Professional.diabetes.org/soc
Process ADA’s Professional Practice Committee (PPC) conducts annual review & revision. Recommendations revised per new evidence, for clarity, or to better match text to strength of evidence. Professional.diabetes.org/SOC Clinical Practice Recommendations Evidence Grading System American Diabetes Association Standards of Medical Care in Diabetes. Introduction. Diabetes Care 2016; 39 (Suppl. 1): S1-S2 A Clear evidence from adequately-powered, well-conducted, generalizable RCTs, including evidence from a multicenter trial or meta-analysis that incorporated quality ratings in the analysis; Compelling nonexperimental evidence; Supportive evidence from adequately-powered, well-conducted RCTs. B Supportive evidence from a well-conducted cohort studies Supportive evidence from a well-conducted case-control study C Supportive evidence from poorly controlled or uncontrolled studies or evidence from observational studies with high potential for bias Evidence from case series or case reports Conflicting evidence with the weight of evidence supporting the recommendation E Expert consensus or clinical experience 4 Reference American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care 2014;37(suppl 1):S15; Table 1 Higher level recommendations defined as A or B evidence grades Lower level recommendations defined as C or E evidence grades Trends in the Number and Proportion of Higher and Lower Level Recommendations Grant R W , and Kirkman M S Dia Care 2015;38:6-8 Trend from 2005 to 2014 in number and proportion of recommendations (Recs) made each year in the ADA Standards of Care that were based on higher-level evidence vs. lower-level evidence. Reference: Grant RW, Kirkman MS. Trends in the Evidence Level for the ADA Standards of Medical Care i Continue reading >>
Medical Nutrition Therapy For Diabetes Mellitus, 7th Edition Cpe Course
This comprehensive, up-to-date manual has been written by one of the most renowned diabetes educators in the country. You will learn how you can have a major impact on medical and clinical outcomes and help patients with diabetes achieve dramatic improvements in the quality of life. You will discover how to: apply strategies for attaining and maintaining blood glucose control in type 1 diabetes implement strategies to achieve nutrition goals for persons with type 2 diabetes recommend guidelines for carbohydrate in diabetes meal planning identify long-term complications of diabetes specify guidelines for fat in diabetes meal planning recognize five stages of intentional behavior change as outlined by the transtheoretical model of change provide follow-up and ongoing nutrition care for people with diabetes Medical Nutrition Therapy for Diabetes Mellitus, 7th Edition Copyright 2014 Wolf Rinke Associates, Inc. All rights reserved for this self-directed, accredited learning program. Reproduction in whole or part without written permission from the publisher is prohibited. Cynthia Jones: "In comparison to other courses I've completed, this one is more precise and provided all the information and up-to-date recommendations for preparing me for the CDE exam. Thank you!" Lori Johnson: "I loved the case studies in the book. I am very familiar with the author, Marion Franz, and I respect her knowledge and enjoy learning from her." Joan Panepinto: "I appreciated how this author utilized the most current recommendations for diagnosis, treatment and explained Nutrition Care Process. A thorough overview of diabetes which would be helpful for any dietitian or student of dietetics! Thank-you." Sharon Specht: "The information was up-to-date and will enhanc my skills as a clinical dietit Continue reading >>
Rebecca Pratt Gregory, Ms, Rd, Cde And Kerri Cavanaugh, Md, Mhs
Rebecca Pratt Gregory, MS, RD, CDE and Kerri Cavanaugh, MD, MHS Addressing The Role of Nutrition Education and Health Literacy in Diabetes Care * Learning Objectives Review of impact of CDEs and medical nutrition therapy (MNT) on diabetes outcomes Review health literacy & numeracy in diabetes self-care Describe design of new randomized controlled trial to: Examine the value of CDE in diabetes care Examine the role of different approaches to MNT Learn about study results, interpretation and applications to clinical practice * Role of CDEs in Medical Nutrition Therapy in Diabetes Care Diabetes self-management education (DSME) can improve patient knowledge, behavior, and glycemic control Medical Nutrition Therapy is an essential part of DSME Addressing carbohydrates as a nutritional strategy is endorsed by the ADA and the AADE Clinical trials have shown that MNT can improve A1C by 1-2% No studies have compared carbohydrate counting and plate method Facilitating positive behavior as well as transferring knowledge is a priority, but little research in this area exists * Summary of previous literature (bullets) about CDEs (i.e. why do we need to do this study – don’t all already think CDEs are worthwhile??!!) Components of Literacy IOM, Health Literacy, 2004 Defining Health Literacy “…ability to read, write, and speak in English, and compute and solve problems at levels of proficiency necessary to function on the job and in society, to achieve one’s goals, and develop ones knowledge and potential†“ The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.†***Highlight the functional aspects of ‘health literacyâ� Continue reading >>
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Medical Nutrition Therapy For Diabetes Ppt - Medicclub.info
