Endocrine: DM Nutrition Tx

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Author:
jcbarbery
ID:
212297
Filename:
Endocrine: DM Nutrition Tx
Updated:
2013-04-08 22:41:45
Tags:
DM diabetes endocrine nutrition
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Description:
General concepts in the nutritional support and therapy of patients with diabetes mellitus
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  1. Goals of Tx
    • Achieve and maintain      
    •      Normal glucose
    •      Goal cholesterol
    •      Goal BP

    Prevent complications (or progression thereof)

    Allow pts freedom and knowledge to make choices good rather than live w/anxiety
  2. Effectiveness of Tx
    • A1c reductions
    •      Type 1 ~ 1%
    •      Type 2 1-2%
    •    
    • LDL dec 15-25 mg/dL
    • BP dec 5-20 mmHg/10 kg lost

    Make individualized recommendations

    • Must consider
    •      Personal needs
    •      Willingness to change
    •      Ability to change
  3. Weight loss meds
    • BMI > 27
    •        
    • 5-10% reduction in weight

    Effective if properly counseled on use
  4. Surgery
    Bariatric surgery for BMI >/= 35

    Curative?
  5. Biometrics
    • BMI
    • IBW
    • waist circumference
  6. Weight Loss
    5-10%/yr

    ~1-2 lbs/wk

    5-10 lb loss assoc. w/ imp. A1c, Glu, lipids, BP
  7. 1 Carb Serving...
    15g

    • 1 slice bread
    • 1/3 cup pasta or rice
    • ¾ cup dry cereal
    • 4-6 crackers
    • ¼ large baked potato
    • 1 small fresh fruit
    • ½ cup juice
    • 1 cup fat-free or reduced fat milk
    • 6 oz cup yogurt (nonnutritive sweetener)
    • 2 small cookies
    • 1 Tb jam, honey, syrup
    • ½ cup ice cream or frozen yogurt
    • 2” square cake or brownie
  8. Carbs
    Encourage dec intake

    Encourage high fiber sources (cereal, fruit, veg)

    Avoid low nutrient sources (sweets, bread, potatoes, corn)
  9. Veggies
    • @ least 3-5 servings/day
    •      1 cup raw
    •     1/2 cup cooked
  10. Fruit
    • 2-4 servings/day; be conservative (maybe 1-2)
    •      ½ cup canned fruit
    •      1 small fresh fruit   
    •      2 tbs dried fruit   
    •      1 cup of melon or raspberries
    •      1 ¼ cup of whole strawberries
  11. Protein
    4-6 oz/day

    • Equal to 1 oz of meat:
    •      ¼ cup cottage cheese
    •      1 egg    
    •      1 Tbsp peanut butter
    •      ½ cup tofu

    Good: Chicken, Turkey, Fish

    Not so good: Beef, Pork
  12. Exercise
    • Ult goal = 300 min/wk (60m x 5d) for wght loss
    •      150 min/wk (30m x 5d) for wght maintenance

    Focus on developing the habit at first

    Start w/ what pt can/feels able to do

    Time/intensity will come
  13. Hypoglycemia Mgmnt
    • 15-20g Glucose
    •      1 tablespoon of honey
    •      3 BD Glucose Tablets
    •      3 Smartie® Rolls (in cellophane)
    •      4 CanAm Dex4® Glucose Tablets
    •      5 Dextrosols Glucose Tablets
    •      5 Wacky Wafers®
    •      6 SweetTart® (3 tabs/packet)
    •      7 Pixy Stix

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