How, When and Why to Use Advanced Insulin Pump Features
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This presentation was authored by Meaghan Anderson MS RD LD CDE, Senior Diabetes Clinical Manager-Houston North - Medtronic Diabetes specially for the Advanced Diabetes Seminar at TLC on April 26, 2014.
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The document provides information about optimizing diabetes control through the use of an insulin pump. It discusses setting and testing basal rates to maintain stable blood glucose levels. It also covers using alternate and temporary basal rates for scheduled or unplanned changes in activity. Additionally, it explains optimizing bolus insulin through testing and adjusting the insulin-to-carb ratio and insulin sensitivity factor. Other topics include timing boluses, disconnecting from the pump, using a super bolus, and the importance of carb counting and blood glucose testing.
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This document discusses insulin pump therapy and its goals of maintaining near-normal glycemia while avoiding crises and minimizing long-term complications. It describes how insulin pumps can more closely mimic physiological insulin secretion by providing basal insulin continuously and bolus doses at meals. Smart insulin pumps now include bolus calculators that help account for active insulin and minimize dosing errors, improving glycemic control for many patients with diabetes.
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This document provides information on using temporary basal rates and advanced bolus options on insulin pumps. It discusses when to increase or decrease temporary basal rates for situations like illness, exercise, or fasting labs. Examples are given of setting temporary basal rates for activities like basketball practice when blood sugar may run low. The document also covers normal, extended, and dual/extended bolus options and provides examples of when each would be best for different types of meals. The concept of a "super bolus" is introduced which delivers additional insulin by suspending part of the basal rate. Tools for reminders and multiple basal patterns are also mentioned.
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The document summarizes a randomized study comparing basal-bolus insulin therapy to sliding scale regular insulin for managing hyperglycemia in non-critically ill patients. The study found that 66% of patients treated with basal insulin glargine plus bolus insulin glulisine were within the glucose target of 140 mg/dL, compared to 38% of patients treated with sliding scale regular insulin. Basal-bolus therapy provides more effective glycemic control with no increase in hypoglycemia. The document then provides details on calculating and adjusting basal and bolus insulin doses.
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Type 1 diabetes is an autoimmune disease where the pancreas cannot produce insulin. It affects about 5% of diabetics and often develops before age 30. For athletes with type 1 diabetes, maintaining steady blood glucose levels is crucial for performance, as hypoglycemia can cause fatigue and reduced endurance. Pre-workout meals and carbohydrate intake during and after exercise are important, as is carefully timing insulin to avoid hypoglycemia. With careful management, type 1 diabetes does not have to limit athletic performance.
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The Power Of The Pump
The document provides information about optimizing diabetes control through the use of an insulin pump. It discusses setting and testing basal rates to maintain stable blood glucose levels. It also covers using alternate and temporary basal rates for scheduled or unplanned changes in activity. Additionally, it explains optimizing bolus insulin through testing and adjusting the insulin-to-carb ratio and insulin sensitivity factor. Other topics include timing boluses, disconnecting from the pump, using a super bolus, and the importance of carb counting and blood glucose testing.
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This document discusses insulin pump therapy and its goals of maintaining near-normal glycemia while avoiding crises and minimizing long-term complications. It describes how insulin pumps can more closely mimic physiological insulin secretion by providing basal insulin continuously and bolus doses at meals. Smart insulin pumps now include bolus calculators that help account for active insulin and minimize dosing errors, improving glycemic control for many patients with diabetes.
Basics of insulin pump theory
Authored by Brant P. Foster, RN, a long time friend and contributor to the Texas Lions Camp. This seminar is for the Advanced Diabetes Seminar 2014 at TLC.
Simulation of insulin pump
The document discusses insulin pumps and their use for managing diabetes. It describes how insulin pumps work by continuously monitoring blood sugar levels and automatically delivering insulin to maintain safe blood sugar ranges. The document outlines important design considerations for insulin pumps, such as safety, reliability, and testing to validate the design and software. It also discusses potential hazards and failure modes that must be addressed.
