Best advice to be given to a patient of newly diagnosed type 2 DM is:
Correct Answer: Exercise
Description: Ref: Harrison 's Principles of Internal Medicine, 18ed.Explanation:The patient with type 1 or type 2 DM should receive education about nutrition, exercise, care of diabetes during illness, and medications to lower the plasma glucoseExerciseIt has multiple positive benefits including:Cardiovascular risk reductionReduced blood pressureMaintenance of muscle massReduction in body fatWeight lossLowering plasma glucose (during and following exercise)Increasing insulin sensitivity.In patients with diabetes, the ADA recommends 150 minAveek (distributed over at least 3 days) of moderate aerobic physical activity.The exercise regimen should also include resistance training.To avoid exercise-related hyper- or hypoglycemia. individuals with type 1 DM should:Monitor blood glucose before, during, and after exerciseDelay exercise if blotxl glucose is >14 mmoi/L (250 mg/dL) and ketones are presentIf the blood glucose is <5.6 mmol/L (100 mg/ dL). ingest carbohydrate before exercisingMonitor glucose during exercise and ingest carbohydrate to prevent hypoglycemiaDecrease insulin doses (based on previous experience) before exercise and inject insulin into a non-exercising areaLearn individual glucose responses to different types of exercise and increase food intake for up to 24 h after exercise, depending on intensity and duration of exercise.In individuals with type 2 DM. exercise-related hypoglycemia is less common but can occur in individuals taking either insulin or insulin secretagogues.Untreated proliferative retinopathy is a relative contraindication to vigorous exercise, as this may lead to vitreous hemorrhage or retinal detachmentNutritional Recommendations for Adults with DiabetesWeight loss diet (in prediabetes and type 2 DM)Hypocaloric diet that is low-fat or low-carbohydrateFat in dietMinimal trans fat consumptionCarbohydrate in dietMonitor carbohydrate intake in regards to caloriesSucrose-containing foods may be consumed with adjustments in insulin doseAmount of carbohydrate determined by estimating grams of carbohydrate in diet for (type 1 DM)Glycemic index reflects how consumption of a particular food affects the blood glucoseProtein in diet: as part of an optimal dietOther componentsNonnutrient sweetenersRoutine supplements of vitamins, antioxidants, or trace elements not advised
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