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Carbohydrate Counting (PowerPoint download)

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									Carbohydrate Counting
    GP Study Day
       Anna Carling
      Senior Dietitian
      September 2010
On each table there are 5 pictures of
meals, please put into order of amount of
carbohydrate starting with the least on top
Why Do We Need to Count CHO?

• Basal Bolus insulin regimes
Why Do We Need to Count CHO?

• Basal Bolus insulin regimes
• Pre-mix BD insulin regimes
                    BD Insulin Profile

Breakfast   Lunch        Tea      Bed            Breakfast




 Novomix                Novomix          Insulin Injection
   30                     30
Why Do We Need to Count CHO?

• Basal Bolus insulin regimes
• Pre-mix BD insulin regimes
• In Type 2 diabetes having regular amounts
  of CHO
               Why
        Carbohydrate Count?
• More choice
• More flexibility in types of foods as well as
  meal times
• Help to maintain your blood glucose levels
  closer to normal levels
Types of CHO

• Starchy
• Sugars
       How to count CHO
• Handy portions
       How to count CHO
• Handy portions
• Pictures
       How to count CHO
• Handy portions
• Pictures
• Labels
PROTEIN                                                        ENERGY
- the total amount of protein                                  - the total amount of energy the food gives you when you eat it
  in the food                                                  - measured in calories (kcals) or Kilojoules (Kj)
- important for body growth and
repair
- we usually eat enough to                                      Per 100g        Per
  meet our needs                                                                serving
                                         Energy                 325kcals/       163kcals        CARBOHYDRATE
                                                                137.9Kj         /690Kj          - the total amount of both sugar
                                                                                                  and starch in the food
                                         Protein                10              6.5             - the amount of sugar is usually
 SODIUM                                                                                         labeled- what’s left is starch!
 - most sodium in our                    Carbohydrate           61.6            30.8
   food is from salt                     (of which sugars)      4.0             2.0
 - the lower the sodium
 content the better                      Fat                    3.0             1.5
 0.5g per 100g is a lot                  of which               0.9             1.8                  SUGAR
 0.1g per 100g is a little               saturates              10.5            2.1                  - the total amount of sugar
                                         monounsturates         18              3.6                    both naturally occurring and
                                         polyunsaturates                                               added
                                         Fibre                  8.4             4.2                 - Foods containing 10g of
                                                                                                        sugar or more per serving
                                                                                                      are high in sugar
                                         Sodium                 0.8             0.45


FAT
- the total amount of fat, including                         FIBRE
polyunsaturated, monounsaturated, and saturated               - the total amount of fibre in the food (usually insoluble fibre)-
- it is better to choose foods with unsaturated fats       Foods with more than 3g of fibre per 100g are high fibre foods
rather than saturated.
Foods containing less than 3g fat per
100g/100mls are low fat
         How to count CHO
•   Handy portions
•   Pictures
•   Labels
•   Weighing
          Snacks
• Up to 20g CHO with no insulin
• Over this need to give insulin
  for all the CHO
      Glycaemia Index (GI)
• Type 1 diabetes – total CHO is important
• Type 2 diabetes – low GI is helpful
• High GI needed for hypos and exercise
     How accurate does one
          have to be?
• Insulin pumps – very accurate because
 you can
• Basal bolus – in 5-10g CHO
• Pre-mix BD – in 10g CHO
• Type 2 diabetes - rough idea about
 amount of CHO
    Carbohydrate Counting
                =
Starting to think for your pancreas
    CHO Counting Sessions
• Monthly 2 hour sessions around the area
• Mainly in the evenings
• Suitable for all type 1 diabetes and type 2
  diabetes on basal bolus
• All welcome

								
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