TLCDBU-2016: How, when and why to use advanced features
The document provides information on using temporary basal rates and advanced bolus options on insulin pumps. It discusses when to use temporary basal rate increases or decreases, such as for illness, exercise, or changes in activity level. It also reviews normal, extended, and dual/split bolus options and provides examples of when each would be appropriate. The document highlights tools like basal patterns, alarms, and pump suspensions that can help manage insulin needs and support forgetfulness. It concludes with tips for pump use and answers to common pump questions.
Avanced Pumping Techniques
This document provides information on using temporary basal rates and advanced bolus options on insulin pumps. It discusses when to increase or decrease temporary basal rates for situations like illness, exercise, or fasting labs. Examples are given of setting temporary basal rates for activities like basketball practice when blood sugar may run low. The document also covers normal, extended, and dual/extended bolus options and provides examples of when each would be best for different types of meals. The concept of a "super bolus" is introduced which delivers additional insulin by suspending part of the basal rate. Tools for reminders and multiple basal patterns are also mentioned.
Hyperglycemia management
The document summarizes a randomized study comparing basal-bolus insulin therapy to sliding scale regular insulin for managing hyperglycemia in non-critically ill patients. The study found that 66% of patients treated with basal insulin glargine plus bolus insulin glulisine were within the glucose target of 140 mg/dL, compared to 38% of patients treated with sliding scale regular insulin. Basal-bolus therapy provides more effective glycemic control with no increase in hypoglycemia. The document then provides details on calculating and adjusting basal and bolus insulin doses.
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Type 1 diabetes is an autoimmune disease where the pancreas cannot produce insulin. It affects about 5% of diabetics and often develops before age 30. For athletes with type 1 diabetes, maintaining steady blood glucose levels is crucial for performance, as hypoglycemia can cause fatigue and reduced endurance. Pre-workout meals and carbohydrate intake during and after exercise are important, as is carefully timing insulin to avoid hypoglycemia. With careful management, type 1 diabetes does not have to limit athletic performance.
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This document discusses the differences between basal-bolus and sliding scale insulin regimens. It explains that basal insulin provides a constant background level, while bolus insulin covers mealtime needs. Sliding scale alone is reactive and can cause blood sugar fluctuations, while basal-bolus is proactive and mimics normal insulin delivery. During hospitalization, patients are best managed with basal-bolus rather than oral agents due to its flexibility and ability to be easily titrated.
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Gestational diabetes develops due to increased insulin resistance during pregnancy. It can cause complications for both mother and fetus if uncontrolled. The standard treatment is insulin therapy, but oral hypoglycemic drugs like glyburide may be used. Glyburide does not cross the placenta and has not been shown to cause fetal anomalies. It can be started at a low dose of 2.5 mg once daily before meals and increased slowly as needed to control blood sugar levels while minimizing risks for the mother and fetus. Lifestyle changes like diet and exercise are also important for managing gestational diabetes.
Insulin initiation adjustment
1) This document discusses the initiation and adjustment of insulin therapy for type 2 diabetes. It recommends starting with a long-acting basal insulin at bedtime and titrating the dose up gradually until fasting blood glucose is at target levels.
2) If HbA1c remains above 7% after 2-3 months, short-acting insulins should be added at mealtimes starting with breakfast. The doses are then titrated based on pre-meal blood glucose readings.
3) If HbA1c is still not at target after a further 2-3 months, a third daily insulin injection may be needed and post-meal blood glucose should be checked to guide adjustments. The goal is to approximate normal pancreatic
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The document outlines guidelines for initiating and titrating insulin therapy for type 2 diabetes. It recommends starting with either bedtime intermediate-acting or morning/bedtime long-acting insulin, and titrating the dose to reach fasting glucose targets. If HbA1c remains above 7% after 2-3 months, additional injections of rapid-acting insulin should be added at mealtimes based on pre-meal glucose levels. Further intensification, such as checking postprandial levels and adjusting prandial insulin, is recommended if HbA1c is still not at target. The guidelines provide a step-by-step approach to optimizing insulin regimens based on glucose monitoring.
