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Managing Teens and Insulin Resistance

Managing Teens and Insulin Resistance. Henry Anhalt, DO, CDE Director, Pediatric Endocrinology and Diabetes Saint Barnabas Medical Center Livingston, NJ. WHAT IS INSULIN RESISTANCE?. Long associated with type 2 diabetes a known risk factor for heart disease

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Managing Teens and Insulin Resistance

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  1. Managing Teens and Insulin Resistance Henry Anhalt, DO, CDE Director, Pediatric Endocrinology and Diabetes Saint Barnabas Medical Center Livingston, NJ

  2. WHAT IS INSULIN RESISTANCE? • Long associated with type 2 diabetes • a known risk factor for heart disease • occurs when the body does not properly use insulin to metabolize blood glucose • when insulin fails to enable cells to admit glucose, necessary for cells' energy production. • glucose then builds up in the blood, and additional insulin is required

  3. TYPE 2 DIABETES-A CARTOON REVIEW

  4. Coping Skills • Accept what I cannot change • Strive to change what I can • Attempt to learn all I can • Set realistic goals • Seek support of others • Hope for new insight

  5. Healthy Eating Finding the Right Balance

  6. DIABETES “TRIAD” NUTRITION Exercise Medication

  7. How do we choose our food? • Taste and enjoyment • Tradition and custom • Convenience • Mood • Hunger • Cost • Health and nutrition

  8. Ask Yourself... • Are you at your best weight? • Are your blood sugars usually within target range? • Is your cholesterol below 200? • Do you have a meal plan which you usually follow? • Is your meal plan varied? Enjoyable?

  9. Why is healthy eating important? • Blood sugar control • Reduces risks of complications • Cholesterol • Blood pressure • Kidney disease • Weight control • Feel good

  10. Meal planning questions:True or False You can’t eat any sugar False You must have 3 snacks a day False It is different for everyone True You don’t need special foods True False It is complicated

  11. Choose Healthy Foods limit fat - especially saturated fat follow the pyramid Be Consistent meal times -don’t skip meals amount of food - have a balanced plate types of foods - control carbohydrates General Guidelines

  12. Fat / Alcohol Protein Carbohydrate

  13. Your meal plan (carb goal) is…. • Based on the way you usually eat • Designed to help improve your control • Planned to space out carbohydrates • Changeable… if it doesn’t work

  14. What about “fast foods”? • Look for healthy choices • Learn what is in the food • Watch out for hidden fats

  15. Exercise Moving Toward Better Blood Glucose Control

  16. DIABETES “TRIAD” EXERCISE Nutrition Medication

  17. Exercise benefits for diabetes control • Weight loss / Weight control • Helps insulin work better • Uses glucose for energy • Lowers blood glucose (in minutes) • Improves A1c (in weeks)

  18. Why bother to exercise? • Medical • blood pressure, cholesterol, triglycerides, weight, A1c • Quality of life • fitness, strength • need for medication, sleep time • Psychosocial • stress, depression feel better

  19. Why exercise? The main reason I am going to exercise is because I want to: ________________________ ________________________

  20. What type of exercise should I do? • Aerobic exercise • Strength training • Flexibility and stretching • Enjoyable and Convenient • SAFE • for diabetes (eyes, feet, kidneys) • for other health concerns (heart, lungs, aches and pains, etc)

  21. Aerobic exercise choices • Weight-bearing activities • walking, jog/run, aerobic dance, ballroom/folk/line dancing, sports • Non weight-bearing activities • biking, swimming, water exercise classes, rowing, armchair exercise, video

  22. Other options • Strength training • Flexibility and stretching • Exercise options to explore • join a health club; use exercise equipment; join an exercise program; call local schools, colleges, malls, clubs, etc. for more information on what is available

  23. My exercise plan... For my exercise program I will ____________________________

  24. How Often? For blood glucose control: 3 to 4 times a week For weight loss: 4 to 5 times a week

  25. My exercise plan… My goal is to exercise ____ times a week. I will start with ____ times a week.

  26. How Long? For blood glucose control: 20 to 30 minutes For weight loss: 45 to 60 minutes

  27. My exercise plan... My goal is to exercise for ____ minutes. I will start with ____ minutes. (Plus a ____ minute warm-up and a ____ minute cool down.)

  28. What Time of Day? Pick a time that fits into: • daily schedule • lifestyle • diabetes management plan

  29. My exercise plan... The time of day I will most likely exercise will be ____ AM / PM.

  30. 30 minutes 15g Carb 30 - 60 minutes 15g Carb + 7-8g Protein Long duration 15g Carb per hour and > 2 hours decrease insulin Pre-exercisesnack adjustments

  31. Summary • Review your reasons to exercise • Review your exercise plan • Be consistent • Enjoy your success!

  32. Who Succeeds? • Has a clear and realistic plan • Is prepared for obstacles • Has a strategy for getting support • Knows exactly what the first steps will be

  33. Who loses their way? • Has goals that are too vague or rigid • Attempts too large of a lifestyle change • May be overly perfectionistic • Thinks that there will be no obstacles • Is not concerned about obtaining support

  34. Developing a clear and realistic plan • Completing the three QuickPlans: • Monitoring • Meal Planning • Making time for exercise

  35. Completing the QuickPlans • One self-care behavior at a time • A one month goal • Consider your obstacles • An immediate action plan to: • overcome obstacles • begin new behavior

  36. Important principles for completing the QuickPlans • Realistic. Begin with small, achievable targets for change. • Action-oriented. Focus on new actions to begin, not old actions to stop. • Concrete. Know the exact actions which you will take.

  37. Obstacles to Exercise • Exercise is boring • Too hard to find the time • May cause hypoglycemia • May cause too much pain/discomfort • Too tired to exercise • No one to exercise with

  38. Overcoming Obstacles to Exercise • Try something new • Turn an unpleasant activity into a pleasant one • Modify environment to make exercise more convenient

  39. Overcoming Obstacles to Exercise • Pay attention to how exercise positively affects blood glucose • Find an exercise partner / group • Seek out professional advice • Fight back against self-defeating thoughts

  40. A Contract for Self-Care • Your action plan for diabetes success • Expect the occasional problems (ongoing problem solving is necessary) • Stay in touch!

  41. Empowerment • The granting of power or authority to oneself • People become empowered when they use all their resources, psychological, social, emotional and spiritual, to solve their own problems or achieve their own goals

  42. Forces that Threaten Empowerment • Fear • Anger • Ignorance • Hopelessness • Misguided Help

  43. 4 Pillars of Empowerment • Awareness • Chioce • Freedom • Resposibility

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