CONTENT: poultry. Red meat is limited.

Wine can be consumed in small amounts (1-2 glasses of

wine per day) with meals.
DIABETES
The Mediterranean style eating pattern has been shown to protect against heart
Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise disease, stroke, and some cancers. Research shows it may also help you improve
higher than normal. This is also called hyperglycemia. Type 2 diabetes is the most blood sugar and lose weight.
common form of diabetes.
Vegetarian or Vegan
If you have type 2 diabetes your body does not use insulin properly. This is called A vegetarian eating pattern is based on plant foods, such as vegetables, fruit, whole
insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, grains, nuts, seeds, beans and meat substitutes with little or no animal products. The
over time it isn't able to keep up and can't make enough insulin to keep your blood vegetarian diet is rich in vitamins, minerals and fiber, and lower in saturated fat
glucose at normal levels. and cholesterol. There are several types of vegetarian eating patterns, and they vary in
terms of what is included:
DIET IN DIABETES
Vegan: This eating pattern includes many plant-based foods such as vegetables,
What is a Meal Plan? fruits, whole grains, nuts, seeds and beans. People following a vegan eating pattern
avoid all meat, poultry, fish and seafood, eggs, and dairy products.
It is a guide to help you plan:
Lacto-vegetarian: This eating pattern includes vegetables, fruits, whole grains, nuts,
 Timing of your meals seeds and beans, milk, cheese and yogurt. People following lacto-vegetarian eating
 How much to eat pattern avoid all meat, poultry, eggs, fish and seafood. However, dairy products are
 What foods to choose included.
A meal plan should take into account your likes, dislikes and lifestyle. It should be a Lacto-ovo vegetarian: This eating pattern includes vegetables, fruits, whole grains,
guide that will help you meet your personal weight and blood glucose goals. nuts, seeds and beans, milk, cheese, yogurt, and eggs. People following a lacto-ovo
vegetarian eating pattern avoid all meat, poultry, fish and seafood, but include dairy
What is an Eating Pattern? products and eggs.
An eating pattern is a term used to describe the foods or groups of foods that a person
chooses to eat on a daily basis over time. The following eating patterns may help Research in the general population has linked vegetarian eating patterns to a lower
people living with or at risk for diabetes: risk of obesity, heart disease, cancer, and diabetes.

Mediterranean Low Carbohydrate

The Mediterranean style eating pattern focuses on mostly plant-based foods like A low carbohydrate eating pattern focuses on non-starchy vegetables such as
vegetables, fruit, whole grains, cereals, nuts, seeds, and beans, seasonally fresh, and broccoli, green beans, kale, salad greens and protein foods like meat, poultry, fish,
locally grown foods. Olive oil is the main source of fat. This eating pattern also shellfish, eggs, cheese, nuts and seeds, fats (oils, butter, olives and avocado). Highly
includes a small amount of dairy products, such as cheese and yogurt, fish, and processed carbohydrate foods and grains are limited or avoided in this eating
pattern. There is no standard at this time for the grams of carbohydrate in a low-carb
eating pattern and research continues to look at the effects of this eating pattern on Tips for Healthy Eating, Diabetes Prevention and Management
diabetes. Work with a registered dietitian who can talk with you about your current Tips Reasons
eating habits and help you figure out the plan that will work best for you. whole grain breads and cereals, you feel full and may lower
lentils, dried beans and peas, brown blood sugar
Low Fat rice, vegetables and fruits. and cholesterollevels.
A low-fat eating pattern includes vegetables, fruits, starches, lean protein, such as Drinking regular pop and fruit
chicken and turkey without the skin, fish, and low-fat dairy products. This eating If you are thirsty, drink water. juice will raise your blood
pattern has been shown to improve heart health when overall calorie intake is reduced sugar.
and weight loss occurs. However, according to some studies, following a low fat diet Regular physical activity will
did not always improve blood glucose or heart disease risk factors. Add physical activity to your life. improve your blood sugar
control.
DASH Alcohol can affect blood sugar
Limit alcohol consumption. levels and cause you to gain
DASH is an acronym for “Dietary Approaches to Stop Hypertension” and was weight.
designed to help lower blood pressure in people with hypertension (high blood
pressure). This eating pattern promotes eating more vegetables, fruits, whole grains,
nuts, seeds, and lower fat or fat-free dairy products, poultry and fish. This eating Plan for healthy eating
pattern also limits foods high in sodium (salt) saturated fat, red meat, sweets, added
sugars and sugar sweetened drinks. The DASH diet is also higher in fiber and is rich Using a standard dinner plate, follow the Plate Method in the image below to control
in nutrients, such as potassium, calcium, and magnesium, which may help to your portion sizes.
lower blood pressure.

