TAILIEUCHUNG - Staged diabetes management a systematic approach - part 3

Phòng thí nghiệm dữ liệu: HbA1c, glucose mức độ huyết tương, ăn chay hồ sơ lipid, huyết áp, chức năng thận và xét nghiệm chức năng gan (ALT) Mục tiêu cho việc chăm sóc bệnh nhân: đường huyết mục tiêu, mục tiêu HbA1c, phương pháp và tần suất giám sát glucose máu và trọng lượng quản lý | TYPE 2 DIABETES MASTER DECISIONPATH 103 Laboratory data HbA1c plasma glucose level fasting lipid profile blood pressure renal function and liver function tests ALT Goals for patient care target blood glucose target HbA1c method and frequency of blood glucose monitoring and weight management Medical clearance for patient to exercise and or other pertinent information related to daily activities Assess obesity. To determine the appropriate nutrition intervention include an assessment of body mass index BMI - divide weight measured in kilograms by the square of the height measured in meters - kg m2 . Recently the National Heart Lung and Blood Institute identified overweight as a BMI of kg m2 and obesity as 30 kg m2. See the BMI chart in the Appendix Figure to calculate the BMI. Body mass index correlates well with body fat as a clinical measure of obesity. A loss of two units of BMI corresponds to a decrease in body weight of about 5-6 kg 11 to lb . Once the BMI has been determined obtain this additional information Thorough diet history including past experience with meal planning Dietary restrictions due to allergies religion culture finances and preferences Weight history including any significant loss or gain in weight over the past five years Weight goals Current appetite recent loss of appetite Eating or digestion problems Eating schedule Meal preparation practices Typical day s food intake to be evaluated for approximate calories and nutrient composition other nutritional concerns frequency and timing of meals Frequency and choices in restaurant meals Alcohol intake Use of vitamins or nutritional supplements Obtain data related to physical activity and exercise 1. What type of activity does the patient currently do 2. Does the patient exercise regularly 3. What limitation does the patient have that would hinder or prevent exercise 4. Is the patient willing or interested in becoming more physically active Assess psychosocial economic issues see

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