Ppt Medical-nutrition-therapy-diabetes | Powerpoint Presentations and Slides View and Download Introduction to Medical Nutrition Therapy - CSU, Chico PPT Presentation Summary : Introduction to Medical Nutrition Therapy NFSC 470 Nutrition Care Process Process of planning for and meeting MNT needs of the individual Assessing nutrition status ... Source : MNT Strategies in Type 2 Diabetes - University of Akron PPT Presentation Summary : MNT in Diabetes and Related Disorders Expected Outcomes of MNT in Diabetes of 1% of A1C in patients with newly diagnosed Type 1 diabetes of about 2% of A1C in ... Source : Diabetes Mellitus . ppt - Central Washington University PPT Presentation Summary : Diabetes Diabetes Mellitus Disease in which the body doesnt produce or properly use insulin, leading to hyperglycemia. Carbohydrate Digestion Insulin Secretion ... Source : Diabetes Mellitus - Home | University of Pittsburgh PPT Presentation Summary : The annual health costs caused by diabetes and its ... appropriate nutrition. Dietary treatment ... 7_Concourse Diabetes Mellitus What is diabetes? Source : Presentation Summary : Identify the importance and the role of medical nutrition therapy in diabetes ... Adjunct treatment for Type 2 diabetes who have failed to achieve glucose ... Source : Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... PPT Presentation Summary : Cardiovascular Disease and the Patient with Diabetes and Metabolic Syndrome Nathan D. Wong, PhD, FACC, FAHA Professor and Director Heart Disease Prevention Program Source : Chronic Kidney Disease (CKD) - Elizabeth Leen PPT Presentation Summary : Diabetic Kidney Disease. Changes in nephrons due to high levels of blood glucose from uncontrolled DM. ... Medical Nutrition Treatment. Nutrition Therapy: 35 kcal/kg. Sourc Continue reading >>
Nutritional Management Of Type 1 Diabetes
2. General principles of Medical Nutrition Therapy (MNT) in type 1 diabetes MNT is an integral component of diabetes management and diabetes self-management education. Nutrition advice should be tailored for people with T1DM based on age, medical, lifestyle, and personal factors, taking into account associated diabetes complications and other concomitant conditions for every individual. Consideration should also be given to an individual's culture and beliefs, eating patterns, and food availability [2]. The following aspects should be highly considered: The nutrition prescription: ABC Optimally manage the "ABCs" of diabetes control: Maintain blood glucose (BG) concentrations in as physiologically a normal range as possible, by coordinating diet and physical activity patterns and insulin therapy. Manage weight appropriately by providing adequate calories, thus also ensuring normal growth and development for children and adolescents with T1DM both physically and emotionally. Manage risk factors and prevent complications of diabetes. Current nutrition recommendations for children and adolescents with diabetes mellitus are rooted in the same principles as those established for all healthy children and adolescents without diabetes. Individualized meal plans should emphasize a wide variety of healthy food choices to meet the recommended nutrient intakes for essential vitamins and minerals, energy, and fiber and to provide for normal growth and development [4]. The patient should be advised of the following: Glycemic targets in people with diabetes are as follows: MNT for type 1diabetes should consider five key aspects: Continue reading >>
- Reversing Type 2 Diabetes with Nutritional Ketosis
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
Guideline Summary: Gestational Diabetes Mellitus Evidence-based Nutrition Practice Guideline. [academy Of Nutrition And Dietetics]
Eating environment and meals eaten away from home Diet history and behavior: previous diets and diet adherence, disordered eating Factors affecting access to food: psychosocial/economic issues (e.g., social support) impacting nutrition therapy Pharmacologic therapy (including insulin or oral glucose-lowering agent) Substance use: alcohol, tobacco, caffeine, recreational drugs Use of dietary supplements, prenatal vitamins, over-the-counter medications, complementary and/or herbal Knowledge, beliefs or attitudes: motivation, readiness to change, self-efficacy; willingness and ability to make lifestyle changes Physical activity and function: exercise patterns, functionality for activities of daily living, sleep patterns Assessment of these factors is needed to effectively determine nutrition diagnoses and formulate a nutrition care plan. Inability to achieve optimal nutrient intake may contribute to poor outcomes. GDM: Assessment of Anthropometric Measurement of Women with GDM The RDN should assess the following anthropometric measurements in women with GDM, including but not limited to: Height, current weight, pre-pregnancy weight and body mass index (BMI) Assessment of these factors is needed to effectively determine nutrition diagnoses and formulate a nutrition care plan. GDM: Assessment of Biochemical Data, Medical Tests, and Procedures of Women with GDM The RDN should evaluate available data of women with GDM and recommend as indicated: biochemical data, medical tests and procedures including, but not limited to: Glycemic tests: glucose challenge test (GCT), oral glucose tolerance test (OGTT), glycosylated hemoglobin (A1C), fasting glucose, random glucose Use of self-monitoring blood glucose (SMBG) meters and urinary ketones, if recommended Maternal and fetal testing Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Role of Medical Nutrition Therapy in the Management of Gestational Diabetes Mellitus
- A Summary of ADA’s New 2018 Standards of Medical Care in Diabetes
Chapter 33 Medical Nutrition Therapy For Diabetes Mellitus And Hypoglycemia Of Nondiabetic Origin.
