medical nutrition therapy for diabetes

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The presentation has three parts: UNITE for Diabetes Philippines CPG recommendations on medical nutrition therapy (MNT), improving adherence to MNT and use of SMS.

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  • Plate, Pyramid or Perseverance? Medical Nutrition Therapy for Diabetes Iris Thiele Isip Tan MD, MSc Associate Professor, UP College of Medicine Chief, UP Medical Informatics Unit July 2014 Melons by kisa12 http://www.freeimages.com/photo/863924 Monday, July 14, 14
  • Improving Adherence to Medical Nutrition Therapy SMS & MNT in Diabetes Medical Nutrition Therapy UNITE CPG Light meal by elvinstar http://www.freeimages.com/photo/318333 Women holding delicious grapefruit in her hand by african_ http://www.freeimages.com/photo/1386617 icon_sms_hires by Hans Dorsch https://ic.kr/p/5mXKNj Monday, July 14, 14
  • UNITE CPG Part 2: Management Section 9. Therapeutic Lifestyle Change: Medical Nutrition Therapy, Alcohol & Smoking Monday, July 14, 14
  • UNITE CPG 9.1.1 Who should receive MNT? All individuals at risk for diabetes, those with prediabetes or diabetes and overweight individuals with metabolic syndrome should be advised regarding MNT to help attain treatment targets (Level 1, Grade A). Morbidly obese belly by FBellon https://ic.kr/p/iczMwD Monday, July 14, 14
  • Goals of MNT in those at risk of diabetes or those with prediabetes ADA Position Statement: Nutrition Recommendations and Interventions for Diabetes. Diabetes Care 2008. Promote healthy food choices and physical activity weight loss Monday, July 14, 14
  • Goals of MNT in those with diabetes Normal or as near normal as possible glucose, lipids and blood pressure Prevent or slow down the rate of development of chronic complications Address individual nutrition needs (personal/cultural preferences and willingness to change) Maintain pleasure of eating by only limiting food choices when indicated by scientic evidence ADA Position Statement: Nutrition Recommendations and Interventions for Diabetes. Diabetes Care 2008. Monday, July 14, 14
  • MNT decreases A1c by 1-2% and reduces LDL by 15-25 mg/dL Monday, July 14, 14
  • UNITE CPG 9.1.2 How should counseling for MNT be carried out? MNT should preferably be provided by a registered dietitian/ nutritionist or other healthcare professional trained in the principles of nutrition (Level 1, Grade A). The scope and manner of delivery of MNT will depend on the setting. Eating salad for health by typexnick http://www.freeimages.com/photo/1432591 Monday, July 14, 14
  • Individual MNT counseling or in small groups Canadian Diabetes Association Counseling upon or shortly after diagnosis, with an initial consultation and 2-3 follow-up sessions. International Diabetes Federation Chair rainbow meeting by deafstar http://www.freeimages.com/photo/1379341 Tube ip calendar & clock by Rendy http://www.freeimages.com/photo/772984 Monday, July 14, 14
  • UNITE CPG 9.1.3 In the barangay health station, the following simple nutrition messages are to be emphasized: a. Food choices b. Idaho plate method diet 1 by ppreacher http://www.freeimages.com/photo/203247 Monday, July 14, 14
  • EAT MOST Use one or more of these foods as the basis of every meal Vegetables, legumes, lentils, noodles, rice, bread, grains, barley, wholegrain cereals, fresh fruit (non- sweet) EAT MODERATELY Have small servings of protein-rich foods sh, seafood, eggs, lean meat, skinless chicken, low- fat cheese, low-fat yoghurt, low-fat milk, nuts EAT LEAST Minimise fats, sugars, salt and alcohol butter, oil, ghee, cream, coconut milk and cream, processed meat, fried foods, preserved or processed foods, pastries, sweets, biscuits, soft drink Fresh vegetables 6 by MeiTeng http://www.freeimages.com/photo/1441972 Bits-n-bites True by Subhadipin http://www.freeimages.com/photo/1437365 Japanese sushi by chokingxi http://www.freeimages.com/photo/1443887 Asia Pacic Type 2 Diabetes Policy Group Monday, July 14, 14
  • From MyPyramid to MyPlate myplate.gov http://www.straitstimes.com/news/singapore/health/story/my- healthy-plate-replace-food-pyramid-singapore-textbooks-20140711 Monday, July 14, 14
  • Idaho Plate Method Provides 1,200-1,500 cal Monday, July 14, 14
  • Idaho Plate Method Provides 1,200-1,500 cal Monday, July 14, 14
  • Plate method works well for the following: Eat 3 meals a day (move side items to snack time) Low literacy level or have cognitive difculties Works well when eating outside the home Does not require math skills or high reading level elderly need to lose weight hospitalized needing survival information Challenging for those whom rice is a staple and those who enjoy only a limited variety of vegetables Brown et al Diabetes Spectrum 2001 Monday, July 14, 14
  • Tight st = 1/2 cup Handful = 1 cup Palm = 3 oz Thumb = 2 tbsp or 1 oz Thumb tip = 1 tsp Hand guides for portion control Monday, July 14, 14
  • UNITE CPG 9.1.4 Hospital-based nutrition advice a. Calculation of caloric requirement & macronutrient distribution b. Exchanges or CHO counting c. How to read food labels d. Glycemic index e. Meal replacement Weighing my food by Judy Baxter https://ic.kr/p/7Jod31 Monday, July 14, 14
  • Fat Not >30% Saturated fat

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