for more of their finished properties. You should not replace more than ½ cup of the total amount of sugar with an artificial sweetener in these recipes.

22. Tips for Using Artificial Sweeteners
When replacing sugar with artificial sweeteners
Start with a little, taste, then add more if needed
Combine different classes of sweeteners
Try flavoring agents
Using pudding or dry milk to add volume and moisture
Small amounts of sugar are acceptable
Checking the official website for a particular artificial sweetener can be a good source of recipes and ideas because the manufacturer has tested the recipes for acceptability.
You can usually reduce the amount of sugar and fat by ⅓ to ¼ in cookies, quick breads and pies without affecting the product. This may not work well with cakes. You should not replace more than ½ cup of the total amount of sugar with an artificial sweetener.
a. Artificial sweeteners need to be used in small amounts at first and increased only gradually to avoid an overly sweet taste or unpleasant aftertaste.
b. When two different classes of artificial sweeteners are combined (such as saccharin with aspartame or Acesulfame potassium with aspartame), the result is a much sweeter taste than it is when one kind is used alone in cooking. If a recipe calls for 6 packages of saccharin sweetener, for instance, try using a total of only 3 packages of sweetener, but use two different kinds, such as one package of saccharin and two packages of aspartame.
Some sweeteners work better in cold items and some are acceptable in heated items. For example, we know aspartame loses its sweet taste when exposed to high heat in baking. When combined with another sweetener or acid, it becomes more stable. Aspartame may also be added to a product after it has been baked. Sucralose, on the other hand, is more frequently used in baked items because it is more stable and does not lose its sweet taste.
Use of Sugar Alcohols
Compared to sugar:
Fewer calories
Help prevent tooth decay
Similar bulk and texture
Use little or no insulin
May have laxative effect

23. Other Recipe Alternatives
Applesauce
Fruit Juices
Fruit Puree
Many people use fruit purees and fruit juices to replace fat in recipes. These products may not be any lower in carbohydrate than any sugar they replace. However, they do help with moisture and volume.
Be sure to read the label on fruit purees and on fat-free baking products to see how much carbohydrate they add to the recipe. There is usually a “trade-off” with these type foods – fat-free items may be higher in sugar and contain more carbohydrates.
Fat-free products may be HIGH in carbohydrate.
READ LABELS CAREFULLY!

24. Balance
You are responsible for your health. You need to keep a balance with your diet and physical activity and any medications you are taking.

25. Exercise: An Important Part of a Healthy Lifestyle
Exercise and diet work together
Aim for 150 minutes of physical activity each week
Check with your physician when starting a new exercise program
You can achieve better blood glucose control by maintaining a healthy diet and exercising regularly. In fact, even moderate weight loss can make a big difference in your blood glucose control. Additionally, when your muscles are active, your body uses glucose more effectively.
The Physical Activity Guidelines for Americans states “All adults should avoid inactivity. Some exercise is better than none. For substantial benefits, adults should get 150 minutes of physical activity per week” This translates to at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week. Increased activity will reap even greater benefits.
This daily exercise can be cumulative. It may be done during one thirty minute session or several shorter sessions throughout the day. The important thing is to be physically active on a regular basis.
Be sure to reinforce this message with participants: You should always check with your health care provider before making changes to your diet or exercise routines!

26. S M A R T SMART Steps pecific easurableeea ttainable elevant imely
What’s one SMART step you can make toward better management of your diabetes?
Now it’s time to decide what our Smart Step for this coming week will be. Thinking about what we’ve talked about, what is one thing you can change to take better control of your diabetes? Here are some tips for how to set a SMART step:
Specific: Details exactly what you want to do. “I will check my blood sugar before meals and two hours after meals to evaluate my blood sugar control.”
Measurable: Your goal should be something that you can measure to see if you’ve accomplished it or not. “I will write down these blood sugars in a log on one weekday and one weekend day.”
Attainable: Don’t set yourself up for failure! Make your goal something that you can actually accomplish. “Bringing my supplies with me and setting an alarm for blood sugars after my meals will help me remember and achieve my goal. Choosing two days of the week is not too overwhelming.”
Relevant: Your goal should be related to what it is that you are trying to accomplish. “This goal will help me gauge my diabetes control and show areas where I can improve.”
Timely: The goal that you set should be time bound, meaning that you should give yourself a specific amount of time to accomplish it. “I will log my blood sugars on one weekday and one weekend day within the next week.”
SMART Step: I will log my blood sugars before each meal and two hours after meals on one weekday and one weekend day within the next week to evaluate my blood sugar control and determine areas for improvement.
Other Smart Step ideas:
-”I will call my eye doctor for an annual exam appointment by next class”
-”I will check with my doctor about my need for vaccinations by next class.”
-”I will take a (or 30) minute walk two times before next class”
-”I will do a foot exam every evening before I go to bed for the next week.”
-”I will choose fruits and vegetables as my morning snack twice in the next week.”
Give the participants a few minutes to think about their Smart Step. Encourage group discussion and/or partner discussion, especially if there are several couples in the room. Pass out index cards for the participants to record their Smart Step. Suggest that the cards with the Smart Step be displayed somewhere prominent in the home as a reminder throughout the week. Also encourage the participants to write their Smart Step down on the My Smart Steps handout so they can monitor their goal over the next week and throughout the course of the class.

27. Useful Websites Calorie Control Council http://caloriecontrol.org
Mayo Clinic
Academy of Nutrition and Dietetics
American Diabetes Association
Artificial sweeteners can be a useful tool in helping to maintain your blood glucose levels within a normal range while eating some of the foods and beverages you enjoy. There are often questions about how to use artificial sweeteners and their safety.
We mentioned on an earlier slide that a sweetener’s website can be good source of recipe information. We also encourage you to look for information about artificial sweeteners from reliable sources, such as the websites listed on this slide.
You may want to have these websites written down on a board or flip chart, or have copies available for participants.

28. What’s Next Fats and sodium Exciting heart healthy tips
More delicious recipes to sample
Remind participants the date for the next class and the topics to be covered.

29. Acknowledgements
This curriculum was developed through the collaborative efforts of the National Extension Dining with Diabetes Working Group.
Special thanks to several individuals for their leadership and contributions:
Shari Gallup, Ohio State University Extension and Fran Alloway, Penn State University Extension, curriculum adapters
Barb Hennard, Ohio State University Extension, recipe compilation
Stephanie Faroh, Purdue University Extension, evaluation coordinator
Appreciation for permission to adapt the content of the
original Dining With Diabetes program is expressed to
West Virginia University Extension Service
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