Chapter 33 Medical Nutrition Therapy for Diabetes Mellitus and Hypoglycemia of Nondiabetic Origin. Published by Lilian Cross Modified over 2 years ago Presentation on theme: "Chapter 33 Medical Nutrition Therapy for Diabetes Mellitus and Hypoglycemia of Nondiabetic Origin." Presentation transcript: 1 Chapter 33 Medical Nutrition Therapy for Diabetes Mellitus and Hypoglycemia of Nondiabetic Origin A group of diseases characterized by high blood glucose concentrations resulting from defects in insulin secretion, insulin action, or both Type 1 (formerly IDDM, type I) Type 2 (formerly NIDDM, type II) Gestational diabetes mellitus (GDM) Prediabetes (impaired glucose homeostasis) Other specific types Immune mediatedbeta cells destroyed by autoimmune process Idiopathiccause of beta cell function loss unknown 5 Diabetes Type 2 Most common form of diabetes accounting for 90% to 95% of diagnosed cases Combination of insulin resistance and beta cell failure (insulin deficiency) Progressive disease 6 Prediabetes (Impaired Glucose Homeostasis) Two forms Impaired fasting glucose (IFG) fasting plasma glucose(FPG) above normal Impaired glucose tolerance (IGT) plasma glucose elevated after 75 g glucose load Glucose intolerance with onset or first recognition during pregnancy 8 DiabetesSymptoms General Hyperglycemia Glycosuria Polyuria Polydipsia Dehydration Type 1 Ketonuria Acetone breath Acidosis Weight loss Polyphagia 9 Type 1 DiabetesCause Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000. Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000. 11 Type 1 DiabetesMedical and Nutritional Management Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, Updated by Marion J. Franz, 2002. 12 Metabolic Continue reading >>
Diabetes Management Guidelines
Source: American Diabetes Association. Standards of medical care in diabetes—2016. Diabetes Care. 2016;39(suppl 1):S1-S106. Available here. Refer to source document for full recommendations, including class of recommendation and level of evidence. Jump to a topic or click back/next at the bottom of each page Lifestyle Changes Medical Nutrition Therapy (MNT) The ADA acknowledges that there is no one-size-fits-all eating pattern for individuals with type 2 diabetes. MNT is recommended for all individuals with type 1 and type 2 diabetes as part of an overall treatment plan, preferably provided by a registered dietitian skilled in diabetes MNT Goals of MNT: A healthful eating pattern to improve overall health, specifically: Achievement and maintenance of weight goals Attainment of individualized glycemic, blood pressure, and lipid goals Type 2 diabetes prevention or delay Attain individualized glycemic, blood pressure, and lipid goals Achieve and maintain body weight goals Delay or prevent diabetes complications Nutrition guidelines from the ADA are available. Click here for summary recommendations on coordinating foods with diabetes medications, eating patterns, and more. Physical Activity Adults with diabetes Exercise programs should include ≥150 min/wk moderate-intensity aerobic activity (50%-70% max heart rate), spread over ≥3 days/wk with no more than 2 consecutive days without exercise Resistance training ≥2 times/wk (in absence of contraindications)* Reduce sedentary time = break up >90 minutes spent sitting Evaluate patients for contraindications prohibiting certain types of exercise before recommending exercise program† Consider age and previous level of physical activity Children with diabetes, prediabetes ≥60 min physical activity/day *Adults with typ Continue reading >>
Diabetic Diet
A diabetic diet is a dietary pattern that is used by people with diabetes mellitus or high blood glucose to manage diabetes. There is no single dietary pattern that is best for all people with all types of diabetes. For overweight and obese people with Type 2 diabetes, any weight-loss diet that the person will adhere to and achieve weight loss on is effective.[1][2] Since carbohydrate is the macronutrient that raises blood glucose levels most significantly, the greatest debate is regarding how low in carbohydrates the diet should be. This is because although lowering carbohydrate intake will lead to reduced blood glucose levels, this conflicts with the traditional establishment view that carbohydrates should be the main source of calories. Recommendations of the fraction of total calories to be obtained from carbohydrate are generally in the range of 20% to 45%,[3][4][5] but recommendations can vary as widely as from 16% to 75%.