Type 1 Diabetes

• What is happening in my body?

• Treatment
• Carbohydrate Counting

Albury Wodonga Health 2014

Food to Sugar (glucose)
• Carbohydrates in food is broken
down to a sugar. This sugar is
called glucose.

• Glucose travels to the blood

where it moves around the body.

• . Glucose

Blood
 Pancreas

This is normal…

Glucose from the The pancreas responds

digestive system to glucose in the blood
goes into by making insulin. A key
bloodstream. to open the cells.
Glucose
Glucose So Glucose can be used
Sugar
as energy.
Energy for….
Cell
 Too Much glucose.. Pancreas

Hyperglycaemia
In type 1 diabetes your
Blood
Pancreas doesn’t give
Glucose will blood the keys to open
keep coming Cell the cells.
even when
Glucose
there are no
keys to unlock
the cell. Glucose cannot get into
the cells to be used as
energy. They get stuck in
your bloodstream and
other parts of the body.

This is called
hyperglycaemia or
Hyperglycaemia hyper’s.
= More than 8mmol
 Short Term problems
The sugar in your blood
attracts water from your cells.

The body then tries to get rid

of all the glucose in your
Water blood by peeing it out.

Glucose You start to feel thirsty so

your drink more. Then you
need to pee more.
 Long term problems
This increases your risk of:

Vision Problems Kidney Disease Foot Ulcers

Heart Disease
Stroke Numb Fingers
 Too much Insulin…
Hypoglycaemia

Blood
• Large amounts
of insulin takes
too much
glucose out of
the blood.

Insulin • Now there is not

enough glucose for
all the cells.
Cells
• This called
Hypoglycaemia
Hypoglycaemia or
= Less than 4mmol
Hypo’s.
 Cell

Low blood • When the cells in

the brain don’t get
enough glucose you
glucose can….

Angry Dizzy Shaky Hungry

Confused Upset No symptoms Unconscious or die

 Treatment
Step 1:
If you are having these symptoms you should:
• Check your blood sugar levels
• If your level is 4 or less:

Step 2:
Eat some food that contains quick acting sugar. These include:

3 Tablespoons of 6-7 jelly

½ a can Small glass of juice
sugar or honey beans
OR OR
OR
Wait 10 minutes. If there is no change, have more quick acting sugar.
 Treatment

Step 3:
If your next meal is more than 20 minutes away eat foods that contain slow acting sugar.
Foods like:

A sandwich Glass of 1 tub of yoghurt A piece of fruit

milk
 How can I avoid having hyper’s
and hypo’s?
Before you eat:
• Step 1: Count your carbs in your food
• Step 2: Match your Insulin
• Step 3: Inject insulin
After you eat:
• Step 4: Check your blood glucose level after 2
hours.
NOTE: If your blood glucose levels are too high or too
low you may need your insulin dose reviewed.
 Exercise
Tips to avoid hypo’s when exercising:

• Eat at least 1 carbohydrate exchange before

exercise.

• Eat 1 exchange for every hour of exercise

on land.

• Check BGL every hour.

Swimming:
• Eat 1 exchange of quick acting sugar every
half hour when swimming.

• Check BGL’s every half hour

• Exercise increases your body’s intake of

glucose.

Talk to your diabetes care team about insulin

and exercise.
 Carbohydrate counting.
Grams Of Carbs Number of carb exchanges

0-5g Do Not count

To count carbs we convert carbs to 6-10g ½ a carb exchange
exchanges. 1 exchange = 15g of carbs
11-20g 1 carb exchange
Here is a key to help you. 21-25g 1 ½ carb exchanges

15g of carbs = 1 exchange 26-35g 2 carb exchanges

1 exchange= __ units of insulin 36-40g 2 ½ carb exchanges
41-50g 3 carb exchanges
Here is a table to help you. 51-55g 3 ½ carb exchanges
56-65g 4 carb exchanges
66-70g 4 ½ carb exchanges
71-80g 5 carb exchanges
81-85g 5 ½ carb exchanges
86-95g 6 carb exchanges
 Label’s Grams Of Carbs Number of carb exchanges

• Weet-Bix 0-5g Do Not count

6-10g ½ a carb exchange

11-20g 1 carb exchange

21-25g 1 ½ carb exchanges

26-35g 2 carb exchanges

36-40g 2 ½ carb exchanges

41-50g 3 carb exchanges

51-55g 3 ½ carb exchanges

56-65g 4 carb exchanges

66-70g 4 ½ carb exchanges

71-80g 5 carb exchanges

2 Weet-Bix = 1 Carbohydrate
81-85g 5 ½ carb exchanges
Exchange
86-95g 6 carb exchanges
 How many Carbs are in that?
• Green = Free foods, don’t count.
Contain no or low amounts of carbs
• Orange = Must Count
These foods contain carbs and need to be
counted.

