Strategies for Implementation of Consistent Carbohydrate Meal Patterns

Abstract

Carbohydrate counting has been recommended as an appropriate method of meal planning for diabetic patients in hospitals as a means of meeting patients' nutrition needs and facilitating improved metabolic control for patients in acute care settings.Although meal plans utilizing consistent carbohydrate content were used in patient education, the clinical nutrition staff identified the continued use of “ADA-type” patterns in the patient food service as an obstacle to utilizing the patient menu and meal tray in reinforcing educational principles. Concerns were also identified with implementing a menu system that only utilized carbohydrate counting, i.e., meeting medical staff requirements, patient expectations, and increasing work for the diet office.Consistent carbohydrate meal patterns were developed with ranges of caloric content to accommodate most patients' nutrition needs. Diabetic menus were based on a cardiac-type diet pattern to provide an appropriate fat content for most patients. Guidelines for diet content were also established to facilitate meal correction: consistent selection of entrees by patients, maximum number of fruit servings allowed per meal, and goal for maximum number of fat servings/day. The use of sucrose-containing foods was limited at the time of implementation, although this may be modified in the future with continued education of the staff and greater public knowledge about consistent carbohydrate as a means of diabetic menu planning.