The daily management of athletes with diabetes.

The unique demands of exercise and competition can predispose diabetic athletes to harmful complications. A basic understanding of glucose metabolism during exercise, nutritional adequacy, blood glucose control, medications, and management of on-field complications is important for medical personnel who care for diabetic athletes on a daily basis. Diabetic athletes are best managed by "individualized"" preventive and treatment algorithms that should be developed by a team of medical professionals including the athletic trainer, sports nutritionist, and physician.

Practical tips on lifestyle management of type 2 diabetes for the busy clinician.

Lifestyle management is a challenging undertaking necessitating the adoption of patient-centered techniques and specialized resource materials. These techniques and resources are described in the form of 10 tips for lifestyle management. The areas covered include assessment, behavioral goal setting, monitoring of behavioral performance and progress, and follow-up, including the involvement of multiple disciplines. Several examples and basic resources are described or provided in an effort to facilitate the adoption of the approaches discussed.

Medications or lifestyle change with medical nutrition therapy.

The United States is experiencing epidemics of both diabetes and obesity. Lifestyle intervention, including medical nutrition therapy (MNT), has been demonstrated to be clinically effective for the prevention and treatment of diabetes; however, it is often underutilized. The majority of people with diabetes are cared for by primary care providers. They should be providing persons with diabetes initial basic nutrition messages that are accurate and can be easily understood; referring to a registered dietitian; following up on the person's progress with nutrition intervention; and providing continued education and support. MNT, along with physical activity, should be the initial monotherapy for the treatment of type 2 diabetes, upon the initial diagnosis and given the blood glucose level is less than 200 mg/dL. The success of MNT is usually seen within 6 weeks and up to a maximum of 6 months. This is the point at which the person with diabetes and their provider(s) should decide whether MNT alone is succeeding or whether medication is needed.

Diabetes medical nutrition therapy: practical tips to improve outcomes.

PURPOSE: To describe the evolving and expanding role of nurse practitioners (NPs) in providing diabetes medical nutrition therapy (MNT) as the United States faces epidemics of diabetes and obesity. DATA SOURCES: Scientific literature and reports from the public health, diabetes, and nutrition fields. CONCLUSIONS: Although clinically effective for both prevention and treatment of diabetes, MNT is often underutilized. The majority of people with diabetes are cared for by primary care providers; the role of NPs as primary care providers is evolving and expanding. NPs are recognized as leaders who creatively adapt to the rapidly changing health care delivery system. IMPLICATIONS FOR PRACTICE: NPs can serve as role models by presenting accurate, basic nutrition messages, referring patients to registered dietitians for MNT, reinforcing nutrition and the importance of lifestyle change as primary treatments for their disease, and following up on their patients' progress with nutrition interventions.