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Skills Carbs & Exercise

Diabetes Self-Care: What Does My Child Need to Know???

Part 6: Adjusting for Carbs and Exercise

For background information for this article, see:
Part 1: Introduction to Diabetes Self-Care Task Analysis
Part 2: Overview of Skills

Task Analysis for Some Common Diabetes Self-Care Tasks:

This breakdown is an outline of skills (related to adjusting for carbohydrate intake and exercise) to consider when handing diabetes care over to your child. It is only a suggested starting point;  we recommend you consult your child’s diabetes health care team and adapt them for your family’s own individual situation, adding, deleting and/or further breaking down the steps as needed, to create a diabetes self-care task analysis that is individualized for you and your child or teen.

Tasks and Steps:

1.  Counting Carbs:

For more information on carb counting, see:    
Level1/Nutrition/Intro to Carb Counting
Level2/Nutrition/Advanced Carb Counting

a. Measures the amount of the food to be eaten according to:

i. Volume (ex. ½ cup of mashed potatoes), OR

ii. Weight (ex. 25 grams of breakfast cereal), OR

iii. Item count (ex. 2 slices of bread).

b. Locates a carb value for a particular food:

i. By reading the nutritional info label on a package, OR

ii. By using a nutritional scale, OR

iii. By looking up carb value in written tables (ex. Healthy Eating manual, personal list), OR

iv. By using a smartphone app, OR

v. By using your insulin pump’s database (Insulin Pump users only), OR

vi. By using nutritional info on a restaurant’s company website, OR

vii. By using any other reliable method of determining carb content.

c. Determines the grams of carbs contained in the current portion size (using steps 1 & 2 above).

d. Determines carb content of whole meal (by adding values of the individual foods).

e. Determines correct insulin dose for the meal (according to his or her individual I:C ratio).

2. Exercise
 
For more information on exercise and its effect on diabetes, see:    
Level1/Exercise/Exercise Affects Blood Glucose
Level2/Exercise/Next Steps for Exercise
Level2/Exercise/During Exercise
Level2/Exercise/After Exercise

a. Recognizes that exercise typically LOWERS blood glucose.

b. Recognizes the conditions under which exercise RAISES blood glucose.

c. Checks blood glucose before, during, and after exercise.

d. Checks blood glucose for several hours after exercise including the middle of the night, looking for delayed lows.

e. Uses an effective strategy to avoid exercise-related LOW blood glucose:

i. consumes extra carbs, OR

ii. decreases insulin doses (under circumstances which typically lead to lower blood glucose).

f. Uses an effective strategy to avoid exercise-related HIGH blood glucose:

i. increases insulin doses under those special circumstances which typically lead to a rise in blood glucose.
 
g. (Pump users) Based on past personal experience, adjusts pump basal rates as applicable to adjust for the increased insulin sensitivity which may follow exercise.

h. Avoids exercise if blood glucose is high AND ketones are present.


What If These Steps Are Too Big?

If a step seems unmanageable for your child or teen, or if you have been trying to teach a given step without success, consider ways to break that skill down into smaller component steps, and then teach one of those sub-steps at a time.


For additional task analyses, see:
Part 3: Blood Glucose Monitoring and Treatment
Part 4: Insulin
Part 5: Managing Insulin Pumps



Any questions? Comments? Feel free to Contact Us.



The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.


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