Diet Instruction Sheet 
                                                                                                        
                                                                                                        
                                                                                                        
                                                              1800 CALORIE (ADA) Diabetic Diet 
                                                                                                                            
                             Reason for the Diet: 
                             To help prevent high blood sugar levels and to control your weight and blood sugar every day, 
                             normal blood sugar levels for persons under 65 years of age is 60-120mg/100ml.  For 65 and 
                             older, normal blood sugar can be 200mg/100ml, if kept stable. 
                              
                             How Much and/or What to Eat: 
                                                                                                                            
                                                  Breakfast:                                                                                                                    Lunch: 
                                1 serving unsweetened juice                                                                                                3 ounces low fat meat 
                                1 serving fat free cereal                                                                                                  1 serving fat free starch 
                                1 fat free egg or meat                                                                                                     1 serving fat free vegetable 
                                2 serving bread                                                                                                            1 serving fat free salad 
                                1 serving fat                                                                                                              2 servings bread 
                                1 serving low fat (2%) milk                                                                                                1 serving fat 
                                Coffee                                                                                                                     1 serving unsweetened fruit 
                                                                                                                                                           Unsweetened tea 
                                                                                                                                                           Water  
                                                      Dinner:                                                                                                         Bedtime Snack: 
                                2 ounces low fat meat                                                                                                      1 serving low fat (2%) Milk 
                                1 serving fat free starch                                                                                                  1 serving bread 
                                1 serving fat free vegetable                                                                                                
                                1 serving fat free salad                                                                                                    
                                1 serving bread                                                                                                             
                                1 serving fat                                                                                                               
                                1 serving unsweetened fruit                                                                                                 
                                Unsweetened tea                                                                                                             
                                Water                                                                                                                       
                              
                             One Serving from Each Different Foo Group is About: 
                                     1  STARCH/BREAD GROUP……………………….. = ½ cup cereal, starchy vegetables or pasta 
                                                                                                                          or 1 slice or small piece bread 
                                     2  MEAT GROUP………………………….……………. = The number of ounces listed 
                                     3  VEGETABLES…………………………………………. = ½ cup cooked vegetables or vegetables juice 
                                                                                                                          or 1 cup raw vegetables 
                                     4  FRUIT GROUP………………………………………… = ½ cup fresh or unsweetened canned fruit or 
                                                                                                                                Juice or ¼ cup dried fruit                       
                                     5  MILK……………………………………………………… = 1 cup fluid milk 
                                     6  FAT……………………………………………………….. = 1 teaspoon margarine, oil or mayonnaise 
                                                                                                                          or 1 tablespoon gravy, diet margarine, or diet 
                                                                                                                                 mayonnaise 
                              
                             For additional information on serving sizes refer to FOOD LISTS FOR DIABETIC DIETS. 
                              
                             Patient’s Name                                                                      Instructor’s Initials:                                           Date: