Patient Education Information Handout

North Florida/South Georgia Veterans Health System (NF/SGVHS)

Nutrition and Food Service

**Healthy Eating With Diabetes**

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height="2.2222222222222223in"}

Healthy eating is important for everyone, especially if you have
diabetes. Good meal planning can help you to successfully manage your
blood sugars. With diabetes, you don't have to be on a diet, but you do
need to make healthy lifestyle choices and follow some basic guidelines:

-   Eat regularly

-   Eat 3 meals and 2-3 small snacks each day

-   Be consistent -- try to eat meals and snacks at the same time each
    day

-   Do not skip meals

-   Limit the use of sugar, salt, and processed/fried foods

-   Eat fruits, vegetables, whole grains, low-fat dairy products, and
    lean

> meat/protein every day

-   Match how much you eat with your activity level

You will also need to learn how to:

-   Use the different food groups as a meal planning guide

-   Count grams or exchanges of carbohydrates by reading the nutrition

> label and paying attention to the serving size

-   Stay within your meal plan while dining out

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height="1.788888888888889in"}

**Carbohydrate Counting**

-   Why should I count carbohydrates (carbs)?

    -   Carbohydrates are the main nutrient that affects blood sugars.
        Don't avoid them. The key is keeping the amount consistent by
        watching your portion size. The concern with diabetes is that
        too many carbs in one sitting can lead to high blood sugars and
        cause complications down the road. Changes in carb intake can
        lead to high and low blood sugars and is discouraged.

-   What foods contain carbs?

    -   Sweets (sugar, honey, syrup, sugary beverages, candy, desserts)

    -   Fruit

    -   Milk (milk, yogurt)

    -   Grains (bread, rice, pasta, cereal)

    -   Legumes (beans, lentils, peas)

    -   Starchy veggies (potatoes, corn, winter squash)

-   What foods do not contain carbs?

    -   Meat, fish, eggs, most cheeses

    -   Non-starchy veggies (very few carbohydrates per serving)

-   How many grams of carb should I eat at each meal?

    -   Breakfast: \_\_\_\_\_\_

    -   Lunch: \_\_\_\_\_\_

    -   Dinner: \_\_\_\_\_\_

-   How many grams of carb should I eat at each snack?

    -   Morning snack: \_\_\_\_\_\_

    -   Afternoon snack: \_\_\_\_\_\_

    -   Bedtime snack: \_\_\_\_\_\_

-   How do I know how much carbohydrate a food contains?

    -   Read the food label. If the food you are eating does not have a
        food label, refer to the list in this packet.

**How to Read a Nutrition Label**

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height="1.4770833333333333in"}

**More on Reading Food Labels**

-   Fat:

    -   A high fat diet is not recommended for people with diabetes

    -   Too much fat may keep your blood sugars up for a long time

    -   Choose lean meats and low-fat dairy products

    -   Do not deep fry food

    -   Bake, broil, grill, roast, or boil foods

    -   Limit saturated fat to 0-15 grams (g) each day

    -   Limit trans fat to 0 grams (g) each day

-   Fiber:

    -   Aim for 35 grams of fiber each day

    -   Increase your intake of fruits, vegetables, beans, oatmeal, and
        whole grain products like whole wheat bread, brown rice, and
        whole wheat pasta

    -   Just because a product is "whole-grain" doesn't mean that it is
        "whole-wheat." Look on the label for the fiber content!

    -   Choose the following:

        -   Bread -- more than 3 g fiber per slice

        -   Cereal -- more than 5 g fiber per serving

-   Sodium:

    -   People with diabetes need to keep their blood pressure in good
        control. Aim for under 130/80

    -   Sodium acts like a sponge and holds on to water. You heart will
        have to work extra hard to pump all of the fluid through your
        body. Limit dietary sodium to decrease the workload on the heart

    -   Salt is made of sodium and chloride. Avoid added salt

    -   Be aware of the sodium that is naturally in the food you eat

    -   Consume less that 2,000 milligrams (mg) of sodium each day if
        you have high blood pressure (less than 2,400 mg if you don't)

    -   1 teaspoon of salt contains 2,300 mg sodium

    -   Sea salt and kosher salt have sodium too!

