Editing Nutrition (section)

=== Diabetic Diet ===

* The modern standard is '''consistent carbohydrate''' intake distributed across meals rather than a rigid "no sugar" diet. Total carbohydrate matters more than the type.
* Carbohydrate counting typically uses 15 g of carbohydrate per exchange.
* Emphasize whole grains, legumes, non-starchy vegetables, and lean protein. Limit sugar-sweetened beverages, which raise glucose fastest.
* Alcohol taken without food can cause '''delayed hypoglycemia''' because it suppresses hepatic gluconeogenesis. Patients on insulin or sulfonylureas should eat carbohydrate with alcohol.
* Treat hypoglycemia in a conscious patient with the '''rule of 15''': 15 g of fast-acting carbohydrate (4 ounces of juice or regular soda, glucose tablets, or 1 tablespoon of honey), recheck in 15 minutes, and repeat if still below 70 mg/dL. Follow with a protein and carbohydrate snack if the next meal is more than an hour away.

'''Nursing application:''' Sick-day rules matter. Patients must continue insulin during illness even if eating poorly, monitor glucose more often, check ketones, and take carbohydrate-containing liquids.