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Eating healthy is an important part of managing your diabetes. The food in your meal plan will provide the calories and nutrients you need each day to manage your blood glucose and to give you the energy you need for healthy living. You can use the following guidelines to estimate how many calories are needed per day to help maintain your weight. For every pound of weight, calculate: • 10 calories for an adult who is obese, very inactive, or always dieting • 13 calories for an adult over 55 years of age, an active woman, or an inactive man • 15 calories for a very active woman or an active man • 20 calories for a very active man or an adult athlete To lose weight, you’ll need to eat fewer calories. To gain weight, you’ll need to eat more calories. You and your healthcare provider will develop a healthy meal plan that is right for you. The Exchange Lists for Meal Planning The Exchange Lists offer a large selection of foods grouped together because they have approximately the same nutritional content. Each serving of a food has about the same carbohydrate, protein, fat, and calories, as the other foods in that list. Any food within a list can be “exchanged” for another food in the same list. Ask your healthcare provider for a copy of the Changing Life With Diabetes booklet, Carb Counting and Meal Planning from Novo Nordisk. It includes the Exchange Lists for Meal Planning and other useful information on healthy eating. Use the Exchange Lists in Carb Counting and Meal Planning with this meal planning information. To become a member of Changing Life With Diabetes, a free program for people who take insulin, enroll on line at ChangingDiabetes-us.com. Another program that will help you manage your diabetes is the free Novo Nordisk Tip Line at 1-800-260-3730.
National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-KDOQI™) Did you know that the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI™) develops guidelines that help your doctor and health care team make important decisions about your medical treatment? The information in this booklet is based on the National Kidney Foundation's KDOQI™ recommended guidelines for diabetes, and it's very important for you to know. What is your stage of kidney disease? There are five stages of kidney disease. They are shown in the table below. Your doctor determines your stage of kidney disease based on the presence of kidney damage and your glomerular filtration rate (GFR), which is a measure of your level of kidney function. Your treatment is based on your stage of kidney disease. Speak to your doctor if you have any questions about your stage of kidney disease or your treatment.
Diabetes Treatment & Diet • Blood glucose (BG) control is the foundation of treatment for diabetes mellitus. High BG increases the risk of infections during illness, slows healing, and can lead to long-term complications. • Blood glucose levels are often elevated during illness and after injury because of stress. Many patients with diabetes come to the hospital with high BG levels, or their BG levels become elevated during hospitalization. Certain medications and decreased physical activity during hospital stay contribute to elevated BG levels. • The American Diabetes Association recommends that a consistent carbohydrate (CHO) diet be provided to patients with diabetes during hospitalization. The Consistent CHO diet doesn’t have a specific calorie level. Instead, it provides a specific amount of CHO. • “Calorie level diabetic diets” are no longer recommended for patients during hospitalization. VUH is phasing out “calorie level diabetic diets.” • The diet order for patients with diabetes in VUH (except on 4 East) is “Diabetic Diet– Consistent CHO.” • On 4 East, a slightly different version of the diet is provided. This diet is known as “the OB Diabetic Diet.”
Good meal planning can help you better control your blood sugar Eating healthy foods and adding variety to your menus is easier than you think. Your doctor or healthcare provider can help you develop a meal plan that helps control tour blood sugar. This sheet can help you make that plan more interesting by providing substitution options, so you don’t have to eat the same foods all the time. It also helps if you eat a balanced diet, eat meals at the same time every day, avoid skipping meals and eat food portions that are indicated by your individual meal plan. The American Diabetes Association recommends good eating habits along with being physically active as the primary part of any good type 2 diabetes management plan. Here’s how you can easily choose foods that fit your type 2 diabetes meal plan: · Find your total daily calorie level on the chart below. · Using the chart, plan your menus for the day with serving amounts from each group. · Look at the sample meal plan below to see how you can do this. · Give your meals variety by choosing other items from the same food groups.
