2. Shelby Polk DNP, FNP-BC, CDE April 21, 2010

3. 2 Exercise Legal Rights Health & Learning Nutrition Insulin Administration Hypoglycemia & Hyperglycemia Ketones Monitoring Blood Glucose Glucagon Administration

4.  Management of children with diabetes  Asked to do more with less staff ◦ Monitoring blood glucose ◦ Recording results ◦ Carbohydrate counting ◦ Calculate insulin needs ◦ Check urine for ketones ◦ Treat low blood sugar ◦ Administer glucagon  7 hours/day – 5 days/week = 35 hours/week  YOU ARE VITAL!!!!!

5.  WHY COUNT CARBOHYDRATES  HOW DO CARBOHYDRATES AFFECT BLOOD SUGAR?  WHAT IS A CARBOHYDRATE? ◦ Protein ◦ Fat ◦ Carbohydrate

6. ◦ Brussel sprouts ◦ Skim milk ◦ Oreos ◦ Orange Juice ◦ Fat free frozen yogurt ◦ Sugar free cookies ◦ Diet Coke ◦ Mayonnaise ◦ Ketchup ◦ Butter

7.  Do we need carbohydrates?  Good versus bad?  The amount of carbohydrate is more important than the type ◦ 1 frosted brownie = 2 slices bread ◦ 1 cup ice cream = 1 cup of cereal 30 grams carbohydrates

9.  1 serving = 15 grams  Meals ◦ 3 – 4 carb servings  45 – 60 grams carbohydrates  Snacks ◦ 1 – 2 carb servings  15 – 30 grams carbohydrates

10.  1 st – Serving Size  2 nd – Total Carbohydrates ◦ ?? Deduct fiber from total carbohydrates if > 4grams ◦ ?? Deduct ½ of sugar alcohol from the total carbohydrates  3 rd – Count Carbohydrates for each food item for a Total Carbohydrate amount for the meal/snack

11.  Serving Size  Total Carbohydrate  Total Fat

13.  Fresh fruit 1 cup, 1/2 banana, 15 grapes, 1/8 cantaloupe, tennis- ball size piece  Canned fruit 1/2 cup  100% fruit juice 4 ounces  Dried fruit 2 Tablespoons

14.  Starches 1 slice bread, 1/3 cup rice, 1/2 cup pasta, 1/2 cup cereal, 1 small roll, 1/2 bun  Starchy vegetables 1/3 cup corn, ½ cup potatoes, dried beans, peas

15.  Milk 8 ounces  Yogurt 1 cup  Pudding & ice cream 1/3 - 1/2 cup

16.  BREAKFAST ◦ 1 large bagel (4 oz) ◦ 1 tsp margarine ◦ ½ cup orange juice ◦ 1 cup skim milk  DINNER ◦ Spaghetti noodles 1 cup ◦ Spaghetti sauce ½ cup ◦ Tossed salad with lettuce, tomato ◦ 2 Tbs salad dressing ◦ Garlic Bread 2 slices (2 oz) ◦ Coke