• Red = Stop, Think and Count..

• Blue = Stop, think, but don’t count.
• Red and Blue foods should only be eaten on
special occasions
These foods contain no carbohydrate or contain less than 5g per serve.
Dairy
Meat and Tofu
Fruit
Want to add flavour without counting?
Make it sweet without the counting

Ground
Cinnamon
Spreads and Toppings
Condiments
Breads and cereals

Turkish bread 1
Bread 1 slice Small roll Medium roll 1 English muffin
medium slice
Carb = 19g Carb = 16g Carb = 27g Carb = 23g Carb = 61g
1 exchange 1 exchange 2 exchanges 1 ½ exchanges 4 exchanges

Gluten free raisin 1 large pita bread

Gluten free bread Raisin toast bread
Carb = 15g Carb = 13g Carb = 30g Carb = 35g
1 exchange 1 exchange 2 exchanges 2 exchanges
 Lavish bread 1 Sultana Bran 1 cup
Mission wraps 1 wrap 2 x Weet-bix
sheet Carb = 33g Carb 20g Carb = 31g
Carb = 30g 2 exchanges 1 exchange 2 exchanges
2 exchanges

All Bran Mini Wheats Oat bran cereal Cooked porridge

2/3 cup 14 biscuits 2/3 cup with water, 1 cup
Carb = 21g Carb = 21g Carb = 23g
Carb = 25g
1 ½ exchanges 1 ½ exchanges 1 ½ exchanges
1 ½ exchanges
Muesli 1 cup Quick Oats Quick Oats Berry Just Right
Carb = 31g 1 sachet flavoured 1 sachet 2/3 cup
2 exchanges Carb = 26g Carb = 23g Carb = 22g
1 ½ exchanges 1 ½ exchange 1 ½ exchanges

Uncle tobys plus Corn flakes Special K, 1 crumpet

2/3 cup 2/3 cup 2/3 cup
Carb = 17g Carb = 17g Carb = 18g Carb = 18g
1 exchange 1 exchange 1 exchange 1 exchange
 Pasta and Noodles

All pasta ½ cup cooked

Carb = 19g
1 exchange

Beef lasagne Egg Noodles Rice Noodles

1/5 slices 1 cup cooked 1 cup cooked
Carb = 25g Carb = 43g Carb = 47g
1 ½ exchanges 3 exchanges 3 exchanges
 Rice and Grains

Rice cooked 1/2 cup

Carb = 25g
1 ½ exchanges

Popcorn, No butter or salt, Quinoa CousCous

2 cups 1 cup cooked 1 cup cooked
Carb = 9g Carb = 39g Carb = 15g
½ exchange 2 ½ exchanges 1 exchange
 Dairy

Milk, 1 cup Soy milk, 1 cup Plain yoghurt, ¾ cup Fruit yoghurt, ¾ cup
Carb = 14g Carb = 14g Carb = 16g Carb = 26g
1 exchange 1 exchange 1 exchange 2 exchanges

Milk powder, 2 tablespoons Low fat custard, 1/3 cup

Carb = 13g Carb = 16g
1 exchange 1 exchange
 Beans, Lentils and Nuts

Cooked lentils, Baked beans, 1/2 Red kidney beans, Mixed beans,
1/2 cup cup 1/2 cup 1/2 cup
Carb = 12g Carb = 15g Carb = 14g Carb = 14g
1 exchange 1 exchange 1 exchange 1 exchange

Chickpeas, Peanuts, ¼ cup

1/2 cup (30g)
Carb = 12g Carb = 7g
1 exchange ½ exchange
 Vegetables

Small potato Medium potato Large potato Mash potato,

60g 140g 220g ½ cup
Carb = 10g Carb = 22g Carb = 35g Carb = 14g
½ exchange 1 ½ exchange 2 exchanges 1 exchange

