Last December, Marci Butcher wrote an excellent blog detailing the 2017 Revised National Standards for Diabetes Self-Management and Support. (if you didn't get time to read it then, it is well worth it to go to archives and refresh your knowledge) This guiding document, available from The American Diabetes Association forms the core of the education process. As diabetes educators we look to guidelines and there are many; AADE, AACE/ACE, ADA, AND.
Annually ADA up-dates and publishes the Standards for Medical Care in Diabetes. If you take a moment to review the Lifestyle Management supplement, it pretty much states what our job as diabetes educators is all about, with the framework of evidence-based rating criteria to support patient centered care decisions.
Rather than making a blog that preaches to the choir, let this be a message of support to continue our good work. So, with intention of Singing along with the Choir, here are the pearls from a recent re-read:
- All people with diabetes should participate in DSMES to facilitate the knowledge, skills, and ability necessary for self-care and implementing and sustaining skills and behaviors
- The four critical times to assess, provide, and adjust DSMES are at diagnosis, annually, when complicating factors arise, and when transition in care occurs
- There is no one size fits all meal plan! Examples of healthy plans include Plate Method, DASH diet and Mediterranean patterns, but most importantly health meal plans that are patient centered
- While evidence regarding low carbohydrate diets is mostly inconclusive, advice for all Americans is consistent for those with diabetes: avoid refined carbs and added sugars and instead focus on carbs from vegetables, legumes, fruits, dairy. With strong discouragement of sugar-sweetened beverages and processed, refined grains-added sugars foods
- Physical activity for adults is recommended at a rate of 150 minutes per week, a number that has become routine in conversations relative to diabetes prevention as well as diabetes care recommendations
- Additionally, prolonged seating is discouraged and suggested to be interrupted every 30 minutes
- And my favorite pearl: spread the activity out over at least 3 days per week and have no more than 2 consecutive days without activity
A final note, consider these several thoughts from the Lifestyle guidelines as something to craft into “scripting”, intended for use when talking with our consumers including other medical care providers as well as patients, participants, and stakeholders. The more our words are heard, the better understanding and outcomes to help our guidelines and standards become a part of life.
http://care.diabetesjournals.org/content/41/Supplement_1/S38