The daily management of athletes with diabetes.

The unique demands of exercise and competition can predispose diabetic athletes to harmful complications. A basic understanding of glucose metabolism during exercise, nutritional adequacy, blood glucose control, medications, and management of on-field complications is important for medical personnel who care for diabetic athletes on a daily basis. Diabetic athletes are best managed by "individualized"" preventive and treatment algorithms that should be developed by a team of medical professionals including the athletic trainer, sports nutritionist, and physician.

Practical tips on lifestyle management of type 2 diabetes for the busy clinician.

Lifestyle management is a challenging undertaking necessitating the adoption of patient-centered techniques and specialized resource materials. These techniques and resources are described in the form of 10 tips for lifestyle management. The areas covered include assessment, behavioral goal setting, monitoring of behavioral performance and progress, and follow-up, including the involvement of multiple disciplines.

Medications or lifestyle change with medical nutrition therapy.

The United States is experiencing epidemics of both diabetes and obesity. Lifestyle intervention, including medical nutrition therapy (MNT), has been demonstrated to be clinically effective for the prevention and treatment of diabetes; however, it is often underutilized. The majority of people with diabetes are cared for by primary care providers.

Diabetes medical nutrition therapy: practical tips to improve outcomes.

Purpose: To describe the evolving and expanding role of nurse practitioners (NPs) in providing diabetes medical nutrition therapy (MNT) as the United States faces epidemics of diabetes and obesity.

Data Sources: Scientific literature and reports from the public health, diabetes, and nutrition fields.

Conclusions: Although clinically effective for both prevention and treatment of diabetes, MNT is often underutilized.

A national diabetes care and education programme: the Ghana model.

An account is given of how a national diabetes care and education programme was developed in Ghana, a developing country, through international collaboration of medical schools, industry and government health care institutions. The approach is by way of trained diabetes teams consisting of physicians, dietitians and nurse educators at two tertiary institutional levels (teaching hospitals) who in turn trained teams consisting of physicians, dietitians or diettherapy nurses, nurse educators and pharmacists at regional and district/sub-regional levels to offer care and education to patients and the community. In three years all regional and about 63% of sub-regional/district health facilities had trained diabetes health care teams, run diabetes services and had diabetes registers at these institutions.

Facilities and resources for diabetes care at regional health facilities in southern Ghana.

In the fall of 1995, each of the five provincial hospitals in southern Ghana was visited and facilities and resources for diabetes care assessed. In addition, health facilities and standards of care questionnaires were completed. Only Korle Bu Teaching Hospital run a diabetes clinic and had diabetologists.

Combination of very-low-calorie diet and behavior modification in the treatment of obesity.

Very-low-calorie diets (VLCDs) cause rapid weight loss. However, weight regain is rapid upon discontinuing the VLCD unless lifestyle is altered. The addition of a behavioral-modification (BMOD) program improves the long-term outcome.

Alternatives to the exchange system for teaching meal planning to persons with diabetes.

Although the most well known, exchange lists are not the only meal-planning approach for persons with diabetes. This paper outlines the steps in the nutrition education process, including initial and continued education stages, and presents six alternative approaches for individualizing meal planning. These include the High Carbohydrate-High Fiber Exchange System, Calorie/Fat Counting, Total Available Glucose, the Point System, Month of Meals, and Individualized Sample Menus.

Psyllium fiber reduces rise in postprandial glucose and insulin concentrations in patients with non-insulin-dependent diabetes.

The ability of psyllium fiber to reduce postprandial serum glucose and insulin concentrations was studied in 18 non-insulin-dependent diabetic patients in a crossover design. Psyllium fiber or placebo was administered twice during each 15-h crossover phase, immediately before breakfast and dinner. No psyllium fiber or placebo was given at lunch, which allowed measurement of residual or second-meal effects.

Nutrition management for individuals with noninsulin-dependent diabetes mellitus in the 1990s: a review by the Diabetes Care and Education dietetic practice group.

Noninsulin-dependent diabetes mellitus (NIDDM), or Type II diabetes, is characterized by two primary defects: insulin resistance and insulin secretion. The two major goals of management of NIDDM are to achieve near normal metabolic control and to prevent/delay the microvascular and macrovascular complications of diabetes. Nutrition, exercise, and, if necessary, medication are the three primary treatment modalities used in NIDDM.