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2. Basedonher24hrrecall,howmanytotalcarbohydratechoicesisDebbiecurrently
consumingperday?Permeal/snack?Todothis,filloutthetablebelow.DoNOTlistthe
gramsofCHO.YouaretoONLYlisttheCHOchoicesusingthecarbohydratecounting
method(CHOchoices=gramsofCHO/15).
BREAKFAST
Largebagel
TReducedfatcreamchs
TJam
Smbanana
16ozcoffee
2TFlavoredcreamer
SNACK
1c.Carrots
1/3c.Hummus
LUNCH
2sl.WholegrainBread
2sl.Tomato
6ozfruitedYogurt
Smapple
DINNER
1c.Tomatoes
1c.greens
1c.Redpepper
1oz.Cheddarcheese
26tortillas
12oz.Gingerale
3gingersnaps
HS
c.Icecream
2T.Chocolatesyrup
TOTALCHOCHOICES
Meal/Snack
Breakfast
Snack
Lunch
Dinner
HS
TOTAL
#CHOchoices
4
0
1.5
1
0
2
0
1
2
0
1
1
1
1
2
2.5
1
1
2
#ofchoices
7.5
1
4
7.5
3
23
3. A.UsingthedailyCHOdistributionthatwasprovidedintheexchangehomework,how
manyCHOchoicesshouldDebbieconsumeateachmeal/snack?Youshouldalready
havefiguredouthowmanygramsofCHOshewouldbeconsumingateachmeal/snack
bycompletingstep8intheExchangeHW.Allyouhavetodohereisconvertthegof
CHOpermeal/snackintoCHOchoicespermeal/snack.
Frompart8ofexchangehw:
Meal
Breakf
ast
Snack
Lunch
Dinner
HS
Snack
% CHO
kcal
CHO
kcal
CHO
g
20%
15%
30%
25%
198
148
296
247
50
37
74
62
10%
99
25
Breakfast:50g/15=3.33CHOchoices(roundto3.5)
Snack:37g/15=2.5CHOchoices
Lunch:74g/15=5CHOchoices
Dinner:62g/15=4CHOchoices
HS:25g/15=1.67CHOchoices(roundto1.5)
B.ModifyDebbiescurrent24hourintakesothatsheisabletomeettheappropriate
amountofcarbohydratechoicesforeachmeal.Todothisyouneedtowriteoutanew
samplemenubaseduponthefoodsDebbiereportedeatinginher24hrecall.Setupa
tableliketheoneinquestion2toshowhowyoumodifiedherchoicestoproduceamore
appropriatemenuforher.
BREAKFAST
plainbagel
2Treducedfatcreamchz
5
/8c.freshstrawberries
12ozcoffee,vanilla
flavoredbeans
Sm.banana
SNACK
1ccarrots
1/3chummus
3/8cblueberries
3gingersnaps
LUNCH
2sl.Wholegrainbread
2sl.Tomato
1romaineleaf
6ozfruitedyogurt
Smallapple
cupapplejuice
DINNER
Sugarfree(diet)gingerale
1ctomatoes
1cgreens
1credpeppers
1ozcheese
26tortillas
HS
c.Chocolateicecream
TOTAL
#CHOchoices
2
0
Mealtotal
3.5
1
2.5
0
1
1
5
2
0
0
1
1
1
4
0
1
1
2
1.5
1.5
16.5
Debbieadmitstoyouthatsheisgettingabetterunderstandingofexchanges,butsheoftenfinds
ithardtoadheretothediet.YousuggestthatDebbiestarttakingafriendorfamilymemberwith
hertoattenddiabetesclassesatthelocalhospitaltohelpherwithcarbohydratecounting.
DebbieasksherfriendTimshemetatwateraerobicstogowithherasheisaTypeIDiabetic.
Heisingoodcontrolandactivelyparticipatesinthewateraerobicsprogram3timesperweek
andtakeswalksaroundtheneighborhoodwithhisdogeachmorning.Forbreakfast,Tim
typicallyeats45gmCHOandtakes5Uofrapidactinginsulin;forlunchheusuallyeats75gof
CHOandtakes5Uofrapidactinginsulin;fordinnerheusuallyeats68gmofCHOandtakes4
Uofrapidactinginsulin.
4. WhatisTimsinsulin:CHOratioforeachmeal(fillinthetablebelow)?
B:45/5=9gCHO/U,ratio:1:9
L:75/5=15gCHO/U,ratio1:15
D:68/4=17gCHO/U,ratio1:17
UsualCHO
45
75
68
B
L
D
UsualInsulin
5
5
4
Insulin:CHOratio
1:9
1:15
1:17
5. TimandDebbiemakeplanstogooutforlunchafterwateraerobicsonSaturday.Tim
anticipatedeatinghisnormalsizelunchandpossiblyadesserttoosohecompensatedby
eatingfewercarbohydratesduringbreakfastanddinner.Usetheinsulin:CHOratiosyou
calculatedinquestion4todeterminehowmuchinsulinTimwouldneedtotakeforthemeals
below.Roundyouranswerstothenearest0.1U.
B:35/9=3.88=3.9Uinsulin
L:90/15=6Uinsulin
D:60/17=3.53=3.5Uinsulin
B
L
D
PlannedCHOintake
35
90
60
Insulinneeded
3.9U
6.0U
3.5U
6. InadditiontotherapidactinginsulinthatTimtakes(seeintroductiontoquestion#4,above),
healsotakes7Uofthelongactinginsulinglargineeachnight.CalculatehisISF.Thatis,
oneunitofinsulinwilllowerherbloodglucosebyabouthowmuch?(Roundyouranswer
tothenearestwholenumber).
TDD=5+5+4+7=21Uinsulin
1800/TDD=ISF
1800/21=85.7=86mg/dL
7. Timcheckedhisbloodglucose4hoursafterhislunchwithDebbie.Itwas245.Histargetis
115.Usingyourfinalanswerfrom#6above,calculatehowmanyunitsofrapidacting
insulinTimshouldtaketobringhisglucoseintothetargetrange.(Roundyouranswerto
0.1U)
245115=130over
130/86=1.5
Needcorrectivedoseof1.5Uinsulin
8. IfTimweretakingshortactinginsulin,whatwouldhisISFbe?Showyourcalculations.
(Roundyouranswertothenearestwholenumber)
1500/TDD=ISF
1500/21=71.4=71mg/dL