Diabetes & Nutrition

Heather Proud
Dietitian
Diabetes & Nutrition
Diabetes Mellitus (Diabetes) is the name given to a group of
conditions that occurs when the level of glucose (a type of sugar) in
the blood becomes higher than normal.

Insulin is a hormone that moves glucose from your blood stream,
into the cells of your body where it is used for energy.

When you have diabetes, the body either cant make enough insulin
or the insulin that is being made does not work properly. This
causes your blood glucose level to become too high.

High blood glucose levels can affect both your short and long term
health.

There are two main types of diabetes type 1 and type 2. At this
stage there is no known cure for either type of diabetes, although
diabetes can be well managed.
Diabetes & Nutrition
Type 1 diabetes

Type 1 diabetes can occur at any age, but is more often diagnosed
in children and young adults.

In type 1 diabetes, the cells in the pancreas that produce insulin are
destroyed by the bodys own immune system. Why this happens is
uncertain.

As the body is unable to make its own insulin, injections of insulin
are the only treatment at present and are needed to survive.

The onset of type 1 diabetes is usually sudden and symptoms are
obvious. Symptoms can include excessive thirst and passing large
amounts of urine, unexplained weight loss, weakness and fatigue
and blurred vision.
Diabetes & Nutrition
Type 2 diabetes

Type 2 diabetes is the most common form of diabetes affecting 85 to 90 per
cent of all people with diabetes.

Type 2 diabetes usually develops in adults over the age of 45 years, but it is
increasingly occurring at a younger age.

Type 2 diabetes tends to run in families and is often triggered by being inactive
or carrying excess weight around the abdomen. It is known as a lifestyle
disease and it is not uncommon to have high cholesterol and high blood
pressure as well.

Unlike type 1 diabetes, people with type 2 diabetes are still able to make their
own insulin. Although the following may occur:
There may not be enough insulin for the bodys needs
The cells in your body are resistant to the action of insulin. It is being produced, but
cannot work effectively. This is called insulin resistance
There is a combination of both problems.
Diabetes & Nutrition
Type 2 Diabetes (continued)

Tablets may be required and eventually, even insulin injections to help control
the blood glucose level.

Symptoms of type 2 diabetes can be similar to those for type 1 diabetes,
although they tend to occur more gradually and rapid weight loss is not usually
seen. Persistent infections, such as candida (genital rash and itching) or skin
infections can also occur.

Many people with type 2 diabetes do not experience any symptoms and feel
completely well, so it is possible to have undiagnosed diabetes for a number of
years. Sometimes, the first sign that something is wrong is when they present
to their doctor with a complication of diabetes such as a heart attack, eyesight
problems or foot problems.

The management of type 2 diabetes involves regular physical activity, healthy
eating and losing excess weight. Many people will also need to take tablets
and/or insulin injections in addition to lifestyle changes as the condition
progresses.

Diabetes & Nutrition
Discussion:

What foods increase BLOOD GLUCOSE
LEVEL?

Why?
Diabetes & Nutrition
Discussion:

What foods have little, if any, affect on
BLOOD GLUCOSE LEVEL?

Why?

Diabetes & Nutrition
Why may the BLOOD GLUCOSE LEVEL
be low?



Why may the BLOOD GLUCOSE LEVEL
be high?


Diabetes & Nutrition
What is the best thing to do if someones
BLOOD GLUCOSE LEVEL (BGL) is high
(hyperglycemia)?


What is the best thing to do if someones
BLOOD GLUCOSE LEVEL (BGL) is low
(hypoglycemia)?

Diabetes & Nutrition
Hypoglycaemia

What is hypoglycaemia (hypo)?

Hypoglycaemia (low blood glucose) is a blood
glucose level (BGL) below 4 mmol/L.
It is a side effect of insulin treatment and mild
hypoglycaemia will occur from time to time.

Severe hypoglycaemia is dangerous and must be
avoided.





Diabetes & Nutrition
What are the main causes of hypoglycaemia?

