5. Facilitating Positive Health Behaviors 23 Flashcards
1
Q
What are some interventions that can potentially improve sleep outcomes?
A
Sleep extension and pharmacological treatments for sleep have been found to improve sleep outcomes AND POSSIBLY INSULIN RESISTANCE.
THERE IS EVIDENCE
2
Q
What percentage of people with type 2 diabetes are estimated to have obstructive sleep apnea?
A
24–86%
3
Q
What is the sleep health recommendation for screening in people with diabetes?
A
The sleep health recommendation is to consider screening for sleep health in people with diabetes, including symptoms of sleep disorders, disruptions to sleep due to diabetes symptoms or management needs, and worries about sleep.
4
Q
Who should be referred to for sleep medicine and/or behavioral health professional?
A
People with diabetes who show symptoms of sleep disorders, disruptions to sleep due to diabetes symptoms or management needs, or worries about sleep should be referred to sleep medicine and/or a qualified behavioral health professional.
5
Q
What has early-onset type 1 diabetes been associated with in terms of intellectual abilities?
A
- Early-onset type 1 diabetes linked to intellectual deficits.
- Repeated severe hypoglycemia may worsen cognitive abilities.
6
Q
What are the consequences of severe hypoglycemia?
A
Severe hypoglycemia is associated with decline and immediate symptoms of mental confusion.
7
Q
What has been associated with cognitive decline in individuals with diabetes?
A
Having diabetes over decades—type 1 and type 2
8
Q
Who should cognitive capacity be monitored for in individuals with diabetes?
A
Cognitive capacity should be monitored throughout the life span for all individuals with diabetes, particularly in those who have documented cognitive disabilities, those who experience severe hypoglycemia, very young children, and older adults.
9
Q
What should be considered if cognitive capacity changes or appears to be suboptimal for patient decision-making and/or behavioral self-management?
A
If cognitive capacity changes or appears to be suboptimal for patient decision-making and/or behavioral self-management, referral for a formal assessment should be considered.
10
Q
What is the recommendation regarding cognitive capacity in individuals with diabetes?
A
The recommendation is to monitor cognitive capacity throughout the life span for all individuals with diabetes, particularly in those who have documented cognitive disabilities, those who experience severe hypoglycemia, very young children, and older adults.
11
Q
When should people be screened for prediabetes or diabetes after psychiatric medication initiation?
A
4 months later
12
Q
Why should people be screened for prediabetes or diabetes regularly?
A
People should be screened regularly because of the increased risk associated with diabetes and prediabetes.
13
Q
What is the recommendation for providing support to people with diabetes and serious mental illness?
A
The recommendation is to provide an increased level of support through enhanced monitoring of and assistance with diabetes self-management behaviors.
14
Q
When should individuals prescribed with atypical antipsychotic medications be screened for prediabetes and diabetes?
A
Screening recommendations:
- Initial screening: Patients should be screened four months after starting medication.
- Early screening: If clinically indicated, patients should be screened sooner than the four-month mark.
- Annual screening: Patients should undergo screening at least once a year.
15
Q
What should be monitored in individuals with diabetes who are prescribed second-generation antipsychotic medication?
3
A
- Weight changes
- Glycemia
- Cholesterol levels.
16
Q
Incretin therapies work in which two circuitries to modulate food intake and energy balance?
A
Incretin therapies work in the appetite and reward circuitries to modulate food intake and energy balance.
17
Q
What are the three symptoms that incretin therapies aim to reduce?
A
Incretin therapies aim to reduce uncontrollable hunger, overeating, and bulimic symptoms.
18
Q
What is the potential relevance of incretin therapies for the treatment of disrupted or disordered eating?
A
The use of incretin therapies may have potential implications and relevance for the treatment of disrupted or disordered eating.
19
Q
What is the link between insulin omission and weight loss in people with type 1 diabetes?
A
Insulin omission is a disordered eating behavior that is commonly reported among people with type 1 diabetes, and it is done in order to induce glycosuria and lose weight.
20
Q
When should screening for disordered or disrupted eating behavior be considered?