Diced potato,
½ cup (75g)
Carb = 10g
½ exchange
Vegetables

Sweet Potato, ½ cup Corn, 1/2 cup Corn cob Taro, 1/2 cup
Carb = 17g Carb = 17g Carb = 17g Carb = 17g
1 exchange 1 exchange 1 exchange 1 exchange

Parsnip Cassava ½ cup

Carb = 17g Carb = 31g
1 exchange 2 exchanges
 Fruit

Apple (medium) 3 Apricots Dried apricots

Banana (medium)
Carb = 17g Carb = 13g 5-6 pieces
Carb = 20g
1 exchange 1 exchange Carb = 14g
1 exchange
1 exchange

Cherries 1 cup 3 large figs Grapes 1 cup Kiwi Fruit

Carb = 18g Carb = 8g Carb = 26g Carb = 10g
1 exchange ½ exchange 1 ½ exchange ½ exchange
Mandarin (medium) Nectarine (medium) Orange (medium) Paw Paw (small) 400g
Carb = 10g Carb = 6g Carb = 17g Carb = 28g
½ exchange ½ exchange 1 exchange 2 exchanges

2cm

Peach (medium) Pear (medium) Pineapple 1 slice (85g) Plum (small)

Carb = 23g Carb = 23g Carb = 7g Carb = 9g
1 ½ exchanges 1 ½ exchanges ½ exchange ½ exchange
 ¼ Rock Melon Watermelon 1 cup Honey dew ¾ cup Canned fruit 1 cup
Carb = 7g Carb = 9g Carb = 10g Carb = 22g
½ exchange ½ exchange ½ exchange 1 ½ exchange

Fruit salad fresh 1 cup Sultanas 2 4 Prunes Strawberries 1 punnet

Carb = 21g tablespoons Carb = 14g Carb = 10g
1 ½ exchanges Carb = 20g 1 exchange ½ exchange
1 exchanges
 Dried apple Dried cranberries
Mango (medium)
5 rings (30g) ¼ cup (30g)
Carb = 24g
Carb = 21g Carb = 22g
1 ½ exchanges
1 ½ exchanges 1 ½ exchanges

Orange Juice 1 cup Apple juice 1 cup Cranberry juice 1 cup

(no added sugar) (no added sugar) (no added sugar)
Carb = 14g Carb = 26g Carb = 6g
1 exchange 2 exchanges ½ exchanges
 Sauces

Sweet Chilli Sauce 1 Oyster sauce 1 Satay Sauce Honey, Garlic and soy. ¼
Tablespoon. Tablespoon 1 Tablespoon sachet
Carb = 9g Carb = 6g Carb = 6g Carb = 11g
1/2 exchange 1/2 exchange ½ exchange 1 exchange

Teriyaki Sauce, 1 Kantong Sweet and Sour Kecap Manis 1

Tablespoon (1/4 small bottle) Tablespoon
Carb = 8g Carb = 29g Carb = 11g
1/2 exchange 2 exchanges 1 exchange
Bolognese Carbonara Butter chicken
¼ of a Jar ¼ of a Jar ¼ Jar.
Carb = 13g Carb = 7g Carb = 13g
1 exchange ½ exchange 1 exchange

Tomato sauce BBQ sauce

Honey mustard
1 tablespoon 1 tablespoon
¼ of a Jar.
Carb = 7g Carb = 13g
Carb = 13g
½ exchange 1 exchange
1 exchange
These foods should only be eaten on special occasions because
they contain large amounts of fat, salt and other additives we
don’t want.
 Extras

Slice of pizza Taco shell x 2 Doritos, 50g (small pack)

Carb = 20g Carb = 12g Carb = 30g
1 exchange 1 exchange 2 exchanges

Shapes, bowl (16 pieces) Cheezels, bowl (12 pieces) Chips, 50g (small pack)
Carb = 24g Carb = 11g Carb = 23g
1 ½ exchanges 1 exchange 1 ½ exchanges
 Ice cream, 1 scoop Iced donut Cinnamon donut Mars bar, regular