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This document provides information about basic insulin pumping. It describes what an insulin pump is, potential benefits, and challenges. It discusses calculating basal rates, bolus doses, and correction factors. It provides guidance on pump maintenance like changing sites and settings. It addresses common questions around pump use, troubleshooting, and ensuring settings are optimized. The overall message is that pumps require diligent self-care and monitoring to achieve good blood sugar control.
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3. Use daily summaries and patient logs to help identify relationships between behaviors, medications, and glucose levels.
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The document discusses insulin therapy and glucose monitoring. It provides details on the different types of insulin including rapid, short, intermediate and long acting insulins. It describes insulin administration including sites, storage, precautions and complications. It also discusses glucose monitoring methods like fasting blood glucose, oral glucose tolerance test and self monitoring of blood glucose. The normal values and nursing considerations for these tests are outlined.
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This document discusses basics of insulin therapy including:
- The discovery of insulin in the 1920s and types of insulin including basal, mealtime, premixed, and newer combinations.
- Insulin action profiles, indications for insulin use, administration techniques using vials, syringes and pens, and common insulin regimens for type 2 diabetes including once or twice daily basal insulin +/- mealtime insulin or premixed insulin.
- Proper storage, mixing, and injection of insulin as well as recommended sites for injection are also reviewed.
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This document provides guidelines for initiating and adjusting insulin therapy for type 2 diabetes. It outlines a step-by-step regimen beginning with initiating either bedtime intermediate-acting insulin or bedtime or morning long-acting insulin. It instructs to monitor fasting blood glucose and increase the insulin dose until the target range is achieved. Additional injections of rapid-acting insulin are added before meals if blood glucose levels remain out of range. The regimen is monitored every 3 months by checking HbA1c and adjusting insulin doses up or down based on blood glucose levels and HbA1c targets.
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This document discusses insulin therapy, including its pharmacodynamics, mechanisms of action, types of insulin, insulin regimens, administration techniques, side effects, and patient education. Insulin is secreted by the pancreas and lowers blood glucose levels by facilitating glucose uptake into cells. It acts on the liver, muscle, adipose tissue, and other organs. Types include rapid, short, intermediate and long-acting insulins. Patient education focuses on proper administration, storage, monitoring, hypoglycemia treatment, and lifestyle factors.
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The document summarizes insulin therapy for diabetes mellitus. It describes the cells in the pancreas that secrete insulin and other hormones. It details the discovery and purification of insulin in the 1920s which revolutionized treatment of diabetes. The document discusses different insulin formulations including short-acting and long-acting types. It explains factors that affect insulin absorption and common dosing regimens for insulin therapy.
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The document discusses guidelines for initiating insulin therapy in patients with type 2 diabetes not controlled on oral antidiabetic drugs (OADs). It recommends starting with either bedtime intermediate-acting insulin or bedtime or morning long-acting insulin, beginning at a dose of 10 units or 0.2 units/kg. The insulin dose is then titrated up based on fasting blood glucose levels until the target range is achieved. Additional injections of rapid-acting insulin may be added if pre-meal blood glucose levels remain out of range.
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Insulin pumps can help manage diabetes during pregnancy by more closely mimicking normal insulin physiology compared to multiple daily injections. Starting insulin pump settings during pregnancy typically involve dividing total daily insulin dose in half, with 50% for basal rates given continuously over 24 hours and 50% for bolus doses with meals. Basal and bolus rates often need adjustment throughout pregnancy as insulin resistance and needs increase. Close monitoring of blood sugars is important for optimizing pump settings to help prevent hyperglycemia and hypoglycemia. After delivery, insulin requirements usually decrease rapidly but may need to be adjusted based on breastfeeding and return of normal glucose levels.