A
Screening for disordered or disrupted eating behavior should be considered when hyperglycemia and weight loss are unexplained based on self-reported behaviors related to medication dosing, meal plan, and physical activity.
21
Q
What is recommended when someone with diabetes presents with symptoms of disordered eating behavior, an eating disorder, or disrupted patterns of eating?
A
When someone with diabetes presents with symptoms of disordered eating behavior, an eating disorder, or disrupted patterns of eating, it is recommended to reevaluate their treatment plan in consultation with a qualified professional who has familiarity with the diabetes disease physiology, treatments for diabetes and disordered eating behaviors, and weight-related and psychological risk factors for disordered eating behaviors.
22
Q
What are the key qualifications required for the professional who should be consulted when reevaluating the treatment plan for someone with diabetes and symptoms of disordered eating behavior or disrupted patterns of eating?
A
The key qualifications include familiarity with the diabetes disease physiology, treatments for diabetes and disordered eating behaviors, and weight-related and psychological risk factors for disordered eating behaviors.
23
Q
According to the recommendations, how often should depressive symptoms be screened in people with diabetes?
A
At least annually
24
Q
Who should be referred to for treatment of depression in conjunction with collaborative care with the diabetes treatment team?
A
Qualified mental health professionals or other trained health care professionals with experience using evidence-based treatment approaches for depression
25
When should assessment for depression be considered for individuals with diabetes?
Beginning at diagnosis of complications or when there are significant changes in medical status
26
When should health care professionals consider screening people with diabetes for anxiety symptoms or diabetes-related worries?
Health care professionals should consider screening people with diabetes for anxiety symptoms or diabetes-related worries.
27
Who should be referred to a trained professional for intervention to help re-establish awareness of symptoms of hypoglycemia and reduce fear of hypoglycemia?
People with hypoglycemia unawareness, which can co-occur with fear of hypoglycemia, should be referred to a trained ANIXIETY professional.
28
What should health care professionals do if anxiety symptoms indicate interference with diabetes self-management behaviors or quality of life?
Health care professionals should discuss diabetes-related worries and may refer to a qualified mental health professional for further assessment and treatment.
29
When should people with diabetes, caregivers, and family members be routinely monitored for diabetes distress?
People with diabetes, caregivers, and family members should be routinely monitored for diabetes distress, particularly when treatment targets are not met and/or at the onset of diabetes complications.
30
Who should be referred for further assessment and treatment if indicated in cases of diabetes distress?
A qualified mental health professional or other trained health care professional should be referred for further assessment and treatment if indicated in cases of diabetes distress.
31
When should a person with diabetes be referred to a qualified behavioral or mental health professional?
A person with diabetes should be referred to a qualified behavioral or mental health professional if they have a positive screen on a validated screening tool for depressive symptoms, diabetes distress, anxiety, fear of hypoglycemia, or cognitive impairment.
32
What are some situations that warrant referral of a person with diabetes to a qualified behavioral or mental health professional?
Some situations that warrant referral of a person with diabetes to a qualified behavioral or mental health professional include a positive screen on a validated screening tool for depressive symptoms, diabetes distress, anxiety, fear of hypoglycemia, or cognitive impairment, the presence of symptoms or suspicions of disordered eating behavior, intentional omission of insulin or oral medication for weight loss, suspicion of serious mental illness, youth and families with behavioral self-care difficulties, declining or impaired ability to perform diabetes self-care behaviors, and before or after bariatric or metabolic surgery if ongoing adjustment support is needed.
33
When are key opportunities for psychosocial screening in diabetes care?
Key opportunities for psychosocial screening occur at diabetes diagnosis, during regularly scheduled management visits, during hospitalizations, with new onset of complications, during significant transitions in care, at the time of medical treatment changes, or when problems with achieving A1C goals, quality of life, or self-management are identified.
34
When should psychosocial screening be conducted for individuals with diabetes?
Psychosocial screening should be conducted at diabetes diagnosis, during regularly scheduled management visits, during hospitalizations, with new onset of complications, during significant transitions in care, at the time of medical treatment changes, or when problems with achieving A1C goals, quality of life, or self-management are identified.
