DIET PLAN OF DIABETES MALITUS

Nutrition in Care Homes for People with Diabetes

Objectives

 Identify the CQC regulation for nutrition & hydration

 Discuss the dietary management of diabetes

 Introduction to dietary advice for overweight & malnourished patients

 Outline the importance of screening for malnutrition with examples

Regulation: Meeting nutritional & hydration needs

 People must have enough to eat & drink to meet their needs

 People must have nutritional needs assessed & food provided to meet their individual
needs

 Must receive support with nutrition & hydration if needed

 Provide a variety of nutritious & appetising food

 Appropriate temperature

 Culturally appropriate

 Preference & choice

 Prompts, encouragement, eating aids

 Follow prescribing plan for supplements

 Regular assessment of needs

 Staff should know when specialist nutritional advice is needed & how to refer

Dietary Advice for Diabetes

Points to consider…

 Priority of the person’s diabetes management

 Individualised assessment & treatment

 No ‘one size fits all’ approach

 Diagnosis, prognosis & quality of life

 Social aspects of eating

  Pleasure from eating

 Respect individuals’ choices

Which Nutrient Affects Blood Glucose?

All affect
Which Nutrient Affects Blood Glucose?


blood
Food is chewed to start breaking it down
Food is broken down further in the stomach
 Carbohydrate is broken down into glucose
glucose!


Shortly after eating carbohydrate blood glucose starts to rise
Body cells use the glucose for fuel or store it for later

Why is Diet Important?

Major influence on diabetes management & health

 Blood glucose control

 Long & short term complications

 Body fat and insulin resistance

 Risk of other diet related diseases

 Vitamins, Minerals, Protein & Fats are essential for good health
People with diabetes shouldn't have:

 Bananas, grapes, melon & mango

 Sweet foods and puddings

 Lots of sugary drinks

People with diabetes should:

 Use diabetic products

 Always snack between meals

 Follow a ‘special’ or ‘diabetic’ diet

Healthy Eating

Healthy Eating in Care Homes

 Regular & Balanced Meals

 Portion control

 Healthy menu planning & cooking

 Appetising meals & variety

 Healthier snack & pudding options

 Limit processed or ‘junk’ foods

 Avoid sugary drinks & added sugars

 Occasional ‘treat’ foods are fine

Healthy Eating
How much is important

 Regular meals spreads carbs out

 Avoid added sugars & sugary food/drinks

 Fruit & fruit juices

 Don’t double up on starches

 Smaller portions of puddings

The type is also important

 Porridge, basmati rice, new potatoes, seeded bread, whole grain starches & cereals

Weight Management

Simple Tips for weight management in care settings

 Regular Meals

 Portion Control – even healthy food can affect weight!

 Healthy, tasty menu choices and healthy snack options

 Healthier puddings & desserts or small portions

 Avoid added sugars (drinks & foods)

 Non restrictive approach with occasional ‘treat’ foods

Simple swaps and small changes

 Swap Chocolate pudding for chocolate Muller light

 Swap Shortcake biscuits for rich tea

 Change drinks to diet, sugar free, no added sugar

  Swap sugar for sweeteners

Weight Management
What would you change?

Breakfast: Large bowl of cereal with milk, 2 Toast with butter, 1 glass of fruit juice

Mid morning: 3 plain digestives with cup of tea

Lunch: Tuna mayo sandwich, 2 slices granary bread with 5 teaspoons mayonnaise and
packet of crisps

Evening Meal: Beef casserole with large portion of mashed potato (made with butter) and
full portion sponge pudding with custard

Supper: 3 plain digestives with cup of tea

Balance the Plate

Malnutrition
 The priority is getting the patient to eat

 At this stage healthy eating is not a priority

 Aim to provide nutritious foods which are high in calories & protein

 Control Blood glucose with medications during this period

Consequences of malnutrition

• Poor wound healing and higher risk of infections

 • Frequent hospital admissions

• Muscle wasting, Lack of energy/Depression

• Dehydration

• Vitamin and mineral deficiencies

Recognising Malnutrition

• Mobility: weakness, impaired movement

• Mood: apathy, lethargy, poor concentration

• Current intake: reduced appetite, changes in meal pattern and food choice

• Physical appearance: loose clothing, rings or dentures, sunken eyes, dry

mouth, emaciation, pale complexion, hair loss

Benefits of using MUST

• Easy to use, rapid and reproducible

• Any care worker can be trained to use ‘MUST’

• Can be used with patients who can’t be weighed and measured

• Available on line from www.bapen.org, as well as paper format in a variety of

sizes

‘MUST’
Bibliography:-

1. Susan rowen james etal, “Nursing care of children principles and

practice” saunders publication-2009, 3rd edition, page no.-898-911.
2. A parthasarathy PSN menon et al, “IAP Textbook of paediatrics” JP
publication-2009, 4th edition, page no.-962-969.
3. Op ghai vinod et al, “Essential pediatrics” CBS publication-2009, 7 th
edition, page no.-509-515.
4. Parul datta, “Pediatric nursing” JP publication-2009,2 nd edition,
page no.-428-430.
5. Marlow R, Dorothy& Redding A. Barbara, “Text book of pediatric
nursing”, 6th edt.2007, Saunders company, Philadelphia,
Pennsylvania, Page no. 194, 580,906,1021,1132.
6. Gupte Suraj, “The short text book of pediatrics” , 11 th edt.2009,
Jaypee brothers medical publishers(p) ltd. New-Delhi, page no.-
103-05