Tips for Healthy Eating, Diabetes Prevention and Management

Tips Reasons
Eat three meals per day at regular
Eating at regular times helps
times and space meals no more than
your body control blood sugar
six hours apart. You may benefit from
levels.
a healthy snack.
The more sugar you eat, the
Limit sugars and sweets such as
higher your blood sugar will
regular pop, desserts, candies, jam
be. Artificial sweeteners can be
and honey.
useful.
High-fat foods may cause you to
Limit the amount of high-fat food you  Have at least three out of the four key food groups at each meal from Eating Well
gain weight. A healthy weight
eat such as fried foods, chips and with Canada’s Food Guide: Vegetables and fruit, Grain products, Milk and
helps with blood sugar control
pastries. alternatives, Meat and alternatives.
and is healthier for your heart.
Eat more high-fibre foods such as Foods high in fibre may help
 Select whole and less refined foods instead of processed foods, such as sugar-  increases your energy for daily activities
sweetened beverages, fast foods and refined grain products.  helps you sleep better
 relieves stress
 Include low-glycemic index foods such as legumes, whole grains, and fruits and
 strengthens your heart and improves your blood circulation
vegetables. These foods can help control blood sugar and cholesterol levels.
 strengthens your muscles and bones
 Eat more vegetables. These are very high in nutrients and low in calories.  keeps your joints flexible
 Choose lean animal proteins. Select more vegetable protein, such as beans, lentils,  improves your balance to prevent falls
or tofu.  reduces symptoms of depression and improves quality of life

 Make lower fat choices (e.g. skim milk, lean ground beef, and use small amounts
of oil and salad dressings). Select plant oils such as olive and canola, and nuts Passive Range of Motion
instead of animal fats.
- It is exercise in which movement is performed by an external force in the
 Have portion sizes that will help you reach or maintain a healthy body weight. available pain free range of motion. The external force may be from the
Your hands can be a very handy Portion Guide. therapist, family member, or the patient or equipment.

Importance of Passive ROM Exercises

EXERCISE IN DIABETES
Passive ROM exercises are very important if you have to stay in bed or in a
Regular activity is a key part of managing diabetes along with proper meal planning, wheelchair. ROM exercises help keep joints and muscles as healthy as possible.
taking medications as prescribed, and stress management. Without these exercises, blood flow and flexibility (moving and bending) of the joints
can decrease. Passive ROM exercises help keep joint areas flexible.
When you are active, your cells become more sensitive to insulin so it can work more
Technical Principles
efficiently. Your cells also remove glucose from the blood using a mechanism totally
separate from insulin during exercise.
Before performing passive exercises, some of the technical principles should be
remembered
So, exercising consistently can lower blood glucose and improve your A1C. When
you lower your A1C, you may be able to take fewer diabetes pills or less insulin. 1- Place the patient in proper comfortable position with proper body alignment
and stabilization to perform the exercise.
Physical activity is also important for your overall well being, and can help with 2- The therapist should be in a proper position and effective stance
many other health conditions. 3- Free the region from restrictive closes, linen, splints, and dressings
4- Drape and cover the patient as necessary.
Benefits 5- Utilize the proper hand holds or grasps by the therapist.
6- Perform the exercise slowly, smoothly with rhythm within the available pain
Regular physical activity:
free range of motion without any force behind the range.
7- Do all ROM exercises smoothly and gently. Never force, jerk, or over-stretch
 lowers blood pressure and cholesterol
a muscle. This can hurt the muscle or joint instead of helping.
 lowers your risk for heart disease and stroke
8- Stop ROM exercises if the person feels pain. The exercises should never cause
 burns calories to help you lose or maintain weight
pain or go beyond the normal movement of that joint.
 9- Repeat the exercise 5 to 10 repetitions according to the patient condition and 12. Dispose of the used lancets and test strips immediately according to the
response facility’s policies or the state mandates.
13. Record the result in the resident’s record and follow physician orders for
BLOOD GLUCOSE notification and providing care.
Blood glucose (blood sugar) is an essential measure of your health. If 14. Document all interventions in the resident’s medical record.
you're struggling to manage your blood glucose levels, we can help! With
the latest tools and strategies, you can take steps today to monitor your
condition, prevent serious complications and feel better while living with When to conduct a fingerstick test
diabetes. Always follow physician orders. Some recommendations for scheduled fingerstick
tests are:
Normal Blood Sugars  Before a meal
 1 to 2 hours after a meal
 A normal fasting (no food for eight hours) blood sugar level is between 70 and  Before bed
99 mg/dL
 A normal blood sugar level two hours after eating is less than 140 mg/dL
REFERENCES:
Procedure of Capillary Blood Glucose Test  Physical Activity is Important. (n.d.). Retrieved from http://www.diabetes.org/food-
and-fitness/fitness/physical-activity-is-important.html
1.Resident Blood Glucose Testing Procedure  What are Normal Blood Glucose Levels? (n.d.). Retrieved from
2. Explain the procedure to the resident. https://www.virginiamason.org/whatarenormalbloodglucoselevels
3.Check the expiration date on the test strips.  What are Normal Blood Glucose Levels? (n.d.). Retrieved from
4.Calibrate the monitor (if necessary) according to the manufacturer’s https://www.virginiamason.org/whatarenormalbloodglucoselevels
instructions.  Basic Meal Planning. (n.d.). Retrieved from https://www.diabetes.ca/diabetes-
5. Ensure the displayed calibration code matches the code on the calibration bar and-you/healthy-living-resources/diet-nutrition/basic-meal-planning
and the code on the test strip package insert.
6. The calibration bar is stored in the carrying case until all of the test strips in
that box have been used
7. Ensure that the monitor and test strips are at room temperature. If there is a
temperature change, the monitor and test strips should sit at room temperature
for 10 to 12 minutes.
8. Insert a test strip in the monitor according to the manufacturer’s instructions.
9. Lance the resident’s finger, obtain a sample of blood.
10. Apply the blood sample to the test strip when prompted by the monitor.
11. If your monitor allows for the addition of a second drop of blood, please refer
to the user’s manual for detailed instructions.