    -   Limit your intake of processed and canned foods

    -   Look at the nutrition label for the amount of sodium in a food

**Blood Sugar Friendly Veggies**

Vegetables that contain small amounts of carbohydrates are on this list.
Generally, a ½ cup of cooked or 1 cup of raw veggies will give you 5
grams of carbohydrate and 25 calories. If you eat 1 ½ cup cooked or 3
cups of raw veggies, you will need to count them towards the total
amount of carbohydrate and calories eaten at that meal or snack.

+---------------------------------+------------------------------------+
| Artichoke                       | Artichoke hearts                   |
|                                 |                                    |
| Asparagus                       | Beans (green, wax, Italian)        |
|                                 |                                    |
| Bean sprouts                    | Beets                              |
|                                 |                                    |
| Broccoli                        | Brussel sprouts                    |
|                                 |                                    |
| Cabbage                         | Carrots                            |
|                                 |                                    |
| Cauliflower                     | Celery                             |
|                                 |                                    |
| Cucumber                        | Eggplant                           |
|                                 |                                    |
| Green onions or scallions       | Greens (collard, kale, mustard,    |
|                                 | turnips)                           |
| Kohlrabi                        |                                    |
|                                 | Leeks                              |
| Mushrooms                       |                                    |
|                                 | Mixed vegetables (without corn,    |
| Onions                          | peas, or pasta)                    |
|                                 |                                    |
| Radishes                        | Okra                               |
|                                 |                                    |
| Sauerkraut                      | Pea pods                           |
|                                 |                                    |
| Salad greens (endive, escarole, | Peppers (all varieties)            |
| lettuce, spinach, romaine)      |                                    |
|                                 | Spinach                            |
| Summer squash                   |                                    |
|                                 | Tomato (juice)                     |
| Tomatoes (fresh or canned)      |                                    |
|                                 | Tomato sauce                       |
| Turnips                         |                                    |
|                                 | Water chestnuts                    |
| Watercress                      |                                    |
|                                 | ![                                 |
|                                 | ](media/image4.wmf){width="1.55in" |
|                                 | heig                               |
|                                 | ht="1.1208333333333333in"}Zucchini |
+---------------------------------+------------------------------------+

**Sources of Cholesterol and Fat**

Fats are broken down into OTHER FATS and cholesterol.

OTHER FATS:

-   Saturated 

-   Unsaturated 

    -   Polyunsaturated

    -   Monounsaturated

CHOLESTEROL:

-   Cholesterol comes only from animal products.

-   It is also made in your liver

+-----------------------+-----------------------+-----------------------+
| Cholesterol           | Saturated Fat         | Unsaturated Fat       |
|                       |                       |                       |
| (limit these)         | (limit these)         |                       |
+-----------------------+-----------------------+-----------------------+
| Meat                  | Meat                  | [POLYUNSA             |
|                       |                       | TURATED:]{.underline} |
| Cheese                | Cheese                |                       |
|                       |                       | Safflower oil         |
| Egg yolks             | Egg yolks             |                       |
|                       |                       | Sunflower oil         |
| Whole milk            | Whole milk            |                       |
|                       |                       | Corn oil              |
| 2% milk               | 2% milk               |                       |
|                       |                       | Soybean oil           |
| Ice cream             | Ice cream             |                       |
|                       |                       | Sesame oil            |
| Butter                | Butter                |                       |
|                       |                       | Walnuts               |
| ![](media/image5      | Cream cheese          |                       |
| .wmf){width="2.625in" |                       | Sesame seeds          |
| height="2.1333        | Sour cream            |                       |
| 333333333333in"}Organ |                       | [MONOUNSA             |
| meats                 | Palm oil              | TURATED:]{.underline} |
|                       |                       |                       |
|                       | Coconut oil           | [(choose most         |
|                       |                       | often)]{.underline}   |
|                       | Cocoa butter          |                       |
|                       |                       | Olive oil             |
|                       | Hydrogenated          |                       |
|                       | vegetable oil         | Canola oil            |
|                       |                       |                       |
|                       | Poultry with skin     | Peanut oil            |
|                       |                       |                       |
|                       |                       | Olives                |
|                       |                       |                       |
|                       |                       | Avocados              |
|                       |                       |                       |
|                       |                       | Almonds               |
|                       |                       |                       |
|                       |                       | Peanuts               |
|                       |                       |                       |
|                       |                       | ![](media/image6.w    |
|                       |                       | mf){width="0.65625in" |
|                       |                       | heigh                 |
|                       |                       | t="1.03125in"}Cashews |
|                       |                       |                       |
|                       |                       | Pecans                |
+-----------------------+-----------------------+-----------------------+