35
Did psychosocial interventions have a significant impact on A1C in a systematic review and meta-analysis?
Yes, psychosocial interventions had a modest but significant improvement on A1C according to a systematic review and meta-analysis.
36
What should be considered when screening older adults with diabetes?
Cognitive impairment, frailty, and depressive symptoms should be considered when screening older adults with diabetes.
37
What is advised in terms of monitoring cognitive capacity for older adults with diabetes?
Monitoring of cognitive capacity, i.e., the ability to actively engage in decision-making regarding treatment plan behaviors, is advised for older adults with diabetes.
38
Is there evidence that vigorous-intensity exercise accelerates the rate of progression of DKD?
No, there is no evidence that vigorous-intensity exercise accelerates the rate of progression of DKD.
39
Do people with DKD need specific exercise restrictions in general?
No, there appears to be no need for specific exercise restrictions for people with DKD in general.
40
Why should individuals with diabetic autonomic neuropathy undergo cardiac investigation before engaging in intense physical activity?
Because cardiovascular autonomic neuropathy is an independent risk factor for cardiovascular death and silent myocardial ischemia.
41
What is cardiovascular autonomic neuropathy?
Cardiovascular autonomic neuropathy is a condition that increases the risk of cardiovascular death and silent myocardial ischemia in individuals with diabetes.
42
How can autonomic neuropathy increase the risk of exercise-induced injury or adverse events?
Autonomic neuropathy can increase the risk of exercise-induced injury or adverse events through decreased cardiac responsiveness to exercise, postural hypotension, impaired thermoregulation, impaired night vision due to impaired papillary reaction, and greater susceptibility to hypoglycemia.
43
What are some potential effects of autonomic neuropathy on exercise?
Some potential effects of autonomic neuropathy on exercise include decreased cardiac responsiveness, postural hypotension, impaired thermoregulation, impaired night vision, and greater susceptibility to hypoglycemia.
44
According to studies, what is the effect of moderate-intensity walking on the risk of foot ulcers or reulceration in those with peripheral neuropathy who use proper footwear?
Moderate-intensity walking does not lead to an increased risk of foot ulcers or reulceration in those with peripheral neuropathy who use proper footwear.
45
Why may vigorous-intensity aerobic or resistance exercise be contraindicated for individuals with proliferative diabetic retinopathy or severe nonproliferative diabetic retinopathy?
Vigorous-intensity aerobic or resistance exercise may be contraindicated due to the risk of triggering vitreous hemorrhage or retinal detachment.
46
Are routine preventive measures for hypoglycemia advised for individuals not treated with insulin or insulin secretagogues BEFORE EXERCISES?
No, routine preventive measures for hypoglycemia are usually not advised in these cases.
47
What factors determine whether individuals on these therapies need to ingest added carbohydrate before exercising?
The factors include pre-exercise glucose levels (<90 mg/dL or 5.0 mmol/L), ability to lower insulin doses during the workout, time of day exercise is done, and intensity and duration of the activity.
48
What options are available for individuals on these therapies to lower insulin doses during workouts?
The options include using an insulin pump or reducing pre-exercise insulin dosage.
49
Why may individuals on these therapies need to ingest added carbohydrate before exercising if their pre-exercise glucose levels are below 90 mg/dL?
They may need to ingest added carbohydrate to prevent hypoglycemia during exercise.
50
How long should aerobic activity bouts ideally last for adults with type 2 diabetes?
Aerobic activity bouts should ideally last at least 10 minutes.
51
What is the recommended goal for daily aerobic activity for adults with type 2 diabetes?
The recommended goal for daily aerobic activity for adults with type 2 diabetes is approximately 30 minutes or more most days of the week.
52
How much does structured exercise lower A1C in people with type 2 diabetes?
Structured exercise interventions of at least 8 weeks’ duration have been shown to lower A1C by an average of 0.66%.
53
Is a significant change in BMI necessary for structured exercise interventions to lower A1C in people with type 2 diabetes?
