天津医科大学内科学课件 Diabetes Mellitus（二）.pptVIP

Profile Definition Diagnosis Classification Pathogenesis Laboratory Findings Management Complications Goals The goals can be divided into three stages: Short term: involving immediate treatment to relieve symptoms or acute infection. Intermediate term: to return the patient to a physiologic state and social life that are as normal as possible. Long term: to prevent the development or delay the progression of the complications of diabetes. Management Plan Patient Education Healthy Nutrition Weight Control Physical Activity Self-monitoring of Blood Glucose (SMBG) Antihyperglycemic Agents Patient Education Explanations of the nature of diabetes, its potential acute and chronic complications, and information on how these complications can be prevented or treated early. The importance of self-monitoring of blood glucose and how to record the data. Be trained in self-management and taught to use algorithms to adjust the timing and quantity of their insulin dose, food, and exercise in response to their recorded blood glucose values. Acceptance the fact that they have diabetes. Medical Nutrition Therapy Daily energy requirements: Carbohydrate: Protein: fat = 0.5-0.6: 0.1-0.2: 0.2-0.3 Glycemic Index refers to the increase in blood glucose level after ingestion of a particular food, expressed as a percentage of the increase in blood glucose following ingestion of the equivalent amount of glucose. Weight Management Therapy Overweight and obesity are major risk factors for T2DM and cardiovascular disease. 5-10% weight loss leads to increased insulin sensitivity with improvement in glycemic control, significant improvements in dyslipidemia and blood pressure. Exercise Therapy Benefits include improvements in blood pressure, endothelial function, insulin sensitivity, lipid profile, cardiovascular fitness, and glycemic control. Regular, moderate physical activity for at least 30 min/day is recommended. Self-monitoring Be encouraged to keep careful records of their