Diabetes Toolkit

Nourished Aging Toolkit:

Diabetes Management

Sysco Canada’s Nutrition Services Team

Sysco’s Nutrition Services offers insight on trends, research and best practices for nutrition in food service. The team of registered dietitians and culinary experts provides a diverse suite of tools and resources to help drive your business.

SYNERGY TECH

SUITE® MENU MANAGEMENT:

• Menu planning

• Recipe development

• Costing & nutrition analysis

• Product linking

• Menu implementation support

NUTRITION COMMUNICATIONS:

• Develop nutrition guidelines & standards

• Seasonal, special events & emergency menu creation

• Education event planning

• Nutrition publications & presentations

PRODUCT AND RECIPE

IDEATION:

• Recipe testing & development

• IDDSI implementation ideation

• Vendor partnership for product feedback

• Sysco Business Resources collaborations

Message From Sysco’s Nutrition Services Team

Over ten million people in Canada are diagnosed with diabetes or prediabetes1. Treatment goals for diabetes can impact an individual's overall health & safety, along with quality of life.

This resource will focus on Type 2 diabetes education in senior living, including practical tips to manage blood sugar levels for residents within your communities. This resource will focus on topics such as:

• Diabetes

Older Adults

• Management of Diabetes in Senior Living Communities

• Nutritional Management of Diabetes in Senior Living Communities

Please reach out to your Sysco Sales Representative for more information on Synergy Tech Suite and product listings.

Note: The information provided within this toolkit are suggestions and should be implemented in consultation with a Registered Dietitian & Medical Team in accordance with your home specific policies

- Sysco Canada’s Nutrition Services Team

Management of Diabetes in Senior Living

• Glycated Hemoglobin (HbA1c) is a measure of your average blood sugar control over the last 3 months4

• When sugar enters your bloodstream, it attaches onto a protein in red blood cells called hemoglobin5

• The percentage of sugar-coated hemoglobin can be measured by an HbA1c test5

• HbA1c targets for elderly people are higher than the younger population due to increased risk of low blood sugar4

• Symptoms of low blood sugars include trembling, sweating, headaches, weakness, dizziness, confusion, and fainting – which may result in more falls and broken bones4

End of Life

Glycemic Targets Diabetes Canada Clinical Practice Guidelines Expert Committee, 2018

• HbA1c measurement not indicated

• Focus on preventing symptoms of high and low blood sugar levels

Diabetes in Older Adults

What is Diabetes?

• Diabetes Mellitus (DM) is defined as a chronic health condition that affects the process involved with turning food into energy2

• The most common type of DM is Type 2 diabetes, which refers to the inability for your body to use and/or produce insulin, resulting in uncontrolled blood sugar levels2

• Untreated high blood sugar levels can lead to incontinence, infection, poor healing, and confusion in older adults3

Diabetes for Elderly:

• DM management in older adults is different compared to the younger population4

• The healthcare team must individualize residents’ diabetes management plan and consider functional dependence, frailty, dementia, and palliative status4

• Low blood sugar levels are a primary concern for the older population due to the use of several medications, aging, and multiple comorbidities4

Resident Centered Medical Management

The nursing team and physician work collaboratively to determine the treatment plan and manage type, timing, and dosage of glucose-lowering medications. Blood sugar levels are monitored by nursing staff as needed6.

Due to the high risk of hypoglycemia and malnutrition in the frail elderly population, some experts recommend adjusting medications to achieve blood glucose targets rather than restricting their diet6.

Lifestyle and Physical Activity

Lifestyle and physical activity is also important to support diabetes management. Residents’ activity program should be individualized and built to help enhance mobility, endurance, gait, balance, and overall strength7

Nutritional Management of Diabetes

Diet liberalization on senior living menus involves simplifying therapeutic diets (i.e., diabetic, diabetic renal, and diabetic renal dialysis diet. The purpose is to help increase food and fluid intake and improve the quality of life for residents.

Healthcare providers may implement an individualized nutritional care approach including:

• Regular timing of balanced meals and snacks provide residents with consistent carbohydrate intake to help regulate blood sugars6

• Reducing intake of added sugars (i.e. ½ portions of dessert, low calorie juice and jams, etc.)

 This may not be applicable to the frail elderly population as it can decrease quality of life and contribute to malnutrition3.

• Assessment by a Registered Dietitian ensures that dietary goals are individualized for residents who have unstable blood glucose levels or require special diets to accommodate other chronic illnesses (i.e. kidney disease, dialysis etc.)3.

Ensure residents are regularly assessed by a registered dietitian and medical team to confirm they receive appropriate dietary interventions based on their needs

Fluctuating Blood Sugar Levels

Other factors that may influence blood sugar levels include:

• Foods and beverages that are enjoyed by residents with friends and family6

• Foods and beverages that are enjoyed during programs and activities6

• High fruit juice or beverage consumption6

• Variable meal and snack intake6

• Changes in health status, such as with illness, injury, or surgery

Artificial Sweeteners

Diabetes Canada guidelines recommend that 10% of daily energy intake (12 teaspoons) can come from sucrose (i.e., table sugar)1

Artificial sweeteners may not be required for residents; however, it may help provide more variety without exceeding the recommended intake of added sugars6

Snack Suggestions for Diabetes Management

Residents may require individualized snack options between meals to manage their blood sugar levels6

• Implementation of snacks are dependent on residents’ energy and nutrient requirement, weight and treatment goals, and medications6

• Protein rich snacks can help improve nutrient intake and provide better blood sugar control6. This may include:

• Cottage cheese topped with fruit

• Peanut butter on toast

• Egg salad sandwich

• Crackers and cheese

• Vegetable sticks and hummus

Ensure residents are regularly assessed by a registered dietitian and medical team to confirm they receive appropriate dietary interventions based on their needs

SYNERGY TECH SUITE

Your key ingredient to bring personalized care to mealtime

Personalize Diet Interventions

Synergy Tech Suite provides the option to add a customized dietary intervention for a resident’s personal menu. Interventions may include personal items, meal/snack substitutions (i.e. reduced or low calorie syrup/jam/jelly/juice), adjustments to serving sizes (i.e. 1/2 portion of baked desserts), likes and dislikes, and items that should not be served (i.e. foods that are high in added sugars).

Customize Diet Types

Synergy Tech Suite provides the option to customize diets that are specific to your home. You can easily add or maintain the diabetic diet.

What is Synergy Tech Suite?

Synergy Tech Suite is our Sysco Canada exclusive foodservice management software and hardware, which can support you and your communities by providing residents with personalized dietary interventions to help manage diabetes.

If you are interested in learning more about our software solution, please reach out to your Sysco rep, or email sysco@mealsuite.com. You can also visit the Sysco Canada website. www.sysco.ca/healthcare where you can sign up for a demo to learn more about Synergy Tech Suite.