[6] The most agreed-upon recommendation is for the diet to be low in sugar and refined carbohydrates, while relatively high in dietary fiber, especially soluble fiber. People with diabetes are also encouraged to eat small frequent meals a day. Likewise, people with diabetes may be encouraged to reduce their intake of carbohydrates that have a high glycemic index (GI), although this is also controversial.[7] (In cases of hypoglycemia, they are advised to have food or drink that can raise blood glucose quickly, such as a sugary sports drink, followed by a long-acting carbohydrate (such as rye bread) to prevent risk of further hypoglycemia.) Others question the usefulness of the glycemic index and recommend high-GI foods like potatoes and rice. It has been claimed that oleic acid has a slight advantage over linoleic acid in reducing plasma glucose.[ Continue reading >>
Eal
Disclosures of Potential Conflict of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. Workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers. Carolyn Leontos - received honorariums from Takeda, Roche Diagnostics, Aventis, Novartis, shareholder in Johnson and Johnson and Abbott Laboratories, Inc. stock. Marion Franz - employed with Nutrition Concept by Franz, Inc., consulted for General Mills, Nestle; has receive honorariums from General Mills, Nestle and Kraft.. Karmeen Kulkarni - employed by Abbott Diabetes Care. The following resources were developed for this project: Diabetes Mellitus Toolkit - This toolkit is designed to assist the registered dietitian in applying the Academy's Diabetes Type 1 and 2 Evidence-Based Nutrition Practice Guidelines. The toolkit includes material such as interactive sample documentation forms, encounter process instructions, case study, and outcomes monitoring forms. It also incorporates the Academy's Nutrition Care Process and Standardized Language for patient/client care. Click to purchase . Diabetes Guideline Presentation - This 56-slide MS PowerPoint presentation includes all recommendations and ratings of the Diabetes Evidence-Based Nutrition Practice Guideline (2008). Ideal for use for meetings, in-service presentations and classes (not designed for the consumer). Click to purchase . Diabetes Type 2 - Tips on How to Live Healthy with Diabetes - this brochur Continue reading >>
Nutrition In Patients With Diabetes
Author: Fazia Mir, MD; Chief Editor: George T Griffing, MD more... Diabetes is a chronic illness that requires a holistic approach in terms of care to prevent both acute and long-term complications. Nutritional management for diabetic patients has been evolving for 100 years as the pathophysiological basis of the complications incurred from diabetes becomes more explicit. Medical nutrition therapy is extremely important for diabetic patients and prediabetic patients so that adequate glycemic control can be achieved. One-on-one consultations with a registered dietician well-versed in diabetic nutrition are most preferable, as has been shown in studies performed in Pakistan [ 1 ] and Hungary, [ 2 ] which proved the utility of a dietician in improving dietary adherence. Nutrition counseling should be sensitive to the personal needs of the patient and how much effort the patient is willing to put in to making the change to eating appropriately. Medical nutrition therapy for diabetics can be divided into (1) dietary interventions and (2) physical activity. Lifestyle and dietary modifications form the cornerstone of therapy in type 2 diabetic patients (insulin resistance). In type 1 diabetic patients , who have an insulin deficiency, a balance between insulin and nutrition needs to be obtained for optimal glycemic control. [ 3 ] Nutrition for diabetic patients can be further divided into prevention and continual management of glycemic control. Prevention is more for individuals at risk for developing diabetes and for type 2 diabetic patients than for patients who have already developed complications, in order to prevent further progression. The goals of nutrition in prevention are as follows: Primary prevention Identification of the population at high risk (body mass index [ Continue reading >>
Fnce 2016: Session: 205. Type 2 Diabetes: Four Critical Times To Refer, Assess And Adjust Care