Alternative to insulin for gestational diabetes
Gestational diabetes develops due to increased insulin resistance during pregnancy. It can cause complications for both mother and fetus if uncontrolled. The standard treatment is insulin therapy, but oral hypoglycemic drugs like glyburide may be used. Glyburide does not cross the placenta and has not been shown to cause fetal anomalies. It can be started at a low dose of 2.5 mg once daily before meals and increased slowly as needed to control blood sugar levels while minimizing risks for the mother and fetus. Lifestyle changes like diet and exercise are also important for managing gestational diabetes.
Insulin initiation adjustment
1) This document discusses the initiation and adjustment of insulin therapy for type 2 diabetes. It recommends starting with a long-acting basal insulin at bedtime and titrating the dose up gradually until fasting blood glucose is at target levels.
2) If HbA1c remains above 7% after 2-3 months, short-acting insulins should be added at mealtimes starting with breakfast. The doses are then titrated based on pre-meal blood glucose readings.
3) If HbA1c is still not at target after a further 2-3 months, a third daily insulin injection may be needed and post-meal blood glucose should be checked to guide adjustments. The goal is to approximate normal pancreatic
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The document outlines guidelines for initiating and titrating insulin therapy for type 2 diabetes. It recommends starting with either bedtime intermediate-acting or morning/bedtime long-acting insulin, and titrating the dose to reach fasting glucose targets. If HbA1c remains above 7% after 2-3 months, additional injections of rapid-acting insulin should be added at mealtimes based on pre-meal glucose levels. Further intensification, such as checking postprandial levels and adjusting prandial insulin, is recommended if HbA1c is still not at target. The guidelines provide a step-by-step approach to optimizing insulin regimens based on glucose monitoring.
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This document provides information about basic insulin pumping. It describes what an insulin pump is, potential benefits, and challenges. It discusses calculating basal rates, bolus doses, and correction factors. It provides guidance on pump maintenance like changing sites and settings. It addresses common questions around pump use, troubleshooting, and ensuring settings are optimized. The overall message is that pumps require diligent self-care and monitoring to achieve good blood sugar control.
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1. Overlay glucose data by meal to examine overnight, pre-prandial, and post-prandial periods.
2. Closely examine the 3 critical periods to identify causes of hypoglycemia or hyperglycemia.
3. Use daily summaries and patient logs to help identify relationships between behaviors, medications, and glucose levels.
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The document discusses insulin therapy and glucose monitoring. It provides details on the different types of insulin including rapid, short, intermediate and long acting insulins. It describes insulin administration including sites, storage, precautions and complications. It also discusses glucose monitoring methods like fasting blood glucose, oral glucose tolerance test and self monitoring of blood glucose. The normal values and nursing considerations for these tests are outlined.
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This document discusses basics of insulin therapy including:
- The discovery of insulin in the 1920s and types of insulin including basal, mealtime, premixed, and newer combinations.
- Insulin action profiles, indications for insulin use, administration techniques using vials, syringes and pens, and common insulin regimens for type 2 diabetes including once or twice daily basal insulin +/- mealtime insulin or premixed insulin.
- Proper storage, mixing, and injection of insulin as well as recommended sites for injection are also reviewed.
د شکر په ناروغانو کې د انسولین پیل کول
This document provides guidelines for initiating and adjusting insulin therapy for type 2 diabetes. It outlines a step-by-step regimen beginning with initiating either bedtime intermediate-acting insulin or bedtime or morning long-acting insulin. It instructs to monitor fasting blood glucose and increase the insulin dose until the target range is achieved. Additional injections of rapid-acting insulin are added before meals if blood glucose levels remain out of range. The regimen is monitored every 3 months by checking HbA1c and adjusting insulin doses up or down based on blood glucose levels and HbA1c targets.