Twelve Great Story Ideas 1. Dental Care for the Baby ONE dental visit when there’s ONE tooth can equal ZERO cavities. 2. Cosmetic and Restorative Dentistry New treatments to enhance or restore a child’s smile. Half of American children get cavities – Learn best treatment choices for children. 3. Behavior Guidance Parents should exercise important rights as partners in dental decisions. 4. Diet and Dental Health It’s not what children eat, but how often, and candy can be OK if children are conscientious. 5. Fluoride Fluoride not only helps prevent tooth decay, it cures beginning cavities. 6. How to Select a Dentist How pediatric dentists are different from general dentists. 7. Dental Care for the Preschooler Tips for parents on a great dental visit. 8. Dental Care for School-Age Children & Sealants A count down to dental health: Five steps to a cavity-free child. Sealants: The invisible protector and the best-kept secret in the dental office. 9. Dental Care for the Teenager Why teens may get their first cavity at the same time they get a driver’s license. 10. Children at Risk Twenty-five percent of our nation’s children have 80 percent of the cavities. 11. Dental Care for Special-Needs Children & Adults Every person can enjoy a healthy smile and benefit from preventive dentistry. 12. Sports Safety & Dental Emergency How to keep children off the “injured list.” What to do when a child has had a tooth knocked out. The American Academy of Pediatric Dentistry (AAPD), founded in 1947, is an organization of more than 8,000 dedicated professionals with special training in children’s oral health. Pediatric dentists and their staff work in a pediatric environment because they enjoy working with children. Pediatric dentists are advocates for children.
Our objective was to conduct a critical review of the factors that account for psychological insulin resistance (PIR) and of the available strategies to reduce it. Medline, PubMed, Cochrane reviews, PsycInfo, ProQuest, Science Direct, and EBSCO databases were searched and 60 studies were included in the final review. Topics reviewed included: research methods, instruments to assess PIR, PIR in patients and in the medical care team, and proposed strategies for overcoming it. The results showed that a large number of factors account for PIR in patients. The main categories are emotional, cognitive, social/cultural, and interaction with health providers. Physicians mainly delay insulin because they lack knowledge on guidelines or pancreas physiology, they fear inducing hypoglycaemia in elderly or impaired patients, and/or they lack time or personnel resources to teach initiation. Strategies proposed to reduce PIR are educational and psychological (exposure, desensitisation, relaxation and counselling). We concluded that there is a great need of evidence-based interventions that help remove psychological barriers about insulin use in patients, as well as in health care providers. Copyright © 2011 John Wiley & Sons. Practical Diabetes Int 2011; 28(3): 125–128
Insulin resistance plays a significant role in numerous and frequent conditions (Reaven, 1988; Human Reproduction Volume 12 Supplement 1 1997 Ferrannini, 1993; Moller, 1993), various physiological states (puberty, elderly, sedentarity, etc.), important pathological entities (obesity, diabetes mellitus, essential hypertension, dyslipidaemias, etc.), and several pharmacological treatments (corticoids, some antihypertensive agents, oral contraceptives, etc.). More particularly, resistance to insulin is a key element of the so-called syndrome X which plays a major role in the development of atherosclerotic cardiovascular diseases (Reaven, 1988; DeFronzo and Ferrannini, 1991; Lefebvre, 1993; Scheen, 1996a). Furthermore, insulin resistance plays a significant role in women and human reproduction since decreased insulin sensitivity has been described during pregnancy, in polycystic ovary syndrome (PCOS) (Poretsky, 1991), after menopause (Khaw, 1992), as well as during treatment with various contraceptive pills (Gaspard and Lefebvre, 1990; Godsland et al, 1993b; Godsland and Crook, 1994). It is thus crucial not only to have adequate methods to measure insulin action (Scheen et al., 1994b; Scheen and Lefebvre, 1996), but also to develop new strategies to improve insulin sensitivity (Vialettes and Silvestre, 1992; Scheen and Lefebvre, 1993; Donnelly and Morris, 1994; Lefebvre and Scheen, 1995). The purpose of the present review is to describe the main approaches currently used for the treatment of insulin resistance in humans, as well as to consider two gynaecological potential applications, i.e. PCOS and menopause. Non-pharmacological approaches Several easy and inexpensive non-pharmacological approaches may result in significant improvement in insulin action (Figure 1; Sharma, 1992). European Society for Human Reproduction & Embryology
Severe Insulin Resistance What is severe insulin resistance? Insulin is a hormone (a chemical signal that travels in the bloodstream) made by the pancreas. It controls how the body uses sugars and fats and is essential for life. Its absence is the underlying problem in type - 1 diabetes. However, from person to person there are significant differences in how sensitive the tissues of the body are to insulin. In other words, in some people a very small amount of insulin produces a large change in the blood levels of glucose and fats (these people are said to be very insulin sensitive), while in others much larger amounts are required to produce the same change (these people are said to be insulin resistant). Those with severe insulin resistance are those whose bodies respond least well to insulin. Although many with severe insulin resistance do go onto develop diabetes, severe insulin resistance is NOT the same as diabetes: as long as the pancreas can produce enough insulin to overcome the insulin resistance, diabetes does not develop. However, even before diabetes appears, insulin levels in the body may be extremely high, and this can produce a range of different problems in its own right. What are the causes of severe insulin resistance? Rarely, people are born with severe insulin resistance and remain severely insulin resistant throughout their lives. Far more frequently insulin resistance develops only at puberty or in later life, while in some people it is only a temporary condition caused by other situations or illnesses. Most commonly a tendency towards insulin resistance is inherited, but only in the presence of environmental or lifestyle factors does it become a problem. There are many different types and causes of severe insulin resistance. One way to group these is by the extent to which they are inherited or acquired, and the extent to which they reflect problems with fat (adipose) tissue:...