No, structured exercise interventions have been shown to lower A1C even without a significant change in BMI.
54
What are some examples of nonsedentary activities that can be promoted to sedentary individuals with type 1 and type 2 diabetes?
Examples include walking, yoga, housework, gardening, swimming, and dancing.
55
What types of training are recommended for older adults with diabetes?
Flexibility training and balance training are recommended 2–3 times/week for older adults with diabetes. Yoga and tai chi may be included based on individual preferences to increase flexibility, muscular strength, and balance.
56
Why should all adults, especially those with type 2 diabetes, decrease the amount of time spent in daily sedentary behavior?
Decreasing sedentary behavior is important for all adults, particularly those with type 2 diabetes, to improve blood glucose levels and overall health.
57
How frequently should prolonged sitting be interrupted for blood glucose benefits?
Prolonged sitting should be interrupted every 30 minutes for blood glucose benefits.
58
How many sessions of resistance exercise per week should adults with type 1 diabetes and type 2 diabetes engage in?
Adults with type 1 diabetes and type 2 diabetes should engage in 2-3 sessions per week of resistance exercise.
59
How much aerobic activity should most adults with type 1 and type 2 diabetes engage in per week?
Most adults with type 1 and type 2 diabetes should engage in 150 min or more of moderate- to vigorous-intensity aerobic activity per week.
60
How many days per week should the aerobic activity be spread over?
The aerobic activity should be spread over at least 3 days per week.
61
What is the recommended minimum duration of vigorous-intensity or interval training for younger and more physically fit individuals?
For younger and more physically fit individuals, a minimum of 75 min/week of vigorous-intensity or interval training may be sufficient.
62
How much time should children and adolescents with type 1 diabetes C, type 2 diabetes, or prediabetes B engage in moderate- or vigorous-intensity aerobic activity per day?
Children and adolescents with type 1 diabetes C, type 2 diabetes, or prediabetes B should engage in 60 min/day or more of moderate- or vigorous-intensity aerobic activity.
63
Does the addition of nonnutritive sweeteners to diets benefit weight loss or reduced weight gain without energy restriction?
No, the addition of nonnutritive sweeteners to diets does not pose any benefit for weight loss or reduced weight gain without energy restriction.
64
Do nonnutritive sweeteners have a significant effect on glycemic management?
No, nonnutritive sweeteners do not appear to have a significant effect on glycemic management.
65
What are some risks associated with alcohol consumption?
The risks associated with alcohol consumption include hypoglycemia and/or delayed hypoglycemia, weight gain, and hyperglycemia.
66
Who is at a higher risk of experiencing hypoglycemia and/or delayed hypoglycemia due to alcohol consumption?
Individuals using insulin or insulin secretagogue therapies are at a higher risk of experiencing hypoglycemia and/or delayed hypoglycemia.
67
What was the finding of the D2d study regarding the benefit of vitamin D on the progression to type 2 diabetes?
The D2d study showed no significant benefit of vitamin D versus placebo on the progression to type 2 diabetes.
68
What type of study design was used in the D2d study?
The D2d study used a prospective randomized controlled trial (RCT) design.
69
Which herbal supplements and micronutrients have insufficient evidence to support their use in improving glycemia in people with diabetes?
The herbal supplements and micronutrients with insufficient evidence to support their use in improving glycemia in people with diabetes include cinnamon, curcumin, vitamin D, aloe vera, and chromium.
70
What is the association between β-carotene and lung cancer and cardiovascular mortality risk?
β-carotene was significantly associated with increased lung cancer and cardiovascular mortality risk.
71
Why is routine supplementation with antioxidants such as vitamins E and C not advised?
Routine supplementation with antioxidants such as vitamins E and C is not advised due to lack of evidence of efficacy and concern related to long-term safety.
72
When should periodic testing of vitamin B12 levels be considered in people taking metformin?
Periodic testing of vitamin B12 levels should be considered in people taking metformin, particularly in those with anemia or peripheral neuropathy.
73
According to the article, what is the recommended daily sodium intake for individuals with hypertension?