Insulin therapy
This document discusses insulin therapy, including its pharmacodynamics, mechanisms of action, types of insulin, insulin regimens, administration techniques, side effects, and patient education. Insulin is secreted by the pancreas and lowers blood glucose levels by facilitating glucose uptake into cells. It acts on the liver, muscle, adipose tissue, and other organs. Types include rapid, short, intermediate and long-acting insulins. Patient education focuses on proper administration, storage, monitoring, hypoglycemia treatment, and lifestyle factors.
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The document summarizes insulin therapy for diabetes mellitus. It describes the cells in the pancreas that secrete insulin and other hormones. It details the discovery and purification of insulin in the 1920s which revolutionized treatment of diabetes. The document discusses different insulin formulations including short-acting and long-acting types. It explains factors that affect insulin absorption and common dosing regimens for insulin therapy.
Insulin therapy in IDDM by Dr. Dilip
Insulin therapy in Diabetes Mellitus discusses various types of insulin, newer insulin analogs, and insulin regimens for managing type 1 diabetes mellitus. Rapid-acting insulin analogs have advantages over regular insulin such as quicker onset of action and less risk of hypoglycemia. Long-acting insulin analogs like glargine have advantages over NPH insulin such as a more consistent time action profile. The document discusses split-mix and basal-bolus insulin regimens and factors to consider when choosing a regimen. It also covers complications of insulin therapy, monitoring of blood glucose and HbA1c levels, and sick day management for patients with type 1 diabetes.
Insulin Therapy in DM
The document discusses guidelines for initiating insulin therapy in patients with type 2 diabetes not controlled on oral antidiabetic drugs (OADs). It recommends starting with either bedtime intermediate-acting insulin or bedtime or morning long-acting insulin, beginning at a dose of 10 units or 0.2 units/kg. The insulin dose is then titrated up based on fasting blood glucose levels until the target range is achieved. Additional injections of rapid-acting insulin may be added if pre-meal blood glucose levels remain out of range.
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This document discusses common errors in insulin therapy. It covers topics like delaying insulin initiation, improper injection techniques, incorrect insulin regimens, and failure to target all glycemic measures including fasting plasma glucose, post-prandial glucose, and A1C. The document emphasizes the importance of properly educating patients on insulin administration and management to achieve optimal glucose control and avoid both short-term and long-term consequences of uncontrolled diabetes.
Starting Insulin by M Daoud
This document discusses two case studies of patients with type 2 diabetes mellitus. For the first case, a 50-year old female patient with HbA1c of 8.5-9% on oral medications, the summary recommends starting basal insulin such as glargine or detemir 15-20 units at bedtime. For the second case, a 68-year old obese male patient with HbA1c of 10.5% on maximum oral medications, the summary recommends starting a total daily dose of insulin of 0.3-0.5 units/kg, starting with premixed insulin such as Mixtard 18/10 units. Both cases emphasize individualizing treatment targets and adjusting insulin doses based on self-
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The document discusses insulin pumps as an alternative treatment for diabetes compared to traditional multiple daily injections. Insulin pumps provide continuous insulin delivery through an infusion set and are programmed to deliver basal and bolus doses. While insulin pumps are more expensive initially than injections, they provide benefits like better blood glucose control and more flexibility with meals and activities. The technology has advanced significantly since the first prototype pump in 1964 and continues to improve, but some disadvantages remain like potential weight gain and the need to remove the pump for certain activities.
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Testing plays an important role in the certification process for systems and software. The certification process involves verification and validation activities to determine if a system meets its specified requirements. Testing is used for both verification and validation at various stages - from unit testing of individual components to system integration testing and user acceptance testing. Standards like DO-178B for aerospace and IEC 60601-1-4 for biomedical engineering define requirements for testing and coverage criteria that must be met for certification based on the criticality of the system. A comprehensive testing approach throughout the development lifecycle is needed to identify defects and improve safety for certification.
