UNIT THREE LESSON 9 OUTLINE

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Leslie Griffin Jordan
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1 UNIT THREE LESSON 9 OUTLINE Welcome participants to the final lesson in Unit Three. Find out how they are doing in terms of counting carbohydrates as learned in Lesson 8. Read and briefly describe objectives to participants.

Tell participants: The food choices you make can determine how well you manage your blood glucose.

heart disease, and eye and nerve damage.

healthy food choices. Large portions of food can cause a rise in blood glucose.

2 Tell participants: The food choices you make can determine how well you manage your blood glucose. By making appropriate food choices, you can keep your blood glucose in the target range set by you and your doctor. When you manage your blood glucose, you are able to avoid diabetes complications such as kidney and heart disease, and eye and nerve damage. In previous weeks we looked at the diabetes food pyramid and carbohydrate counting as a means of making healthy food choices. Large portions of food can cause a rise in blood glucose. Let participants know that even if they eat smaller amounts of carbohydrates and protein foods, they could have one or two extra servings of non-starchy vegetables such as lettuce, broccoli, cauliflower, etc. One of the first steps to eating smaller meals is cutting back on portion sizes.

How does planning meals ahead of time help a person with diabetes?

Ask participants: How do you feel about making healthy food choices?

Tell participants: If your plate is more than 9 inches, you will need to downsize.

Ask participants the size of their dinner plates.

3 How does planning meals ahead of time help a person with diabetes? Answer: It helps him or her make healthier food choices. Ask participants: How do you feel about making healthy food choices? What challenges do you experience as you try to choose healthier foods? How can you overcome these challenges? Tell participants: If your plate is more than 9 inches, you will need to downsize. Using an oversized plate would encourage you to eat larger portions of food. Ask participants the size of their dinner plates. It is good to have both a raw vegetable (such as a salad) and a cooked vegetable at each meal. Remember to vary your veggies! Some choices of vegetables include lettuce, cucumber, tomatoes, broccoli, carrots, cauliflower, peppers, etc. Remind participants that they need to buy vegetables in order to make this happen. Rusty: Change to picture of food. Add food in each section.

4 Read information on slide. Potatoes, corn, beans, butternut squash, and peas are all counted as starchy vegetables. Cheese also is counted as a protein. Use lean cuts of meats and cooking methods such as baking, grilling, steaming, or broiling. Eat about 2 to 3 ounces of meat twice a day. Read information on slide.

Serving size for desserts: ½ cup of ice cream or frozen yogurt; 2 small cookies;

Desserts and sweets contain mainly carbohydrates and they tend to raise blood

The serving for the cake in the picture should be smaller especially because it

Ask participants: How will you go about making these changes so that your plate

5 Serving size for desserts: ½ cup of ice cream or frozen yogurt; 2 small cookies; 1¼ inch-square brownie, unfrosted. Desserts and sweets contain mainly carbohydrates and they tend to raise blood glucose quickly. The serving for the cake in the picture should be smaller especially because it contains frosting and filling. Ask participants: How will you go about making these changes so that your plate looks more like the plate in the picture? What changes have you made to ensure a healthier plate? How will making these changes improve your life and the lives of those around you? Ask participants to share other ways they can make the plate method work.

If your blood glucose level is above 180 mg/dl, you may have to decrease the amount of carbohydrates you eat.

6 Test your blood glucose level 2 hours after you begin eating. The target range for blood glucose after meals is below 180 mg/dl. If your blood glucose level is above 180 mg/dl, you may have to decrease the amount of carbohydrates you eat. At this time, show the Diabetes Education Series CD and select the section on Think Your Plate, participants share their experiences about their food choices. Allow time for participants to share their feelings and experiences.

1. Ask participants how they did in accomplishing their goal from last week. For those who accomplished their goals, ask what actions were taken to be successful.

7 1. Ask participants how they did in accomplishing their goal from last week. For those who accomplished their goals, ask what actions were taken to be successful. Provide incentives for those who met their goals. For those who did not accomplish their goals, ask if they took steps to meet them. If they did, acknowledge that they are moving in the right direction. 2. Move onto setting a new goal for this week. Talk with your participants about how goal-setting can help them with diabetes management. 3. Tell participants to set a goal that they can accomplish in the upcoming week. 4. This week, the goal should be related to the Think Your Plate method. 5. The participants can record their goals on the Goal Setting Worksheet (found in the Appendix for Lesson 7). 6. Discuss SMART goals. Is your goal Specific, Measurable, Action-oriented, Realistic, and Time framed? 7. Select goals from some of the participants to share with the group. The answers to the PowerPoint questions can be found in the appendix for this lesson. Show the next slide as you read the story.

Gradually, however, she slipped back into her old eating habits and life of inactivity. Desiree thinks she is making good food choices, but she has a tendency to eat too much.

8 Desiree s family has a history of diabetes. Her mother died from kidney failure and her sister had both legs amputated. When Desiree was diagnosed with type 2 diabetes two years ago, she got serious and lost 15 pounds with diet and exercise. Gradually, however, she slipped back into her old eating habits and life of inactivity. Desiree thinks she is making good food choices, but she has a tendency to eat too much. Her dietitian suggested trying the plate method. She is willing to learn strategies that would help her control her eating habits and her weight. What is Desiree s problem? Desiree needs to: (a) manage her weight and make healthy food choices; and (b) control portion sizes. What other information would you need in order to help her? In order to help Desiree, a person needs to know: (a) the types of food she cooks and how she cooks them; (b) the cooking methods she uses; (c) the types of physical activity she enjoys; and (d) whether her husband would support her in her decisions to eat healthier and exercise (as a means of social support). What are some ways in which she can solve her problem? Desiree could solve her problem by: (a) using the plate method to make healthy food choices and manage her portion sizes; (b) continuing her physical activity; (c) not skipping breakfast; (d) eating slowly and enjoying the taste of her food; (e) having a glass of water before she begins to eat and drinking more water throughout the day; (f) eating her non-starchy vegetables and salad first; (g) identifying situations that cause her to overeat and finding ways to solve the problem; (h) not using food as a source of comfort when stressed (and taking a walk or talking to a friend instead); (i) enjoying the foods she loves and not removing all sweet or rich foods (and just having these foods in very small portions and only once in a while); (j) snacking on veggies if hungry before a meal; and (k) keeping a journal of the things she eats each day. What would work best for Desiree in this situation? Have participants choose from the suggestions listed above or make other suggestions. Give reasons for your suggestion. What would you do if you were in Desiree s situation? Allow participants to share what they would do.

The handout with completed answers can be found in the Appendix

The handout for participants to complete will be in their

The questions can be completed as group work or take-home work.

Dumplings, Recipe: Tomato Cucumber Salad, and Recipe: Cranberry

9 The handout with completed answers can be found in the Appendix for this lesson. The handout for participants to complete will be in their folders. The questions can be completed as group work or take-home work. Tell participants to locate Recipe: Low-Fat Chicken and Dumplings, Recipe: Tomato Cucumber Salad, and Recipe: Cranberry Applesauce Squares in their folders. Take some time to allow participants to share what they learned this week. Allow the group to discuss ways in which they can support each other.

UNIT ONE LESSON 3 OUTLINE

UNIT ONE LESSON 3 OUTLINE Welcome participants and ask how they are doing supporting each other. Remind them: When a person has diabetes their blood glucose level is too high. Taking part in physical activity