The article states that restriction to <1,500 mg of sodium per day is generally not recommended, even for those with hypertension.
74
In the REDUCE-IT trial, what was the effect of supplementation with 4 g/day of pure EPA?
Supplementation with 4 g/day of pure EPA significantly lowered the risk of adverse cardiovascular events.
significantly lowered the risk of adverse cardiovascular events.
عكس ASCEND
75
Did the ASCEND trial show any cardiovascular benefit for people with diabetes without evidence of CVD when using n-3 fatty acids(EPA) supplementation?
No, the ASCEND trial did not show any cardiovascular benefit when using n-3 fatty acids supplementation at the dose of 1 g/day.
76
Did dietary supplements with n-3 (EPA)and n-6 fatty acids improve glycemic management in individuals with type 2 diabetes?
No, two systematic reviews concluded that the dietary supplements did not improve glycemic management.
77
What was the conclusion of the systematic reviews on dietary supplements with n-3 and n-6 fatty acids in individuals with type 2 diabetes?
The conclusion was that the dietary supplements did not improve glycemic management.
78
Do n-3 supplements conclusively support the prevention or treatment of cardiovascular events in people with diabetes?
No, evidence does not conclusively support recommending n-3 supplements (EPA and DHA) for all people with diabetes for the prevention or treatment of cardiovascular events.
79
How can a Mediterranean eating pattern improve glycemic management and blood lipids?
A Mediterranean eating pattern can improve both glycemic management and blood lipids.
80
Is there an ideal percentage of calories from fat for people with or at risk for diabetes?
No, evidence suggests that there is not an ideal percentage of calories from fat for people with or at risk for diabetes.
81
At what hypoglycemia alert value should patients be treated with pure glucose or carbohydrate-containing foods?
Patients should be treated with pure glucose or carbohydrate-containing foods at a hypoglycemia alert value of <70 mg/dL.
82
Why should the use of carbohydrate sources high in protein be avoided to treat or prevent hypoglycemia?
The potential concurrent rise in endogenous insulin can occur, which is why it should be avoided.
83
What is the potential risk of using carbohydrate sources high in protein to treat or prevent hypoglycemia?
The concurrent rise in endogenous insulin.
84
Does reducing the amount of dietary protein below the recommended daily allowance alter glycemic measures, cardiovascular risk measures, or the rate at which glomerular filtration rate declines?
No, reducing the amount of dietary protein below the recommended daily allowance does not alter glycemic measures, cardiovascular risk measures, or the rate at which glomerular filtration rate declines.
85
According to current evidence, do people with DKD need to restrict protein intake?
No, current evidence does not suggest that people with DKD need to restrict protein to less than the generally recommended protein intake.
86
What does DKD stand for?
DKD stands for Diabetic Kidney Disease.
87
What has some research found about successful management of type 2 diabetes with meal plans including slightly higher levels of protein?
Some research has found that meal plans including slightly higher levels of protein (20–30%) may contribute to increased satiety in the management of type 2 diabetes.
88
What is the recommended protein intake for an individual based on body weight and total calories?
The recommended protein intake is typically 1–1.5 g/kg body wt/day or 15–20% total calories.
89
What should meal planning emphasize for individuals on a fixed daily insulin schedule?
Meal planning should emphasize a relatively fixed carbohydrate consumption pattern with respect to both time and amount while considering insulin action.
90
When should you check glucose after eating to determine if additional insulin adjustments are required?
You should check glucose 3 hours after eating to determine if additional insulin adjustments are required.
91
What type of meals may benefit from using the split bolus feature of an insulin pump?
High-fat and/or high-protein mixed meals may benefit from using the split bolus feature of an insulin pump.
92
What is the recommended approach for increasing insulin doses for high-fat and/or high-protein mixed meals?
A cautious approach is recommended to address delayed hyperglycemia that may occur 3 h or more after eating.
93
When does delayed hyperglycemia after eating may occur for high-fat and/or high-protein mixed meals?
Delayed hyperglycemia may occur 3 hours or more after eating.
94
What do high-fat, high-protein meal studies suggest about insulin?