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Slide Deck for the 2014 School RN talk on Insulin Pump use by Stephen Ponder MD, FAAP CDE on June 21, 2014 in Austin, Texas at the TypeOneNation conference.
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The document discusses insulin pump therapy and technologies for managing diabetes. It provides information on:
1. Education needed before starting insulin pump therapy, including determining basal and bolus rates.
2. Safety measures to prevent hyperglycemic crises and inpatient considerations for insulin pump use.
3. Advanced pump features like temporary basal rates, prolonged boluses, and data downloads that can help fine-tune insulin delivery and management of blood glucose levels.
Managing your Blood Pressure.pptx
This document provides information about managing blood pressure through a voluntary wellness program. The program offers incentives for completing health assessments and meeting six health criteria, such as maintaining total cholesterol below 200, blood pressure under 120/80, and not using tobacco. It describes blood pressure, risks of high blood pressure, and lifestyle changes to control it, such as getting adequate sleep, maintaining a healthy weight, following the DASH diet low in sodium and high in fruits/veggies, and engaging in regular physical activity. Tips for an accurate reading include being well-rested, relaxed, and not smoking or drinking caffeine beforehand.
6 weeks beach body transformation
Think about the excitement and pride as you unveil, strip down your swimwear confident relax and proud, feeling new and better and people comment on your impressive well-earned physique. whatever you have been failing for years but never seen results, If you just decide now it the time for that great change after months of letting yourself setback, here the plan to achieve the dream body with incredible training and diet program, you will see the hard work translates into a lean muscular defined physique.
10 practical tips to make type 1 diabetes work for you tlc retreat 2013 ponder
This document provides 10 practical tips to help manage type 1 diabetes. It begins with an overview of managing glucose flux and drift, understanding how diabetes tools like insulin, food, exercise, and monitors work and their limitations. It emphasizes recognizing trends versus randomness, making prudent changes, and treating diabetes management like a team sport. The document also covers common emergencies, how other factors like family impact management, and new developments in type 1 diabetes treatment. It aims to help readers better understand and control their condition through mastery of these diabetes management principles and tools.
29 ways to lose weight extremely fast, effective, and scientifically proven.pdf
Are you looking to lose weight to improve your appearance, your health, or even both? If you are, you may be looking for advice. The good news is that there are a number of tips that you can use to help you successfully lose weight and hopefully achieve your weight loss goal.
When it comes to losing weight, the best thing that you can do is eat healthy. Eating healthy involves watching the foods that you eat, not necessarily how much food you eat. Of course, you may want to restrict the amount of foods that you eat, when on a diet, but it is more important to focus on the foods that you do eat. For instance, if you were to eat fruit instead of chips, you could have more fruit snacks with your meals than you would be able to if you were just to eat junk food.
Since eating healthy is an important component of losing weight, you may be wondering how you can go about doing so. One of the first things that you should do is find and familiarize yourself with healthy meals. You can do this by way of standard internet search or by buying a collection of healthy eating recipe books. To reduce the boredom often associated with healthy eating, especially if you are not use to it, it is important that you “spice,” up your foods and try to not eat the same meals over and over again each week.
In connection with healthy eating, regular exercise is also important to weight loss. If you are looking to lose weight, you should start an exercise plan for yourself. Exercise is important as it burns off calories. When you burn calories, the amount of calories that your body absorbs decreases. This is, essentially, what makes it possible for you to lose weight. If you haven’t been exercising regularly in the past, it is important that you take it slow. Exercise is a great way to lose weight, but you do not want to overdo it, especially at first.
If you don’t currently have an exercise plan or program in place, you may be wondering more about what you can do. One of the many ways that you can go about finding exercises or workouts to do is by buying a collection of fitness magazines. Many fitness magazines have detailed exercises outlined in them, often accompanied by pictures. You may also be able to find free instructional workout videos or exercise moves online. As a reminder, it is important to start out slow or at least start with exercises that would be easy for you to.
