APPROPRIATE HEALTH CARE
Regular outpatient follow-up except for complicating emergencies such as severe hyperglycemia, hyperosmolar coma, and severe infections
GENERAL MEASURES
- Home monitoring of blood glucose
- Regular examination for complications: retinopathy, neuropathy, nephropathy
- Diabetes is a high risk factor for coronary heart disease. NCEP Adult Treatment Panel III recommends an LDL-cholesterol goal of < 100 mg/dL.
- Strict control of hypertension (goal BP <130/80) reduces the risk of complications and death related to diabetes and decreases progression of diabetic retinopathy and deterioration in vision
SURGICAL MEASURES N/A
ACTIVITY
Regular aerobic exercise can improve glucose tolerance and decrease medication requirements
DIET
- American Diabetes Association (ADA) provides dietary recommendations for NIDDM. The emphasis is on achieving glucose, lipid, and blood pressure goals. Mild caloric restriction is recommended to achieve mild to moderate weight loss (5-10 kg).
- Food choices are similar to Dietary Guidelines for Americans and the Food Guide Pyramid:
– 10-20% of calories from protein
– < 10% of calories each from saturated and polyunsaturated fat
– Remainder of calories from monounsaturated fat and carbohydrates, depending on individual patient factors
– Sugar is not specifically prohibited
PATIENT EDUCATION
- Education is critical for patients with NIDDM. Include information on the disease, medication treatment, self-monitoring, foot care, physical activity and diet management
- Support groups and classes certified by the ADA are recommended
- The ADA has prepared numerous patient education materials (430 North Michigan Ave. Chicago, IL 60611 or contact local ADA affiliate listed in white pages of telephone directory)
- http://www.diabetes.org