Medical nutrition therapy is a critical component of diabetes care and is included in the new diabetes self-management education and support (DSME/S) algorithm of care. The DSME/S algorithm of care addresses the four critical times to refer, assess and adjust DSME/S. The presentation will engage the audience through case studies, polling and discussion to understand how all dietitians can use the algorithm to support and expand their role in diabetes. Planned with the Diabetes Care and Education DPG. After this presentation, the attendee will be able to describe the RDN's role in the 4 critical times to assess, provide, and adjust diabetes self-management education and support as described in the Algorithm of Care. After this presentation, the attendee will be able to utilize the five Guiding Principles of Initial and Ongoing DSME/S to improve diabetes care. After this presentation the attendee will be able to demonstrate how the Algorithm of Care can be used to support the role of the RDN in the care of persons with type 2 diabetes Continue reading >>
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Patient Education: Type 1 Diabetes Mellitus And Diet (beyond The Basics)
TYPE 1 DIABETES OVERVIEW Diet and physical activity are critically important in the management of the ABCs (A1C, Blood pressure, and Cholesterol) of type 1 diabetes. To effectively manage glycated hemoglobin (A1C) and achieve stable blood sugar control, it is important to understand how to balance food intake, physical activity, and insulin. Making healthy food choices every day has both immediate and long-term effects. With education, practice, and assistance from a dietitian and/or a diabetes educator, it is possible to eat well and control diabetes. This topic discusses how to manage diet in people with type 1 diabetes. The role of diet and activity in managing blood pressure and cholesterol is reviewed separately. (See "Patient education: High blood pressure, diet, and weight (Beyond the Basics)" and "Patient education: High cholesterol and lipids (hyperlipidemia) (Beyond the Basics)".) WHY IS DIET IMPORTANT? Many factors affect how well diabetes is controlled. Many of these factors are controlled by the person with diabetes, including how much and what is eaten, how frequently the blood sugar is monitored, physical activity levels, and accuracy and consistency of medication dosing. Even small changes can affect blood sugar control. Eating a consistent amount of food every day and taking medications as directed can greatly improve blood sugar control and decrease the risk of diabetes-related complications, such as coronary artery disease, kidney disease, and nerve damage. In addition, these measures impact weight control. A dietitian can help to create a food plan that is tailored to your medical needs, lifestyle, and personal preferences. TYPE 1 DIABETES AND MEAL TIMING Consistently eating at the same times every day is important for some people, especially those w Continue reading >>
Nutrition Therapy Nutritional Therapy Nutrition Therapy For Diabetes Pdf
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- Reversing Type 2 Diabetes with Nutritional Ketosis
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
Medical Nutrition Therapy |authorstream
Automatically changes to Flash or non-Flash embed The presentation is successfully added In Your Favorites . This Presentation is Public Favorites: Medical Nutrition Therapy (MNT) By Tarek Al Areeny , MD I will apply dietetic measures for the benefit of the sick according to my ability and judgment. --The Hippocratic Oath Medical Nutrition Therapy (MNT) Definition : : Medical Nutrition Therapy (MNT) Definition : development and provision of a nutritional treatment or therapy based on a detailed assessment of a person's medical history, psychosocial history, physical examination, and dietary history. It is used to treat an illness or condition, or as a means to prevent or delay disease or complications from diseases such as diabetes . The purpose of the assessment is to: Determine the persons' need for therapy Set parameters to plan a therapy Develop a therapy plan Determine the best method to initiate the therapy Evaluate the effectiveness of the therapy Assessment Components : medical history : assessment of acute or chronic diseases or conditions, as well as any surgeries a person may have had. Medication and drug or alcohol use: # medications may interfere with nutrient absorption or increase the excretion of nutrients. Vitamin, mineral, and herbal supplementation can affect nutritional balance, and interactions with medications are also possible Physical examination : assessment of sex, age, and anthropometric data (measurement of height, weight, body mass index , and arm or wrist circumference) appearance of the hair, skin, and nails can assist in identifying nutritional deficiencies . For example, spoon-shaped, pale, and brittle fingernails may indicate an iron deficiency. Psychosocial assessment : reviewing a person's economic status, ethnic and cultural backgro Continue reading >>
