Dm part 2

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Author:
Prittyrick
ID:
312025
Filename:
Dm part 2
Updated:
2015-11-24 21:53:16
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dm
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dm
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  1. Nutrition
    • behavioral, cognitive, socioeconomic, cultural, religious considerations
    • ADA- healthy eating plan
    • - maintain total calories within limits
    • - portion control
    • - healthy body weight
    • - control blood glucose
    • - maintain lipids and BP wnl
  2. Nutrition
    type 1
    • balance of food choices, insulin and exerise
    • plan with insulin to maximize glucose
    • minimize hypoglycemia
    • manage glu, keep wnl, prevent hypo
  3. nutrition type 2
    • wt loss
    • reduced fats and simple sugars- dec calories
    • combine with exercise
    • 50-70% of total body weight will help to control glucose
  4. nutrition
    meal planning
    • starts with thorough review of diet history
    • - preferences, lifestyle
    • - need for weight loss or gain
    • consistency, esp type 2 unless counting cho
    • - meals and snacks, esp type 1
    • goal to avoid sharp changes in glucose after eating
    • create a balance
  5. nutrition
    CHO 50-60%
    • 3 types:
    • - starches (complex carbs)- some veggies, dried beans, lentils, grains
    • - sugars (simple carbs)- fast acting
    • - fibers- plant foods
    • whole grain best
    • concentrated sweets- 10%
    • easily digested converts into glucose easily
  6. nutrition
    fats and proteins
    • fats 20-30%
    • - saturated fats- 10% (animal products)
    • Protein- 10-20%- animal and non animal like legumes, nuts
    • fiber- incr (at least 25G) may improve glu levels, and dec chol and LDL
    • - soluble
    • - insoluble
  7. nutrition
    things to help guide pt
    • strategies to help pts follow nutrition guidelines
    • exchange list- foods similar group together- gives pts a general idea for interchanges
    • nutrition labels- make sure they understand how to read lables
    • education on portion size
  8. look at power pt for exchange list
  9. create your plate
    • ADA
    • portion sizes and healthy choices
    • fill plate with non starchy veggies and small portions of starchy foods and meat
  10. CHO and insulin
    • CHO counting- insulin amounts pre meal based on CHO intake (ie 1U per 15G)
    • - 'CHO budget' target per a meal
    • - may increase flexibility
    • - type 1 and type 2
  11. plate
    • largest section- non starchy veggies half cooked and uncooked
    • one quadrant- starch- cereal, rice, grains, cooked beans
    • other quadrant- meat in other section- size of your fist
    • fruit, milk and water
    • fats oils and sweets- very little- if you eliminate it u tend to want this
    • you will get a question in regards to meal planning for DM
    • know this, look at some options
  12. Nutrition glycemic index
    other than meal plate
    • amt of food increases blood glu compared to an equal amount of glucose
    • combine starchy foods with proteins and fats
    • raw, uncut foods lower glycemic index than cooked or chopped pureed
    • whole fruits lower index than juices
  13. Nutrition other
    • alcohol- bc of fat converts into fat..may not have enough insulin to convert fat so---
    • - hypoglycemia
    • - DKA- ketone acidosis
    • Sweetners
    • - moderation
  14. exercise
    • lowers blood glucose
    • decre CV risk
    • plan at peak of glucose level- to prevent hypoglycemia
    • stay consistent-  start slow- go slow
    • moderate intensity 30 mins x 5 day- same time each day
    • - remember incr risk for MI, stroke
    • consider overall health
  15. exercise 2
    five things it does
    • incre glucose uptake in cell
    • improves insulin use- more efficient
    • helps with wt loss- type 2
    • improves chol
    • increase insulin sensitivity- esp with type 2
  16. types of exercise
    • examples of moderate exercise
    • - active housework
    • - walking briskly
    • - roller skating
    • golf
    • - dancing
    • - bicycling
    • good foot wear bc of neuropathy
  17. exercise
    hyperglycemia v hypoglycemia
    • Hyperglycemia
    • - avoid if glu > 250 or ketones in the urine
    • - incre secretion of glucagon, GH and catecholamines (stress- stimulates SNS)-  all incr glu
    • Hypoglycemia
    • - type 1- cho snack before and after- about 15g of carbs (effects can occur 48hrs after exercise so u need to eat after)
    • - hypoglycemic after exercise

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