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Monday, February 27, 2012
  Clinical Accuracy Spoken Here  

DM Care Standards: Goals of MNT

  1. For youth with type 1 diabetes, provide adequate energy to ensure normal growth and development; integrate insulin regimens into usual eating and physical activity habits
  2. For youth with type 2 diabetes, facilitate changes in eating and physical activity habits that reduce insulin resistance and improve metabolic status
  3. For pregnant and lactating women, provide adequate energy and nutrients needed for successful outcomes
  4. For older adults, provide for the nutritional and psychosocial needs of an aging individual

[Reference: Diabetes, Module D, Care Standards]
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  Excellence in Case Mgmt  

DM Standards: Lowering BP

Clinical trials have demonstrated incontrovertible benefits of lowering blood pressure in persons with diabetes.

  • ACE inhibitors have been shown to decrease the risk of progression of nephropathy and to decrease cardiovascular events.
  • ARBs have been shown to reduce the rate of progression of nephropathy
  • Beta-blockers were substantially less effective in reducing congestive heart failure than diuretic therapy. Many patients will require three or more drugs to reach target goals.

A target blood pressure goal of <130/80 mmHg is reasonable if it can be safely achieved.

[Reference: Diabetes, Module D, Care Standards]
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  Improving Patient Care...  

Diabetic Retinopathy

Several case series and a controlled prospective study suggest that pregnancy in type 1 diabetics may aggravate retinopathy. During pregnancy and 1 year postpartum, retinopathy may be transiently aggravated. Laser surgery can minimize this risk.

[Reference: United Kingdom Prospective Diabetes Study (UKPDS)]
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Tom RasmussenTom Rasmussen
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Cathy WrightCathy Wright, BSN, RN
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