Carb = 13g Carb = 27g Carb = 18g Carb = 37g

1 exchange 2 exchanges 1 exchange 2 ½ exchanges

Cherry ripe, regular Crunchie, regular Snickers, regular

Carb = 30g Carb = 35g Carb = 30g
2 exchanges 2 exchanges 2 exchanges
Cadbury bar, regular Chocolate block, 4 squares Caramello Koala, 40g
Carb = 29g Carb = 15g Carb = 24g
2 exchanges 1 exchange 1 ½ exchanges

Freddo frog, 35g Mousse, tub (62g) Muesli bar

Carb = 13g Carb = 19g
Carb = 20g
1 exchange 1 exchange
1 exchange
 Small fries Regular fries Regular fries Small fries
Carb = 29g Carb = 35g Carb = 52g Carb = 29g
2 exchanges 2 exchanges 3 ½ exchanges 2 exchanges

Hot chips, 100g Big Mac Quarter pounder Cheeseburger

Carb = 26g Carb = 35g Carb = 34g Carb = 26g
2 exchanges 2 exchanges 2 exchanges 2 exchanges
McChicken burger 6 chicken nuggets Small Sundae Small Thickshake
Carb = 38g Carb = 15g Carb = 53g Carb = 47g
2 ½ exchanges 1 exchange 3 ½ exchanges 3 exchanges

Coke can Fanta can Lemonade can Pepsi can

Carb = 40g Carb = 42g Carb = 32g Carb = 41g
2 ½ exchanges 3 exchanges 2 exchanges 3 exchanges
 Milo, tablespoon Honey, teaspoon Sugar, teaspoon Jam, teaspoon
Carb = 6g Carb = 10g
Carb = 13g Carb = 10g
½ exchange ½ exchange
1 exchange ½ exchange

Banana bread Banana bread, McDonalds Coles fruit cake,

1/16 slice
Carb = 28g Carb = 84g
Carb = 27g
2 exchanges 5 ½ exchanges
2 exchanges
 Chocolate Block cake, 1/10 slice Chocolate mud cake, 1/8 slice
Carb= 24g Carb= 39g
1 ½ exchanges 2 ½ exchanges

White cake, 1/8 slice 1 mini cupcake Bavarian cake, 1/6 slice
Carb= 36g Carb= 11g Carb= 27g
2 ½ exchanges 1 exchange 2 exchange
 1 woolworths muffin
1 lamington finger 1 lamington square
Carb= 55g
Carb= 14g Carb= 25g
3 ½ exchanges
1 exchange 1 ½ exchanges

1 coles muffin 1 woolworths muffin

1 Cupcake out of 12
Carb= 54g Carb= 80g
Carb= 27g
3 ½ exchanges 5 exchanges
2 exchanges
Snakes, 2 snakes Jelly babies, 4 pieces Marshmallows , 4 pieces
Carb = 16g Carb = 16g Carb = 16g
1 exchange 1 exchange 1 exchange

1 x chupa chump Mother can, 500ml 1 X Up&Go, 250ml

Carb = 12g Carb = 52g Carb = 30g
1 exchange 3 ½ exchanges 2 exchanges
1 cookie 1 cream biscuit 1 cookie
Carb= 7g Carb= 11g Carb= 16g
½ exchange 1 exchange 1 exchange

1 biscuit 1 jam donut 1 pancake

Carb= 16g Carb= 23g Carb= 19g
1 exchange 1 ½ exchange 1 exchange
 Battered fish Chicken schnitzel, Meat pie
100g 200g
Carb = 14g Carb = 30g Carb = 34g
1 exchange 2 exchanges 2 exchanges

Hot dog, donut king

Carb = 54g
3 ½ exchanges
 Alcohol
Recommendations:

- No more than 2 standard drinks a day.

- 2 alcohol free days per week.

 Tips to help avoid hypos:
- Don’t drink alcohol on an empty stomach.

- Eat carbohydrate foods before and during drinking.

- Eat a carbohydrate snack before you go to bed.

- Test your blood glucose levels before bed (4-8mmol/L).

- Avoid alcohol after heavy exercise.

- Always carry some fast acting sugar.

- Make sure someone with you knows you have diabetes and
wear some form of medical ID.
 Watch your Alcohol
Some of your serves of alcohol contain more than one standard drink.

