diabetes history

DIET CONTROLLED: periodically; ORAL MEDS: 1-2/day (may to 2-3/wk if stable); QD INSULIN:1-2/day (may to 2-3/wk if stable); BID INSULIN: 2-4/day; TID-QID INSULIN or PUMP: 3-6/day

Goals for blood pressure control: blood pressure less than 140/85 mmHg, emphasis on systolic blood pressure control. www.icsi.org

LDL less than 100 mg/dL or on a statin. www.icsi.org

LDL is less than 70 mg/dL or on a statin. www.icsi.org

Screening for microalbuminuria can be performed by one of three methods: (1) Measurement of the albumin-to-creatinine ratio in a random, spot collection. This is easiest to perform, generally accurate and therefore is the preferred screening method. (2) 24-hour collection with creatinine, allowing for simultaneous measurement of creatinine clearance. (3) Timed (four-hour or overnight) collection NOTE: A microalbumin screening test should be done each year on patients with type 2 diabetes. If positive (exceeds 30 mg/gm), it should be repeated twice in the next three months. If two out of three of these screening microalbuminuria tests are positive, the individual has microalbuminuria, and interventions should be considered. A negative finding should be followed annually; a positive finding should be followed periodically, for example annually, to see if the interventions are effective in diminishing the albuminuria.

exceeds 30 mg/gm on three separate measurements over 3 months.

If one chooses to drink alcohol and has not been cautioned against it, limit intake to one drink per day for women and two drinks per day for men, according to USDA guidelines. A drink is defined as 12 oz. of regular beer, 5 oz. of wine, or 1.5 oz. of 80-proof distilled spirits. To reduce the risk of hypoglycemia, alcohol should be consumed with food.

People with diabetes should peform at least 150 minutes a week of moderate intensity activity (50%-70% maximum heart rate), and resistance training three times a week unless contraindicated.

- Healthful food choices: foods containing carbohydrates from whole grains, fruits, vegetables, legumes and low-fat milk should be included in a healthy eating plan. - Reducing total caloric intake by moderating food/beverage and limiting total fat intake. - Distributing carbohydrates evenly throughout the day to smaller meals and snacks. - Monitoring carbohydrates remains a key strategy in achieving glycemic control, whether by carbohydrate counting, exchanges or experience-based estimation - Initial and periodic consultation with a dietician is very important toward succeeding in lifestyle modification