Hypoglycaemia can be caused by one or a number of events
such as:
-Delaying or missing a meal
-Too much quick acting insulin for the amount of
carbohydrate eaten
-Too much basal insulin (long acting insulin)
-Drinking alcohol
-Vomiting
-Strenuous activity




Diabetes & Nutrition
What are the symptoms of hypoglycaemia?
Symptoms of hypoglycaemia can vary between individuals.

Early warning symptoms
Weakness, trembling or shaking
Feeling dizzy light headed
Sweating
Hunger
Tachycardia (racing heart beat)
Late symptoms (when your BGL is very low)
Behaviour changes such as aggression, irritability, tearful or crying
Lack of concentration
Tingling around the lips
Blurred vision
Headache
Confusion
Poor co-ordination
Drowsiness (feeling very sleepy) which may lead to unconsciousness

Diabetes & Nutrition
What should be done if a resident has symptoms of hypoglycaemia?

Check their BGL, if able to do so. If not, treat as a hypo just to be sure

Blood glucose levels under 4 mmol/L, even if there are no symptoms need to be treated. Don't wait, treat
the hypo quickly because it can get worse and the resident may have a seizure or lose consciousness.

How is hypoglycaemia treated?

Step one
Give some quick acting easily absorbed carbohydrate. For example,
Glucose tablets equivalent to 15 grams carbohydrate (Read the label on packing to ensure you are
getting the correct dose)
Six or seven jelly beans
Half a can regular soft drink (not diet sugar free)
Three teaspoons of sugar or honey
Half a glass fruit juice

Try not to over treat the hypo, as this may cause high blood glucose levels. Treating it quickly with fast
acting glucose is better than slow acting sugars such as chocolate. This may help stop the strong hunger
that some people feel when having a hypo, which leads to eating too much.
If possible re-check the residents BGL after 10 - 15 minutes to ensure it is above 4mmol/L.
If symptoms persist or BGL remains below low, repeat Step 1.


Diabetes & Nutrition
Step two
If the next meal is more than 20 minutes away, you will
need to provide some long acting carbohydrate, such as:

One slice of bread
One glass of milk
One piece of fruit
Two or three pieces of dried apricots, figs or other
dried fruit
One tub natural low fat yoghurt
Six small dry biscuits and cheese

Diabetes & Nutrition
What should be done if the resident is unconscious, drowsy or
unable to swallow?

This is a diabetic emergency assistance and treatment is required.
Never give food or drink by mouth.
Place person on their side to make sure the airway is clear.
Give an injection of glucagon if available and you are trained to give
it.
Phone for an ambulance (Dial 000) let the operator know that it is a
diabetic emergency .
Wait with the person until help arrives.
When they regain consciousness, the person will require glucose
and long acting carbohydrate.

Diabetes & Nutrition
Glucagon
Glucagon is a hormone that raises the blood glucose level. It is injected in a
similar way to insulin and is used to reverse severe hypoglycaemia in the
person with diabetes (If the person cannot swallow, is unconscious or
fitting).
Glucagon stimulates the release of glucose from the liver and usually raises
the blood glucose level 10 minutes after injecting and lasts for
approximately half an hour.

Glucagon needs to be administered by someone other than the person with
diabetes which means family members and or friends should be trained in
how to use it.

Glucagon is only available on prescription from your doctor. Glucagon
should be available for people with insulin treated diabetes when travelling
and camping and if frequent severe hypos occur.

People with diabetes should discuss the need for glucagon with their doctor
or diabetes educator


Diabetes & Nutrition
Summary:

What is diabetes?

Type 1

Type 2

Diabetes & Nutrition

What foods increase Blood Glucose
Level? Why?

What foods have little affect on Blood
Glucose level? Why?

Diabetes & Nutrition
What is hyperglycemia?

What is a hypoglycemia (a hypo)?

How is a hypo best treated?

What is the best course of action if the
person is unconscious?
Diabetes & Nutrition
What is glucagon?

When is it used?

Q & A?

The End!