Light beer, Full strength beer, Mid strength beer,

Schooner (425ml) Middy/Pot (285ml) Can (375ml)
Carb= 10g Carb= 9g Carb= 12g
½ exchange ½ exchange 1 exchange
*1 standard drink *1 standard drink *1 standard drink

If you are having more than 2 standard drinks, you must talk to
your diabetes care team to avoid having a hypo.
Toohey’s extra dry Strongbow original Rekorderlig cider
(345ml) Bottle 355ml Bottle (500ml)
Carb= 9g Carb= 20g Carb= 25g
½ exchange 1 exchange 1 ½ exchange
*1.4 standard drinks *1.5 standard drinks *1.6 standard drinks

5 seeds Sparkling white

Bottle (345ml) Glass (120ml)
Carb= 17g Carb= less than 5
1 exchange No exchange
*1.4 standard drinks *1.2 standard drinks
White wine Dry White wine sweet Port,
Glass (100ml) Glass (100ml) Glass (60ml)
Carb= less than 5 Carb= 11g Carb= 8g
No exchange 1 exchange ½ exchange
*1 standard drink *1 standard drink *1 standard drink

Spirits Vodka Cruiser

1 shot/nip (30ml) Bottle (275ml)
Carb= 0 Carb= 25g
No exchange 1 ½ exchange
*1 standard drink *1.1 standard drinks
UDL WKD Smirnoff red
Can (375ml) Bottle (275ml) Bottle (335ml)
Carb= 26g Carb= 22g Carb= 27g
2 exchanges 1 ½ exchanges 2 exchanges
*1.4 standard drinks *1 standard drink *1.3 standard drinks

Johnnie Walker cola Jim Beam and cola

Can (375ml) Can (375ml)
Carb= 35g Carb= 21g
2 exchanges 1 ½ exchanges
*1.4 standard drinks *1.5 standard drinks
These foods contain no or very low amounts of carbohydrates.
They should only be eaten on special occasions because they
contain large amounts of fat, salt and other additives.
Bacon Salami Fatty Ham

Devon Sausages Fatty Rissoles

Butter Cream
 Cream cheese Fatty cheese e.g. brie and
Creamy based dips
camembert

Sour cream Fatty cheese e.g. deli

Cheesy spread
cheeses.

Diet Soft Drinks Diet Soft Drinks Diet Soft Drinks

What a healthy meal should look like.
 Meats from the
green section = ¼
Vegetables from of the plate.
the green section
= ½ the plate.
Vegetables or
breads and
cereals from the
orange section=
¼ of the plate.
 Green section-
Green section-
Don’t count!
Don’t count!

Orange section-
Count!
 What do I need to count in my stir frys?

Need to count your rice and

sauce.
REMEMBER:
½ cup of rice = 25g of carb
1 ½ exchanges

Count your sauce using the

label or use the sauces in the
orange section.
 Free food
Need to count pasta and sauce.

Remember:
1 cup of pasta = 38g of carb and
2 ½ exchange.

Count your sauce using the label

or use the sauces in the orange
section.

Bolognese ¼ jar = 13g of Carb =

1 exchange

TOTAL= 3 ½ exchanges
Free Food
Don’t count
vegetables and pesto
sauce from the green
section.

Need to count your

cooked pasta.

Remember:
1 cup of pasta = 38g of
Carb
= 2 ½ carb exchanges.

TOTAL= 2 ½ exchanges
 Other Resources
Phone Apps Software Cost Description
CalorieKing iPhone and Free - Contains Australian foods.
Australia iPad - Can view carbohydrate in grams
for different serves.
The traffic light iPhone, iPad, $9.50 - Contains Australian foods.
guide to food- Android, - Shows carbohydrates in grams
Australian Blackberry. and exchanges.
- Able to develop and store meals.
carbohydrate
counter.

Lenny iPhone, iPad, Free - Play games for carbohydrate

Android counting.

Websites Address
CalorieKing www.calorieking.com.au
Diabetes Australia www.diabetesaustralia.com.au

Baker IDI http://www.bakeridi.edu.au/

 Books
Title: How much Carb in that?
Author: Julia Zinga
Shop: https://www.facebook.com/HowMuchCarbInThat

Title: The Traffic Light Guide to Food Pocket Size Carbohydrate

Counter
Author: Sydney Diabetes Clinical Research Unit
Shop:
http://www.thetrafficlightguide.com.au/site/shp.php?pID=23

Title: Calorie King

Author: Allan Borushek
Shop: Newsagents and book stores