Lifestyle Management of a Person w/ DM Flashcards Preview

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Flashcards in Lifestyle Management of a Person w/ DM Deck (17):

State the objective of diabetes self-management education (DSME)

to support informed decision- making, self-care behaviors, problem solving, and active collaboration with the health care team to improve clinical outcomes, health status, and quality of life in a cost-effective manner


Identify the four critical times in the management of a person with diabetes when DSME referral should be made

-At diagnosis
-Annually for assessment of education, nutrition, and emotional needs
-When new complicating factors (health conditions, physical limitations, emotional factors, or basic living needs) arise that influence self-management
-When transitions in care occur


Who is central to the management of the person with diabetes?

the patient himself/herself


goals of medical nutrition therapy

-promote and support healthful eating patterns, emphasizing a variety of nutrient-dense foods in appropriate portion sizes, to improve overall health and:
*achieve and maintain body weight goals
*attain individualized glycemic, blood pressure, and lipid goals
*delay or prevent the complications of diabetes
-address individual nutrition needs based on personal and cultural preferences, health literacy and numeracy, access to healthful foods, willingness and ability to make behavioral changes, and barriers to change
-maintain the pleasure of eating by providing nonjudgmental messages about food choices
-provide an individual with diabetes the practical tools for developing healthy eating patterns rather than focusing on individual macronutrients, micronutrients, or single foods


in terms of meal planning, what is the emphasis placed on?

healthy eating patterns including nutrient dense foods


Define nutrient dense

-Food that is high in nutrients but relatively low in calories
-Nutrient-dense foods contain vitamins, minerals, complex carbohydrates, lean protein, and healthy fats


examples of nutrient dense foods

fruits and vegetables, whole grains, low-fat or fat-free milk products, seafood, lean meats, eggs, peas, beans, and nuts


what is the purpose of using a diabetes plate method?

for providing basic meal planning guidance as it provides a visual guide showing how to control calories (by featuring a smaller plate) and carbohydrates (by limiting them to what fits in one-quarter of the plate) and puts an emphasis on low-carbohydrate (or nonstarchy) vegetables


what is the daily energy deficit needed for weight loss?

500–750 kcal/day energy deficit


Identify the total kcal/day for men and women for weight loss

∼1,200–1,500 kcal/day for women and 1,500–1,800 kcal/day for men, adjusted for the individual’s baseline body weight


what is the percent weight loss needed for optimal impact on glycemic control

For many obese individuals with type 2 diabetes, weight loss >5% is needed to produce beneficial outcomes in glycemic control, lipids, and blood pressure, and sustained weight loss of ≥7% is optimal


caloric density of carbohydrates, fat, and protein

-1 gram of carbohydrate = 4 kcal
-1 gm of protein = 4 kcal
-1 gram of fat = 9 kcal


Given a patient’s insulin to carb ratio and the amount of carbohydrates in the meal, determine the units of bolus insulin to be administered

-Initially, the patient may be instructed to administer 1 unit of a bolus insulin for every 15 gm of carbohydrate in the meal
-For example, one cup of cheerio cereal contains 22 gm of carbohydrate, a 3/4 cup of milk contains 9 gm of carbohydrate, 6 oz. of orange juice contains 15 gm of carbohydrate. The total amount of carbohydrate is 46 gm. If a 1:15 insulin:carb ratio is used, then the amount of bolus insulin given before the meal is 3 units


recommended daily dietary restriction of saturated fat

Limit saturated fats to <10% of total calories (raises LDL)


recommended daily dietary restriction of sodium for most adults

less than 2,300 mg per day for adults and children ages 14 years and older


Identify the guidelines for daily alcohol consumption for men and women

For women, no more than one drink per day; for men, no more than two drinks per day is recommended (one drink is equal to a 12-oz beer, 5-oz glass of wine, or 1.5-oz distilled spirits)


What is the risk of alcohol intake in people with diabetes

-Moderate alcohol intake doesn't have major detrimental effects on long-term blood glucose control in people with DM
-Risks associated with alcohol consumption include hypoglycemia (particularly or those using insulin or insulin secretagogue therapies), weight gain, and hyperglycemia (for those consuming excessive amounts)
-People with DM can follow the same guidelines as those without DM if they choose
to drink