High-fat, high-protein meal studies suggest the need for additional insulin to cover these meals.
95
How can dietary fat and protein impact postprandial glycemia?
Dietary fat and protein can impact postprandial glycemia, both in the early and delayed phases.
96
How much fiber should people with diabetes consume per 1,000 kcal?
People with diabetes should consume a minimum of 14 g of fiber per 1,000 kcal.
97
What kind of carbohydrate sources should the focus be on?
The focus should be placed on high-quality, nutrient-dense carbohydrate sources that are high in fiber and minimally processed.
98
What were the effects of the ketogenic plan on triglycerides?
The ketogenic plan led to a greater decrease in triglycerides.
higher LDL
99
A low-carbohydrate ketogenic diet and a low-carbohydrate Mediterranean diet.
Metabolic improvements were seen in both diets without significant differences between them.
100
What type of eating patterns were found effective in reducing A1C in the short term?
Carbohydrate-restricted eating patterns, particularly those considered low carbohydrate (<26% total energy).
in 6 months with less difference in eating patterns beyond 1 year
101
What eating patterns have been found to reduce A1C and the need for antihyperglycemic medications in people with type 2 diabetes?
Low-carbohydrate and very-low-carbohydrate eating patterns.
102
Was there a significant difference in weight loss between continuous calorie restriction and the inermitted fasting?
No, there were no significant differences in weight loss when compared with continuous calorie restriction.
103
What is the recommended approach for individualizing meal plans?
The recommended approach is to individualize meal plans with a macronutrient distribution that is more consistent with personal preference and usual intake to increase the likelihood for long-term maintenance.
104
Why is it important to individualize meal plans?
It is important to individualize meal plans to increase the likelihood for long-term maintenance by aligning with personal preference and usual intake.
105
What percentage of total calories do most individuals with diabetes report as their carbohydrate intake?
Most individuals with diabetes report a moderate intake of carbohydrates at 44-46% of total calories.
106
According to the information, what eating pattern is suggested for individuals with type 2 diabetes not meeting glycemic targets?
Reducing overall carbohydrate intake with a low- or very-low-carbohydrate eating pattern.
107
What are some of the structured low-calorie meal plans for dm?
The structured low-calorie meal plans mentioned in the article include meal replacements, a Mediterranean eating pattern and low-carbohydrate meal plans with additional support.
108
What are the benefits of a Mediterranean eating pattern?
The Mediterranean eating pattern has several benefits including promoting heart health, reducing the risk of chronic diseases, and improving overall well-being.
109
What has studies demonstrated about the effectiveness of different eating plans in achieving weight loss in people with diabetes?
Studies have demonstrated that a variety of eating plans, varying in macronutrient composition, can be used effectively and safely in the short term (1–2 years) to achieve weight loss in people with diabetes.
110
What is the impact of weight reduction beyond 10-15% on cardiovascular outcomes?
Weight reduction beyond 10-15% has an impact on cardiovascular outcomes.
111
What percentage of weight loss is needed for beneficial outcomes in individuals with overweight and obesity with type 2 diabetes?
5%
112
What outcomes can be achieved by individuals with overweight and obesity with type 2 diabetes through a 5% weight loss?
Beneficial outcomes in glycemic control, lipids, and blood pressure
113
What is the weight loss goal in prediabetes for preventing progression to type 2 diabetes?
The weight loss goal is 7-10%.
114
What type of eating pattern may improve glucose metabolism and lower cardiovascular disease risk?
An eating plan emphasizing elements of a Mediterranean eating pattern rich in monounsaturated and polyunsaturated fats.
115
What types of foods are recommended to prevent or treat cardiovascular disease?
Foods rich in long-chain n-3 fatty acids, such as fatty fish (EPA and DHA) and nuts and seeds (ALA).
116
What is the recommended approach for improving glucose metabolism and lowering cardiovascular disease risk in terms of dietary fat intake?
Considering an eating plan rich in monounsaturated and polyunsaturated fats, similar to the Mediterranean eating pattern.
117
What is the recommended daily limit for sodium consumption?
