Medical Nutrition Therapy in Diabetes Mellitus Flashcards
What is diabetes self-management?
recognizing that people are responsible for the day-to-day decision that influence their disease, supporting behaviors that promote effective self-management
effective management requires proper use of multiple technologies, complex treatment strategies and problem-solving skills
important to deliver education and training at to patients that are prepared and competent
What are the 5 steps in diabetes self management?
assessment, goal setting, planning, implementation and evaluation
Lifestyle optimization requires DSME/T in these self-care behaviors.
healthy eating being active monitoring (blood glucose) taking medication problem solving healthy coping reducing risks
Define medical nutrition therapy.
MNT is healthy eating education performed by a registered dietitian
Lifestyle optimization requires DSME/T in these self-care behaviors.
healthy eating being active monitoring (blood glucose) taking medication problem solving healthy coping reducing risks
note diabetes self management training usually occurs in group setting (up to 10h in the first year and additional 2 hrs in subsequent years)
Define medical nutrition therapy.
MNT is healthy eating education performed by a registered dietitian (focusing on assessment, goals, intervention and evaluation)
MNT is most effected at the time of diagnosis, 1% decrease in newly diagnosed DM1 and 2% in DM3; blood lipid concentrations and blood pressure decreases also observed
How do patients get access to MNT consoling?
consists of a series of 3-4 encounters with a RD for 45-90 min beginning with a referral at diagnosis (completed within 3-6mo
at least 1 followup encounter is recommended annually to reinforce lifestyle changes and evaluate/monitor outomes
payment: a glucose of >125 on 2 tests permits 3 h in first year, 2h follow-up in subsequent years (requires MD referral each calendar year
Name 4 behaviors associated with improved glycemic control by the DCCT.
adherence to a meal plan
consistent snacking behaviors
appropriate treatment of hypoglycemia
prompt response to hyperglycemia
Name 4 behaviors associated with improved glycemic control by the DCCT.
adherence to a meal plan
consistent snacking behaviors
appropriate treatment of hypoglycemia
prompt response to hyperglycemia
What are the tenets of healthy eating?
promotes energy balance,
limits saturated and transfat intake,
encourages consistent carbohydrate intake,
controls sodium intake and
meets dietary reference for intake of micronutrients
What are the tenets of healthy eating?
promotes energy balance,
limits saturated and transfat intake,
encourages consistent carbohydrate intake,
controls sodium intake and
meets dietary reference for intake of micronutrients
What degree of modest weight loss has been shown to prevent the progression from pre-diabetes to type 2 diabetes?
losses of 5-10%, reductions in visceral and subcutaneous adipose tissue,
** leads to fewer free fatty acids interfering with hepatic glucose production and production of fewer pro-inflammatory chemicals
What is important to consider about the quality of carbohydrates consumed by diabetics?
simple carbs usually cause more rapid blood sugar increase
unrefined carbs usually contain more nutrients
recommended 50% calories (same as all people) for diabetics, carbs do not need to be eliminated or severely limited
What does glycemic index tell you about a food?
glycemic index is the effect on raising blood sugar that is measured for a given carb dose after a 12h fast
high glycemic index foods are 70 or greater, low 55 or less
What is important to consider about the quality of carbohydrates consumed by diabetics?
simple carbs usually cause more rapid blood sugar increase
unrefined carbs usually contain more nutrients
recommended 50% calories (same as all people) for diabetics, carbs do not need to be eliminated or severely limited
44-50g of fiber daily is shown to improve glycemia, soluble fiber has a stronger influence on glycemic control (increases viscosity, slows digestion)
natural and added sugars are safe but should be monitored (less than 24g for women and less than 36 for men)
