• Breakfast: 8:30 AM: Similar to workdays.
• Lunch: 12:30 PM: Frozen light entrée with piece of fruit.
• Mid-afternoon snack: 3:00 PM: Similar to workdays.
• Evening meal: 6:30 PM: Similar to workdays.
• Bedtime snack: 9:30 PM: Similar to workdays.
Weekends:
• Wakes: 8 AM; Meds: 8:30 AM
• Breakfast: 8:30 AM: Similar to workdays.
• Lunch: 12:30 PM: Frozen light entrée with piece of fruit.
• Mid-afternoon snack: 3:00 PM: Similar to workdays.
• Evening meal: 6:30 PM: Similar to workdays. Eats one or two evening meals out at Chinese, Italian, or Japanese restaurants. Might have glass of wine at meal and split a dessert.
• Bedtime snack: 9:30 PM: Similar to workdays.
Physical Activity: Moves around at work. Mary takes one 15 minute walk either before or after lunch. Weekends does gardening and housework.
SMBG: Checks one to two times per day—fasting and before evening meal. Average fasting: 160—220 mg/dl. Average pre-evening meal: 150—175 mg/dl.
Meal Planning: The only diabetes education Mary has had is one session with a dietitian at the hospital about one year after she was diagnosed. She was provided with a 1500-calorie meal plan and a booklet with diabetes exchanges. Mary notes she made a number of changes in her food choices and the portions she eats, but she is not able to follow the eating plan as she knows she should. She was frustrated by that meal plan because she didn’t feel it provided information on the wide variety of foods she likes to eat. She is interested now in knowing how to fit a wider variety of foods into her eating plan, including convenience foods, restaurant foods, and sweets.
Action Plan:
1. Mary will attend the diabetes education center’s class, Managing Type 2 Diabetes, to help her learn more about the elements of diabetes care and how to set goals to make behavior and lifestyle changes. This class also introduces Mary to the basic skills of carbohydrate counting, with the key message that eating a similar amount of carbohydrate at meals and snacks each day will help control blood glucose.
2. Mary will be provided with guidelines about how much carbohydrate to eat at her meals. She will be encouraged to limit her snacks to once a day. In class, Mary will write two sets of sample meals using the carbohydrate servings and grams she needs (see Table 3-2 on page 25).
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