Foundationas of Care: Education, Nutrition, Physical Activity, Smoking Cessation, Psychosocial Care, and Immunizations

Question 1

When should patients receive diabetes self-management education (DSME) and diabetes self-management support (DSMS)?

Answer 1

• When their diabetes is diagnosed

- As needed thereafter

Question 2

What are the key outcomes of DSME and DSMS?

Answer 2

• Effective self-management

- Quality of life

Question 3

Goal physical activity for children with diabetes or prediabetes

Answer 3

At least 60 minutes each day

Question 4

Goal physical activity duration for adults with diabetes

Answer 4

• At least 150 min/week of moderate-intensity aerobic physical activity (50 - 70% of maximum heart rate)
• Spread over at least 3 days/week with no more than 2 consecutive days without exercise
• Also recommend reducing sedentary time, particularly by breaking up extended amounts of time sitting (>90 minutes)
• Encourage resistance training at least twice per week (unless contraindicated)

Question 5

When should a hyperglycemic patient avoid exercise?

Answer 5

• Exercise should be avoided during ketosis (blood or urine)

Question 6

Patients with diabetes are at high risk of depression. Which subgroup is considered a high priority population for depression screening and treatment?

Answer 6

Older adults (>= 65 years)

Question 7

What percentage of patients with diabetes are affected by depression?

Answer 7

About 20 -25% of people with diabetes which also increases their risk of MI and all-cause mortality

Question 8

Diabetes-related distress is clinically distinct from depression but hard to define. What is it? How many patients are affected? What is the impact?

Answer 8

• Condition characterized by worry, frustration, concern, and burnout.
• During any 18 month span, 38 - 48% of patients will experience diabetes-related distress
• High levels of distress are related to A1C, self-efficacy, dietary and exercise behaviors, and medication adherence