Eating healthy and regular exercise are both important components of losing weight, but there are additional tips that you can use to help you lose weight. One of those tips involves finding a workout partner or a workout buddy. This is a person who can exercise with you, whether your exercise involves visiting a local gym or just going for a walk at a local shopping center. Having a workout partner may help to keep you motivated and it may help to keep exercising and losing weight fun and exciting for you.
Sport Nutrition For Competitive Rowing
Cristina Sutter, MHSc., BSc (Kines)
Registered Dietitian
www.satoriintegrativehealth.com
csutter@sfu.ca
6 weeks beach body transformation
Think about replacing the extra weight with excitement and pride as you unveil your beach body. You will feel lighter, sexier and confident. Whatever you have been feeling: setback, disappointment, lack of visible results… Now it is the time for that fabulous great change after months of letting yourself down, here is the plan to achieve the dream body. I have the recipe: blend of incredible training and a diet program. Follow my rules, work hard and soon you will see the result: your new lean body and muscular tone physique.
General athlete eating guide
This document provides an athlete eating guide with recommendations for meal timing and composition throughout the day to support performance and recovery. It recommends eating 6-7 small meals per day with plenty of water and getting protein, carbohydrates and nutrients within 60 minutes of workouts. Sample meal plans are provided that emphasize high-quality protein, complex carbs and hydration. Supplement recommendations focus on creatine, glutamine and protein/amino acids around workouts. The effects of alcohol on performance are discussed. Maintaining proper hydration is highlighted as critical for peak athletic performance.
LS Vibe 30 Day Pledge to Weight Loss
This document provides information about a program to help people lose weight and improve their health and fitness. It outlines a 6-day per week plan including consuming protein shakes, meal replacements, and supplements to support weight loss goals. The plan emphasizes developing healthy habits through eating whole foods, staying hydrated, getting enough sleep, and exercising regularly, including interval cardio and resistance training. Customers can order the products retail or sign up for discounted monthly subscriptions.
1500 calorie diet_programs
This document discusses a 1500 calorie diet program for losing weight and burning fat. It describes the program as involving 6 meals per day of around 250 calories each, containing protein, carbohydrates, and fats. The program is said to allow significant weight loss without drastically reducing calories. It also includes exercise recommendations for fat burning and strength training.
Insulin therapy- art of initiation and titration
The document outlines guidelines for initiating and titrating insulin therapy. It recommends starting with either bedtime intermediate-acting or morning/bedtime long-acting insulin, and titrating the dose to reach fasting glucose targets. If HbA1c remains above 7% after 2-3 months, additional injections of rapid-acting insulin should be added at mealtimes based on pre-meal glucose levels. Further intensification, such as checking postprandial levels and adjusting prandial insulin, is recommended if HbA1c is still not at target. The guidelines provide a step-wise approach to optimizing insulin regimens based on glucose and HbA1c monitoring.
What Did You Eat This Morning?
Watch the results before your eyes:
http://www.facebook.com/pages/Shapeworks-Tips-For-Better-Results/174161048871?v=app_2392950137#/video/video.php?v=213325257066
godd carbs vs bad carbs: how this could save your life
This document discusses the differences between "good" and "bad" carbohydrates. It notes that carbohydrates control insulin levels and fat storage, so limiting carb intake can help with weight loss. Not all carbs are bad - fruits and vegetables are preferable sources due to their nutrient content and lower carb counts per serving compared to grains, legumes, and processed foods. The document recommends limiting intake of grains, sugars, legumes, and processed foods, and consuming 0-100g of carbs per day for weight loss or maintenance.
Nutrition for exercise and sport
This document discusses nutrition guidelines for exercise and sport. It covers nutrient needs for active individuals, including dietary reference intakes and recommendations for carbohydrate, protein, fat, fluid and pre-workout meal intake. Guidelines are provided for different types of sports and phases of training, including carbohydrate loading. The needs for weight gain and muscle building are also outlined. Nutrient timing for resistance training is discussed.
