Physical Activity for Children/Adolescents with Diabetes (1 & 2) & Pre-DM -
ANSWER At least 60 minutes per day of moderate to strenuous aerobic activity.
At least three times a week, engage in intense muscular and bone-strengthening
activities.
Physical Activity for Adults with Diabetes: ANSWER 150 minutes of moderate to
intense aerobic activity weekly (across at least three days).
At most two consecutive days without activities.
75 minutes of strenuous aerobic activity each week (if appropriate).
2-3 weekly resistance workout sessions on nonconsecutive days.
All individuals should reduce sedentary time (interrupt every 30 minutes for BG
benefit).
Flexibility and balance training are recommended 2-3 times per week for older
persons with diabetes.
Potential contraindications for diabetes and exercise: ANSWER Retinopathy (risk
of vitreous haemorrhage or retinal detachment).
Peripheral neuropathy (examine feet and wear protection)
,Autonomic neuropathy (a complete heart evaluation)
Diabetic renal disease (an abrupt rise in urine albumin excretion), although no
special workout limits are required.
DM and Psychosocial Care - ANSWER Should be incorporated patient-centred and
delivered to all those diagnosed.
may include attitudes, expectations about medications and outcomes, affect or
mood, quality of life, financial, social, and emotional resources, and mental history.
Critical periods to examine DSMES - ANSWER 1. At the diagnosis
2. Annually
3. When difficulties develop.
4. When shifts in care occur
Behaviour Management for Diabetics - DSMES
MNT
Physical activity.
Smoking cessation
Psychosocial Care
Pharmacotherapy for type 2 diabetes: ANSWER Metformin first (cheap cost).
Early insulin therapy if there is evidence of catabolism, hyperglycemia, and A1c >
10%.
,SGLT-2 inhibitors or GLP-1 agonists in individuals with CVD, renal disease, or
heart failure.
DPP–4 inhibitors - weight-neutral type II diabetes medicine.
Ends in -gliptin
(Januvia)
Better GI tolerance than Metformin.
Thiazolidinediones are a low-cost type II diabetes medication that might cause
weight gain.
Sulfonylureas (Glyburide, Glipizide, Glimepiride) are low-cost.
Injections that impact POMC neurons and cause satiety
SGLT2 inhibitors: Canagliflozin (Invokana)
Dapagliflozin (Farxiga)
Empagliflozin (Jardiance)
, hinders the reabsorption of glucose and water in the renal tubules.
Assessment of Obesity Management in Type II Diabetes: ANSWER Annual BMI
calculations (more regularly if necessary).
Inpatient evaluation may be required if the deterioration in the medical state is
linked to considerable weight gain or loss (medication use, food consumption,
glycemic status).
For patients with severe weight-related stress, extra measures should be taken to
ensure privacy.
Obesity Management in Type II Diabetes (short-term) - ANSWER Diet, PA, and
BT planned to achieve and sustain >/= 5% weight loss (3-5% is the minimal
benefit).
>/= 16 sessions in six months.
Create a 500-750 kcal deficit (individualized meal planning)
Individual or group situations.
Very low-calorie diets (</= 800 kcal) are administered only to carefully selected
patients.
Obesity Management in Type II Diabetes (Long-Term) - ANSWER For >/= 1-year
weight maintenance:
- Minimum monthly contact
- 200-300 minutes per week of physical activity.
-self-monitoring
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