Insulin Management Strategies for Exercise in Diabetes
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Diabetes management
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Diet plays an important role in the effective management of type 1 diabetes and type 2 diabetes and is fundamental to the prevention of type 2 diabetes. The aim of nutritional management of diabetes is to optimize glycaemic and blood pressure management, correct any lipid abnormalities, and, in doing so, reduce the risk of long-term complications. Weight management is now understood to be the primary strategy for prevention of type 2 diabetes and for glycaemic management in people with type 2 diabetes who have overweight or obesity. Remission of type 2 diabetes refers to the normalization of blood glucose concentrations in the absence of anti-diabetes medications, although there is currently no consensus on the exact definition. The relationship between carbohydrate intake and glycaemia in type 2 diabetes is not straightforward and currently there is no definitive evidence that carbohydrate reduction per se durably lowers glycaemia.
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Abstract The changing pattern of obesity‐related disease has created a need for a greater range of weight management options for the increasing number of people for whom weight loss and maintenance cannot be addressed by conventional dietary methods. Formula diet weight loss programmes [very low‐calorie diets ( VLCD s) (400–800 kcal/day) and low‐calorie diets ( LCD s) (800–1200 kcal/day)] can deliver weight loss at rates of 1–2 kg/week. This rate of weight loss can result in 10–20 kg weight loss in 8–12 weeks. Many health benefits associated with weight reduction seem to require between 10 and 20 kg weight loss. Formula diet programmes can result in weight loss, reduction of liver volume and reduction of visceral fat before bariatric surgery; weight loss before knee joint replacement surgery has also been shown. The benefit of pre‐operative weight loss is still under investigation and such practices before bariatric surgery are variable in surgical units across the UK . Weight loss with formula diet in obesity‐associated conditions where inflammation is an important component, such as osteoarthritis and psoriasis, has been demonstrated. Maintenance of about 10% of initial bodyweight loss, with symptom improvement in elderly obese people with knee osteoarthritis, has been shown over a period of 4 years. In obese people with psoriasis, weight loss with skin improvement has been maintained for 1 year. Clinical trials are currently underway to examine the merits of an initial weight loss with formula diet in pre‐diabetes, in early type 2 diabetes and in insulin‐treated type 2 diabetes. Rapid initial weight loss can result in rapid symptom improvement, such as reduced joint pain in osteoarthritis, improved sleep quality in obstructive sleep apnoea, reduced shortness of breath on exertion, reduced peripheral oedema and rapid improvement in metabolic control in diabetes, all changes that are highly motivating and conducive towards compliance. There is also some evidence for improved vitamin D status and maintained bone health in elderly obese people with osteoarthritis but more research is needed. Rapid initial weight loss was feared to be followed by rapid weight regain. However, provided initial weight loss is delivered in parallel with an intense education programme about nutrition, cooking, shopping and lifestyle for long‐term maintenance; and where long‐term support is provided, subsequent weight maintenance after VLCDs and LCDs has been shown to be possible. A recent literature review identified high‐protein diets, obesity drugs and partial use of formula meal replacements as methods which can result in statistically significantly greater weight maintenance after initial weight loss with VLCDs or LCDs . Anxiety about serious adverse side effects seems to be unfounded although users need to be aware of both minor and more serious, though very infrequent, adverse events, such as gallstones and gallbladder disease.
Management of obesity
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This Scientific journal covers the following topics broadly such as diet pills, liquid diet, Yoga for weight loss, green tea weight loss, Vitamins for weight loss, Weight management, Ideal body weight, Obesity, Weight Reduction, Weight loss surgery, Overweight and Obesity, Ornish diet, Rapid weight loss, Body mass index (BMI), Adipose Tissue, Lipid Metabolism, Body Mass composition, Colon cleanse weight loss, Non-surgical weight loss, Weight loss supplements, Weight loss diet, Weight Loss Medical Devices, Very low Calorie diet and Weight loss management program, Monitoring and treatment protocols. This journal was also accepting articles about animal nutrition.
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Tolerability
Diabetes management
Blood Glucose Self-Monitoring
Diabetes treatment
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Diabetes management
Disease management
Macrovascular disease
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Objective Individuals with obesity are often recommended weight loss for their health; however, the amount of weight loss that is recommended varies. Lay people's beliefs about weight loss could influence the types of behaviours they view as necessary for people with obesity. The present study explored lay beliefs regarding the health benefits of varying degrees of weight loss.Design Participants (379 community members and 235 students) read information about an obese target who lost varying amounts of weight (none vs. modest vs. substantial) following behaviour changes.Main outcome Participants evaluated the target's health and recommended health-related behaviours to the target.Results The substantial weight-loss target, but not the modest weight-loss target, was perceived as being healthier than the no weight-loss target. There were no differences in behaviour recommendations made to the no weight-loss and modest weight-loss targets, with most participants recommending further weight loss to both targets.Conclusions Lay people appear to view substantial, but not modest, weight loss as beneficial to health, and they recommend further, more unrealistic amounts of weight loss to obese individuals who have already achieved modest weight loss. A failure to recognise the health benefits of modest weight loss may contribute to unrealistic weight loss goals.
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Previous research has shown that realtime continuous glucose monitoring (RT-CGM) is a useful clinical and lifestyle aid for people with type 1 diabetes. However, its usefulness and efficacy for people with type 2 diabetes is less known and potentially controversial, given the continuing controversy over the efficacy of self-monitoring of blood glucose (SMBG) in this cohort. This article reviews the extant literature on RT-CGM for people with type 2 diabetes, and enumerates several of the advantages and disadvantages of this technology from the perspective of providers and patients. Even patients with type 2 diabetes who are not using insulin and/or are relatively well controlled on oral medications have been shown to spend a significant amount of time each day in hyperglycemia. Additional tools beyond SMBG are necessary to enable providers and patients to clearly grasp and manage the frequency and amplitude of glucose excursions in people with type 2 diabetes who are not on insulin. While SMBG is useful for measuring blood glucose levels, patients do not regularly check and SMBG does not enable many to adequately manage blood glucose levels or capture marked and sustained hyperglycemic excursions. RT-CGM systems, valuable diabetes management tools for people with type 1 diabetes or insulin-treated type 2 diabetes, have recently been used in type 2 diabetes patients. The extant studies, although few, have demonstrated that the use of RT-CGM has empowered people with type 2 diabetes to improve their glycemic control by making and sustaining healthy lifestyle choices.
Diabetes management
Blood Glucose Self-Monitoring
Blood glucose monitoring
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