Lifestyle Management of a Person w/ DM Flashcards
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
