Diabetes & Hypertension

Transcription

1 Diabetes & Hypertension A TRAINING FOR HEALTH CARE PROFESSIONALS Presented by: Maureen Molinari PhD, RDN, LD, CDE Independent contractors working with the Chronic Disease Prevention Program, Wyoming Department of Health

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4 This presentation is brought to you by the Chronic Disease Prevention Program at the Wyoming Department of Health and funded through the State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health Grant (DP ). FOR MORE INFORMATION PLEASE CONTACT Hannah Herold, CHRONIC DISEASE PREVENTION PROGRAM MANAGER AT OR (307)

5 Objectives: Program Objectives: Module 4-1. Review of Basic Nutrition for Diabetes and Hypertension 2. Identify elements of DASH diet 3. Define SMART goals

6 Preventing and Managing Diabetes and Hypertension Stress Medications Nutrition Activity

7 T2DM incidence per 100 person-years Diabetes prevention program Goal: 7% reduction in baseline body weight through low-calorie, lowfat diet and 150 min/week moderate intensity exercise % 31% Intensive lifestyle intervention* (n=1079) Metformin 850 mg BID (n=1073) Placebo (n=1082) Diabetes Prevention Program Research Group (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The New England Journal of Medicine, 346, DOI: /NEJMoa012512

8 Diabetes prevention program FOLLOW-UP MEAN FOLLOW-UP OF FIFTEEN YEARS Diabetes incidence was reduced by 27% in the lifestyle intervention group 18% in the metformin group Interpretation Lifestyle intervention or metformin significantly reduced diabetes development over a 15 years period of time No overall differences in the aggregate microvascular outcome between treatment groups Those who did not develop diabetes had a lower prevalence of microvascular complications than those who did develop diabetes. This result supports the importance of diabetes prevention.

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11 New plate method

12 1 teaspoon of sugar = 4 grams of carbohydrates

13 Legumes

14 Added sugar DOES NOT refer to sugars in fresh fruits, vegetables, and milk Refers to sugar added during processing benefits from reducing daily intake to 10% of total energy intake A 5% reduction, or roughly 25 grams (6 teaspoons) per day may provide additional health benefits (WHO, 2015). Free sugars are added to foods and drinks Less than 10% reduces the risk of overweight, obesity, tooth decay World Health Organization (WHO, March 2015)

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16 Nutrition

17 fiber Soluble (pulp) Attracts water Slows digestion Oat bran, barley, nuts, seeds, beans, lentils, peas, and some fruits and vegetables Insoluble (skin) Adds bulk to stool Helps food to pass more quickly through stomach and intestines Wheat bran, vegetables, whole grains

18 sodium Consume less than 2300 mg per day Some foods have excessive sodium. Limit these foods to once per week: Asian foods (Chinese, Japanese, Vietnamese, etc.) Cured meats, such as ham or bacon Corned beef Soy sauce, look for low sodium Frozen foods Fast foods (commercial hamburgers, pizzas, tacos, etc.)

19 Physical Activity!

20 T2DM incidence per 100 person-years Diabetes prevention program Goal: 7% reduction in baseline body weight through low-calorie, lowfat diet and 150 min/week moderate intensity exercise % 31% Intensive lifestyle intervention* (n=1079) Metformin 850 mg BID (n=1073) Placebo (n=1082) Diabetes Prevention Program Research Group (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The New England Journal of Medicine, 346, DOI: /NEJMoa012512

21 Physical activity Make it fun Do it with a friend Do it often mins, 5 x a week Make it as active as you can Walk, ride a bike, swim, do chair exercises

22 Healthy activity behaviors Tip: Increase your activity slowly every day. Just minutes can make a difference! Move it! Muscles need motion! Make movement your personal prescription for health! Remember: Exercises can even be done in chairs! Tip: Set aside time every day just for you!

23 5 healthy eating habits 1. Eat at regular times 2. Use the DASH eating plan Try using spices and less sodium 3. Increase vegetable consumption 4. Eat moderate portions 5. Be physically active 4-5 days of the week or more than mins

24 Motivational interviewing (MI) Collaborative, patient centered approach Connecting behavior - something one cares about Honors patient autonomy

25 Four guiding principles of mi R: Resist the righting reflex U: Understand motivations by asking L: Listen, avoid guessing E: Empower, get person thinking aloud

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27 Assessing goals Tell me about your goals. What is working? What challenges are you facing? How about physical activity? What are you doing for self-care? What are the challenges in my schedule? Tell me about your support system? (Spend time asking about support systems. Many people don t think about support systems or are unable to identify a supportive person. Help them think through this step.

28 Experiential exercise Write two open-ended questions One addressing diabetes One addressing hypertension What are your health/self-care goals? Write your own SMART goal Share and Discuss

29 Evidence based resources Protocol.pdf bp_low.pdf

30 Thank you for participating!