Nutrition

  By admin | November 3, 2011 - 12:34 pm | Type 1 diabetes
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The American Dietetic Association recommends a diet that emphasizes fruits, vegetables, whole grains, and fat free milk. This diet includes lean meats, poultry, fish, beans, eggs, and nuts. It is low in saturated fats, trans fats, cholesterol, salt, and added sugars. There is no perfect diet for everyone and diet should be individualized for each person based on age, activity, and preferences. My Pyramid can be found on the American Dietetic Association’s website and the patient can input his or her own information and receive recommendations for dietary consumption. Carbohydrate counting is generally accepted as the “state of the art” in diabetes management. Every patient with diabetes should be taught carbohydrate … Continue reading →

Exercise

  By admin | November 3, 2011 - 12:32 pm | Type 1 diabetes
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Exercise is an essential part of any plan of care. It should be emphasized to all patients with diabetes that this is as important as the other aspects of care. It is something that is generally overlooked and not discussed in a busy office visit, but patients need to understand the importance of this aspect of diabetes management. Patients often have a misconstrued idea of what exercise is. They can incorporate exercise into their daily life. It does not mean they need to join a gym or jog every day, though this would be good. They can take the stairs instead of the elevator, park far away from the store or … Continue reading →

Travel

  By admin | November 3, 2011 - 12:31 pm | Type 1 diabetes
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Traveling with diabetes is always an adventure. Many people have a job that requires travel and many others travel for pleasure. If a patient is traveling on an airplane, he or she needs to do the following according to the American Diabetes Association and the Transportation Security Administration: Notify the screener that you have diabetes and are carrying your supplies with you. Please note that while Transportation Security Administration is not currently requiring a prescription label, it recommends having the label available to identify the medication in order to expedite the security checkpoint screening process. The following diabetes-related supplies and equipment are allowed through the checkpoint once they have been screened: … Continue reading →

Planning for Sick Days, Surgery, and Travel

  By admin | June 22, 2011 - 10:52 am | Diabetes and Lifestyle
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Diabetes control can be adversely affected by stressful situations related to physical or emotional distress. Health care providers must be able to advise patients with diabetes who become ill with infections, injuries, or other ailments that complicate their diabetes management routine and cause hyperglycemia. Definition of a sick day: A sick day could be caused by a variety of situations, from a common cold to a broken bone to a death in the family. If the patient is thrown off of his/her usual diabetes management routine, or experiences persistent hyperglycemia despite self-management techniques that usually maintain glucose control, he or she is having a sick day. Risks associated with concurrent illness … Continue reading →

Patient recommendations for the perioperative period

  By admin | June 22, 2011 - 10:51 am | Diabetes and Lifestyle
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Ideally, a patient with diabetes who is scheduled for surgery should discuss their perioperative management with the diabetes care provider prior to the surgical preparation. Often, patients receive insufficient or inaccurate recommendations from the anesthesia and/or operative team. Many times older patients with type 1 diabetes are assumed to have type 2, and are thought to be safe temporarily without basal insulin. Iatrogenic diabetic ketoacidosis is fairly common due to omission of insulin during the perioperative period. In contrast, if hospital professionals have a poor understanding of the differences in insulin requirements between insulin-resistant patients with type 2 diabetes (very large doses) and insulin-sensitive type 1 patients (sometimes very small doses), … Continue reading →

Patient guide to sick day management

  By admin | June 22, 2011 - 10:47 am | Diabetes and Lifestyle
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Type 1 Diabetes What is a sick day? Any day that you are not feeling well, having trouble eating your usual meals, or are experiencing a medical procedure or extreme emotional upset. Why are sick days important? Diabetes is affected not only by what you eat and the insulin you take, but also by other hormones in the body. Hormones that work against insulin usually increase during illness or stress, causing the insulin you take to work less effectively. This is why illness and stress cause the blood sugar to rise. Diabetic ketoacidosis is a severe, life-threatening complication of diabetes that commonly occurs during illness or severe stress. This develops due … Continue reading →

Nutritional Therapy for Diabetes in Older Patients

  By admin | June 22, 2011 - 10:19 am | Diabetes in Elderly
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Impaired glucose tolerance is associated with advanced age and nearly half of the individuals with type 2 diabetes are over age 60. However, only about 10% of the variability of a response to an oral glucose load can be attributed to age; alterations in glucose tolerance are also affected by activity level and diet. Although type 2 diabetes is the prevalent type of diabetes seen in older adults, some elderly individuals do become insulin dependent and must be carefully monitored. Diabetes contributes to a variety of complications that affect nearly all organ systems; vascular compromise is one of the primary etiologies of diabetes-associated conditions. Micro-vascular pathology contributes to cardiovascular disease, blindness, … Continue reading →

Diabetes in older adults age-related risk factors

  By admin | June 22, 2011 - 10:18 am | Diabetes in Elderly
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Aging is associated with changes in body composition that include loss of lean body mass, reduced total body water, decreased bone mass, and increased relative or actual fat mass. Not only is abdominal fat linked to insulin resistance but also visceral fat, which accumulates with advancing age. Metabolism is altered due to the decrease in lean body mass and associated reduction of the total body protein pool. For many years, age was considered a significant factor in glucose intolerance; however, the fasting blood glucose thresholds for diabetes in older adults was lowered and a greater number of older adults were diagnosed as diabetics. Early prevention with continued interventions makes common sense … Continue reading →

Weight loss and diabetes management

  By admin | June 22, 2011 - 10:17 am | Diabetes in Elderly
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Control of body weight and blood glucose may be associated with a lower risk of late-life dementia. Weight loss in older adults is surprisingly controversial; there is no strong indication that obesity in adults over 70 years contributes to increased mortality. There is a theory that excess weight may provide available energy or nutritional reserve during periods of stress and illness. However, control of blood glucose levels is easier if weight is maintained or a rational weight loss is supported by a plan that the individual can manage without confusion, stress, or major lifestyle changes. Weight loss should be gradual, using a nutritionally complete dietary regimen that includes all essential nutrients … Continue reading →

Weight-loss options for older adults

  By admin | June 22, 2011 - 10:16 am | Diabetes in Elderly
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Weight-loss attempts in overweight and obese people are often frustrating, difficult to manage, and unsuccessful. Regardless of sound advice from nutrition professionals, every new diet becomes the faddish thing to try. Weight loss is a big business in the United States with a few, new, quick weight-loss regimens promoted every year. Although some of these fad diets lead to rapid weight loss, they may be based on poor science and may cause health problems over time. The greatest problem is recidivism — weight lost and regained — because a limited diet is unsustainable over long periods. Some of the weight-loss diets may lack essential nutrients and require dietary supplements to provide … Continue reading →