The recommended daily limit for sodium consumption is <2,300 mg/day.
118
Should dietary supplementation with vitamins, minerals, herbs, or spices be recommended for glycemic control in people with diabetes?
No, dietary supplementation with vitamins, minerals, herbs, or spices is not generally recommended for glycemic control in people with diabetes who do not have underlying deficiencies.
119
What is the recommended alcohol consumption for adults with diabetes?
Adults with diabetes should drink alcohol in moderation, with no more than one drink per day for adult women and no more than two drinks per day for adult men.
120
What should people with diabetes be educated about regarding drinking alcohol?
People with diabetes should be educated about the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin or insulin secretagogues. The importance of glucose monitoring after drinking alcoholic beverages to reduce hypoglycemia risk should be emphasized.
121
What is the recommended approach when treating or preventing hypoglycemia in individuals with type 2 diabetes?
Carbohydrate sources high in protein should be avoided.
122
What type of eating pattern rich in fats may be considered to improve glucose metabolism and lower cardiovascular disease risk?
An eating plan emphasizing elements of a Mediterranean eating pattern rich in monounsaturated and polyunsaturated fats may be considered.
123
Which types of foods are recommended to prevent or treat cardiovascular disease?
Foods rich in long-chain n-3 fatty acids, such as fatty fish (EPA and DHA) and nuts and seeds (ALA), are recommended.
124
What should carbohydrate intake emphasize and what should it minimize?
Carbohydrate intake should emphasize nutrient-dense carbohydrate sources that are high in fiber and minimally processed. It should minimize consumption of foods with added sugar.
125
What should people with diabetes and those at risk replace sugar-sweetened beverages with?
People with diabetes and those at risk are advised to replace sugar-sweetened beverages with water or low calorie, no calorie beverages as much as possible.
126
How can education on the impact of carbohydrate, fat, and protein optimize mealtime insulin dosing?
Education on the glycemic impact of carbohydrate, fat, and protein can be tailored to an individual's needs and preferences and used to optimize mealtime insulin dosing.
127
Why should individuals with type 2 diabetes avoid carbohydrate sources high in protein when treating or preventing hypoglycemia?
In individuals with type 2 diabetes, ingested protein appears to increase insulin response without increasing plasma glucose concentrations, therefore carbohydrate sources high in protein should be avoided when trying to treat or prevent hypoglycemia.
128
What does the evidence suggest about reducing overall carbohydrate intake for individuals with diabetes?
Reducing overall carbohydrate intake has demonstrated the most evidence for improving glycemia and may be applied to a variety of eating patterns that meet individual needs and preferences.
129
Is there an ideal macronutrient pattern for people with diabetes?
No, there is no ideal macronutrient pattern for people with diabetes; meal plans should be individualized while keeping nutrient quality, total calorie, and metabolic goals in mind.
130
What is recommended for all people with type 1 or type 2 diabetes, prediabetes, and gestational diabetes mellitus?
An individualized medical nutrition therapy program provided by a registered dietitian nutritionist
131
Which macronutrient should be tailored to an individual's needs and preferences to optimize mealtime insulin dosing?
Carbohydrates
132
When should people with diabetes be referred for diabetes-specific MNT?
People with diabetes should be referred for diabetes-specific MNT at diagnosis and as needed throughout the life span.
133
According to the article, when do technology-enabled diabetes self-management solutions improve A1C most effectively?
Technology-enabled diabetes self-management solutions improve A1C most effectively when there is two-way communication between the person with diabetes and the health care team.
134
According to the study, what duration of DSMES interventions led to better outcomes?
DSMES interventions that were more than 10 hours over the course of 6–12 months led to better outcomes.
135
When should the need for DSMES be evaluated?
The need for DSMES should be evaluated at four critical time points: at diagnosis, annually and/or when not meeting treatment targets, when complicating factors develop that influence self-management, and when transitions in life and care occur.
136
What is DSMES?
DSMES stands for Diabetes Self-Management Education and Support.
137
What are effective methods to deliver diabetes self-management education and support?
Digital coaching and digital self-management interventions.
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