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Self-management diabetes education (Physical Activity (Children and…
Self-management diabetes education
Nutrition Therapy
Individualized
Collaborative developed eating plan with input from the patient
All patients sshould be referred for individualised nutrition therapy
Limit salt
Limit saturated fats
Add unsaturated fats
unsaturated fats lead to better glycaemic control (but not supplements, whole food)
Moderate alchohol
females one glass of alchohol and males 2 glasses per day
Moderate sugar/honey intake or sweetners
Sweetners not associated with better glycemic control but associated with weight loss.
Micro nutrients and supplements is of no benefit
Metformin is associated with Vit B12 deficiency
Should be tested in pts with anaemia and peripheral neuropathy
Diet should be according to the diabetic diet food plate chart small plate half low calorie vegetable (non starchy) quater starch and quater proteien
Psychological factors
Questions
Has there been any changes in the mood in the last two weeks or since the last visit?
Are there new or different barriers to treatment and self management
Overwhelmed or stressed by diabetes or other life stressors.
Routinely monitor people with diabetes for diabetes distress, particularly when treatment targets are not met and at the onset of diabetes complications.
Education should be given if DD is suspected. and referral
Physical Activity
Children and adolescents with type 1 or type 2 diabetes or predi- abetes should engage in 60min/day or more of moderate- or vigorous- intensity aerobic activity, with vig- orous muscle-strengthening and bone-strengthening activities at least 3 days/week
Most adults with type 1 C and type 2 B diabetes should engage in 150 min or more of moderate-to- vigorous intensity aerobic activity per week, spread over at least 3 days/week, with no more than 2 consecutive days without activity. Shorter durations (minimum75min/ week) of vigorous-intensity or inter- val training may be sufficient for younger and more physically fit individuals.
Adults with type 1 C and type 2 B diabetes should engage in 2–3 sessions/week of resistance exer- cise on nonconsecutive days.
c
All adults, and particularly those with type 2 diabetes, should de- crease the amount of time spent in daily sedentary behavior. B Pro- longed sitting should be interrupted every 30min for blood glucose ben- efits, particularly in adults with type 2 diabetes. C
c
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 prefer- ences to increase flexibility, muscu- lar strength, and balance. C
Physical
Smoking
Stop smoking
The initial weight gain after stop smoking is far less of a problem than the damage that the smoking does on the arteries etc.