Intensive diabetes management / Georgeanna J. Klingensmith, editor.

Format:

Book

Contributor:

Klingensmith, Georgeanna.

American Diabetes Association.

Language:

English

Subjects (All):

Diabetes--Treatment.

Diabetes.

Diabetes Mellitus--therapy.

Diet, Diabetic.

Insulin--administration & dosage.

Patient Education as Topic.

Self Care--methods.

Medical Subjects:

Diabetes Mellitus--therapy.

Diet, Diabetic.

Insulin--administration & dosage.

Patient Education as Topic.

Self Care--methods.

Physical Description:

xv, 160 pages : illustrations ; 23 cm + 1 CD-ROM (4 3/4 in.)

Edition:

Third edition.

Place of Publication:

Alexandria, Va. : American Diabetes Association, [2003]

System Details:

text file

Summary:

For clinicians striving to deliver diabetes therapy for the 21st century, "Intensive Diabetes Management includes guidelines for diagnosis and classification of diabetes and identification candidates for intensive management. This groundbreaking, hands-on guide delivers practical advice for helping patients achieve a better lifestyle and better health through improved glucose control. Using this resource, health care providers can more effectively take a team approach to intensive diabetes management of types 1 and 2.

In-depth chapters cover such areas of concern as psychosocial issues, multicomponent insulin regimens, insulin infusion pump therapy, monitoring, and nutritional management. Major updates include information about the newest insulins and therapeutic approaches. This book includes a searchable CD-ROM of its contents.

Contents:

Rationale for and Physiological Basis of Intensive Diabetes Management 1

Physiological Basis of Intensive Management Methods 6

Normal Fuel Metabolism 6

Regulation of Fuel Metabolism 8

Implications for Therapy 9

The Team Approach 13

Integrated Diabetes Management Team 17

Role Definition 19

Team Communication 21

Functional Considerations 21

Diabetes Self-Management Education 25

Integration of the Team Approach 27

Diabetes Continuing Education 27

Assessment 28

Instruction 29

Environment 29

Planning 30

Sequencing of Classes 31

Approaches/Strategies 31

Motivation 33

Negotiation 33

Evaluation 34

Documentation 34

Psychosocial Issues 37

Assessing Patient Suitability for Intensification 40

Practicing Behavior 40

Assessing Psychological Status and the Psychosocial Support System 41

The Family System 42

The Individual 43

Assessing the Effect of Stress on Glycemic Control 44

Assessing Coping Skills 46

Assessment of Diabetes-Related Coping 46

Identifying Psychosocial Resources 46

Helping Patients Deal with Complications 47

Potential Adverse Psychological Outcomes of Treatment 48

Eating and Body Image Disorders 48

Fear of Hypoglycemia 49

Needle Phobia 50

Helping Patients with Long-Term Adherence 51

Supporting and Maintaining Patients' Behavior Changes 52

Helping Patients with New Therapies 53

Acceptance of Multiple Therapies 54

Lifestyle Changes 54

Patient Selection and Goals of Therapy 59

Patient Selection 61

Patients with Type 1 Diabetes 63

Patients with Type 2 Diabetes 64

Goals of Therapy 65

Glycemic Goals 67

Modifying Glycemic Goals 68

Weighing Benefits and Risks in Type 2 Diabetes 69

Multiple-Component Insulin Regimens 73

Insulin Pharmacology 76

Insulin Timing and Action 76

Stability and Miscibility of Insulins 78

Insulin Absorption 79

Insulin Regimens 80

Multiple-Component Insulin Regimens: General Points 80

Specific Flexible Multiple-Component Insulin Regimens 82

Other Insulin Programs 86

Insulin Dose and Distribution 89

Initial Insulin Doses 89

Insulin Dose Distribution 90

Insulin Adjustments 91

Acute Adjustments 91

Pattern Adjustments 92

Injection Devices 96

Insulin Infusion Pump Therapy 99

Benefits of CSII 104

Insulin Dosage Calculations for Insulin Pump Therapy 105

Insulin Adjustments 108

Diet 108

Exercise 108

Illness 109

Correction of Hyperglycemia 109

Risks of CSII 109

Skin Infection 109

Unexplained Hyperglycemia and Ketoacidosis 110

Hypoglycemia 112

Wearing the Pump 113

Patient Education for CSII 114

Implantable Insulin Infusion Pumps 117

Monitoring 121

Monitoring by the Patient 123

Blood Glucose 123

Ketone Monitoring 125

Record Keeping 126

Monitoring by the Health Care Team 127

A1C 127

Hypoglycemia 128

Prevention 128

Hypoglycemia Unawareness 130

Continuous Glucose Monitoring 130

Monitoring for Long-Term Complications 131

Retinal Examinations 131

Lipid Screening 132

Blood Pressure 132

Urinary Albumin Screening 133

Foot Examinations 133

Nutrition Management 135

Goals of MNT 138

Target Nutrition Recommendations 139

Strategies for Type 1 Diabetes 141

Strategies for Type 2 Diabetes 143

Glucose Monitoring and the Nutritional Plan 145

Hypoglycemia 145

Skipping or Delaying Planned Meals or Snacks 145

Inappropriate Timing of Insulin Relative to Meals 147

Imbalance Between Food and Meal-Related Insulin Dose 148

Inadequate Food Supplementation for Exercise 148

Consuming Alcohol on an Empty Stomach 149

Oral Treatment of Hypoglycemia 150

Facilitating Nutrition Self-Management 150

Meal-Planning Approaches for Intensified Management 151

Carbohydrate Counting 151

Weight Gain Associated with Intensive Management 153

Prevention 153.

Notes:

Includes bibliographical references and index.

ISBN:

1580401643

OCLC:

52040743

Online:

Publisher description