diabetes assessment/plan

by Mark Morgan on August 11, 2010A1c: -at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). -quarterly in patients whose therapy has changed or who are not meeting glycemic goals. -for microvascular disease prevention and macrovascular risk reduction, the A1C goal for nonpregnant adults in general is -less stringent A1C goals if a history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, or extensive comorbid conditions -also for those with longstanding diabetes in whom the general goal is difficult to attain despite diabetes self-management education, appropriate glucose monitoring, and effective doses of multiple glucose-lowering agents including insulin. Diet: For those with high risk for developing type 2 diabetes: -lifestyle changes including moderate weight loss (7% body weight) and regular physical activity (150 min/week), with dietary strategies including reduced calories and reduced intake of dietary fat, can reduce the risk for developing diabetes. -achieve the U.S. Department of Agriculture (USDA) recommendation for dietary fiber (14 g fiber/1,000 kcal) and foods containing whole grains (one-half of grain intake). -saturated fat intake should be -reducing intake of trans fat lowers LDL cholesterol and increases HDL cholesterol For this with type 2 diabetes: -monitoring carbohydrate, whether by carbohydrate counting, exchanges, or experience-based estimation, remains a key strategy in achieving glycemic control. -perform at least 150 min/week of moderate-intensity aerobic physical activity (50–70% of maximum heart rate). -in the absence of contraindications, people with type 2 diabetes should be encouraged to perform resistance training three times per week.

in Endocrine