> **What Can I Drink?**
>
> Your body needs fluids, especially in warm weather. The trick is to
> quench your thirst without adding extra calories or carbohydrates.

-   Use sugar substitute to sweeten coffee, tea, and fruit drinks

-   To keep water cool for hours, freeze it the night before

-   Freeze lemon or lime juice in ice cube trays and add to tea or water

-   When you drink a caffeinated fluid, drink an equal amount of water

-   Take water with you wherever you go

+-----------------------------------+-----------------------------------+
| **DO raise blood sugar**          | **Do NOT raise blood sugar**      |
+-----------------------------------+-----------------------------------+
| Regular soda                      | Water                             |
|                                   |                                   |
| Fruit drinks made with sugar      | Diet soda                         |
|                                   |                                   |
| Powdered drink mixes              | Club soda                         |
|                                   |                                   |
| Sports drinks                     | Tonic water, sugar-free           |
|                                   |                                   |
| Fruit juice                       | Coffee and tea, plain             |
|                                   |                                   |
| Tea made with sugar or honey      | Sugar-free powdered drinks        |
|                                   |                                   |
| Lemonade                          | Flavored water, sugar/carb-free   |
|                                   |                                   |
| Coffee or tea with sugar          | ![](me                            |
|                                   | dia/image7.wmf){width="1.59375in" |
| Alcohol (even lite beer)          | height="2.0in"}                   |
|                                   |                                   |
| Milk                              |                                   |
+-----------------------------------+-----------------------------------+

**Proper Treatment of Hypoglycemia**

Low blood sugar, called **[hypoglycemia]{.underline}**, occurs when your
blood sugar drops below 70 mg/dL. This can be dangerous and needs to be
treated **properly**.

**Signs & Symptoms**

-   Shakiness, sweating, fast heart beat, dizziness, hunger, blurred
    vision, difficulty thinking, anxiousness, headache, tired feeling

-   Difficulty moving, confusion, unusual behavior

-   Seizure, coma, combative behavior

**Causes**

-   Taking too much insulin or medication

-   Missing a meal or snack or eating less than usual

-   More activity or exercise than normal

-   Drinking alcohol on an empty stomach

**Proper Treatment \-\-- The 15/15 Rule**

Keep a source of 15 grams of carbohydrate within reach at all times.

-   1 tube glucose gel (buy at local drugstore)

-   3-4 glucose tablets (buy at local drugstore)

-   6 pieces chewable candy

-   8 ounces (1 cup) fat-free milk

-   4 ounces (1/2 cup) juice (not tomato or vegetable)

-   6 ounces (1/2 of can) regular soda

-   1 tablespoon sugar, jelly, or honey

![](media/image8.wmf){width="0.9013888888888889in"
height="1.0055555555555555in"}Treat with one of the above choices. Wait
15 minutes and test your glucose again. If it is still low, treat again
with 15 grams of carbohydrate. Once your blood sugar is above 70, eat a
meal or snack within 1 hour. If your glucose was below 50 before
treating, double the serving, taking 30 grams of carbohydrate instead of
only 15. Do **[NOT]{.underline}** treat with a candy bar, sandwich, or
cheese/peanut butter/crackers. These have protein and fat which will
SLOW the digestion of the carbohydrate.

**Carbohydrate Content of Common Foods**

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height="1.7708333333333333in"}

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height="1.3868055555555556in"}

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height="1.2555555555555555in"}

![Logo - The North Florida/South Georgia Patient Education Commitee
APPROVED logo with the most recent month and year of
approval.](media/image12.jpeg){width="1.8929133858267717in"
height="0.5417322834645669in"}

Visit your NF/SGVHS Internet site at:

http://www.northflorida.va.gov