Type II diabetic subjects are both insulin-deficient and insulin-resistant. Recent studies suggest that the insulin resistance is due to a combined receptor and postreceptor defect with the postreceptor defect being the predominant lesion. In the present study, we examined the effects of exogenous insulin therapy upon these defects in insulin action in six untreated type II diabetic subjects. Glycemic control and adipocyte insulin binding were measured and in vivo insulin dose-response curves for overall glucose disposal and suppression of hepatic glucose output were constructed before treatment. Following these initial studies, the diabetic subjects were treated with twice-daily injections of regular and NPH purified pork insulin for 14 days and the pretreatment studies repeated. Glycemic control was significantly improved by this treatment regimen. The mean fasting serum glucose level (±SE) fell from 287 ± 20 to 125 ± 13 mg/dl, the mean glycosylated hemoglobin level (± SE) decreased from 14.2 ± 1.1% to 8.3 ± 0.5%, and the mean 24-h urinary glucose excretion (±SE) declined from 65.6 ± 40.3 to 0.6 ± 0 . 1 g/24 h. Adipocyte insulin binding did not change significantly during the treatment period. In contrast, the 14-day period of insulin treatment produced a 72% increase (P < 0.005) in the maximal rate of insulin-stimulated glucose disposal, 321 ± 32 mg/M2/min compared with 187 ± 32 mg/M2/min before treatment, indicating that the postreceptor defect in insulin action was significantly ameliorated by insulin treatment. The dose-response curve for insulin-mediated suppression of hepatic glucose output was rightshifted, consistent with the decrease in insulin binding, with no decrease in the maximal effect before treatment and not significantly changed following insulin treatment. In conclusion, the postreceptor defect in insulin-stimulated glucose disposal is largely ameliorated by exogenous insulin treatment, suggesting that this defect in insulin action is an acquired abnormality which is secondary to some aspect of the insulin-deficient state, DIABETES CARE 5.- 353-363, JULY- AUGUST 1982.
Insulin resistance is a condition in which the body produces insulin but does not use it properly. Insulin, a hormone made by the pancreas, helps the body use glucose for energy. Glucose is a form of sugar that is the body’s main source of energy. The body’s digestive system breaks food down into glucose, which then travels in the bloodstream to cells throughout the body. Glucose in the blood is called blood glucose, also known as blood sugar. As the blood glucose level rises after a meal, the pancreas releases insulin to help cells take in and use the glucose. When people are insulin resistant, their muscle, fat, and liver cells do not respond properly to insulin. As a result, their bodies need more insulin to help glucose enter cells. The pancreas tries to keep up with this increased demand for insulin by producing more. Eventually, the pancreas fails to keep up with the body’s need for insulin. Excess glucose builds up in the bloodstream, setting the stage for diabetes. Many people with insulin resistance have high levels of both glucose and insulin circulating in their blood at the same time. Insulin resistance increases the chance of developing type 2 diabetes and heart disease. Learning about insulin resistance is the first step toward making lifestyle changes that can help prevent diabetes and other health problems.