Total Life Changes HCG Guide
The document discusses how the HCG Life Drops weight loss program works. It explains that HCG activates the hypothalamus to mobilize abnormal stored body fat to be used as energy when following a very low calorie diet of 500 calories per day. The program is divided into 4 stages, where stages 1-3 involve taking the drops daily and following the low calorie diet, and stage 4 gradually increases calorie intake while maintaining the new weight. The science behind it is that HCG reprograms the brain's metabolism to start burning fat like a thin person rather than storing it. Strict adherence to the program, including the low calorie intake, is required to achieve weight loss of 1-2 pounds per day.
Iaso HCG Diet Life Drops Program Guide and FAQ
HCG (Human Chorionic Gonadotropin) is what triggers the hypothalamus region to mobilize stored fat into the bloodstream to be used as food. It is believed to reset your metabolism and to protect your body’s good fat and keep muscle tissue from breaking down. (which occurs in other low calorie diets without using HCG).
How to Lose Weight in a Week
A Simple Yet Effective Tip!Maintain a daily food journal. Writing down what you eat, drink, and in w...
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TLCDBU-2016: Emotional Foundation for Managing Diabetes
This document provides information and advice for managing the emotional challenges of living with type 1 diabetes (T1D). It discusses how the demands of diabetes management can take an emotional toll on families and lead to distress, conflicts, burnout and feelings of being overwhelmed. It emphasizes that distress and burnout are common for all families dealing with T1D and offers suggestions for recognizing signs that outside support is needed. The document provides recommendations for setting realistic goals, using positive language, praising diabetes management behaviors, finding humor, getting support and focusing on living well with T1D despite the challenges.
TLCDBU-2016: Diabetes Emergencies
This document discusses managing diabetes emergencies such as high blood glucose levels and ketones. It provides guidance on correcting high blood glucose and ketone levels, identifying the cause, and learning from the experience. Specific tips are given for fluid management and insulin adjustments when sick with high blood glucose and ketones. Signs for when to call the diabetes care team are outlined. Instructions are also provided for using mini-dose glucagon to treat hypoglycemia during illness. The presentation aims to help patients and care teams find patterns in blood glucose levels to better manage diabetes and emergencies.
TLCDBU-2016: Road to the artificial pancreas 2016
Researchers are making progress toward the artificial pancreas (AP) with 2016 focusing on real-world testing of algorithms. Key areas of interest for 2017 include transparency of researcher methods and data, effort required by patients, and reimbursement discussions. Continuous glucose monitoring accuracy and wear time remain barriers, as do pump reliability and immune responses. Both algorithmic and heuristic approaches are being studied, with personalization seen as important. Success has also come from grassroots integration and sharing of existing technologies.
TLCDBU-2016: Sugar Surfing workshop - Dr. Steven Ponder
This document contains notes from a presentation on Sugar Surfing, which is described as a metaphor for "Dynamic Diabetes Self-Management" that goes beyond fixed dosing formulas. It involves learning to steer one's glucose responses in the moment using pattern management. Examples are provided of glucose readings from individuals of various ages who practice Sugar Surfing, demonstrating how it can be done regardless of insulin method or diet. Key concepts of Sugar Surfing like pivots, drops, shelves and following trends are defined and illustrated with graphs.
Mixing Sports and Diabetes
This document discusses how people with diabetes can participate in sports and exercise safely by managing their blood glucose levels. It explains that all sports are allowed for people with diabetes, but they need a plan to monitor and adjust insulin doses and carbohydrate intake before, during, and after physical activity, as exercise can either increase or decrease blood glucose depending on its intensity and duration. The document provides specific tips, such as checking blood sugar more frequently during exercise and consuming carbohydrates to prevent or treat low blood sugar. It emphasizes the importance of education coaches and teammates about diabetes management as well as having necessary supplies available for physical activity.
Challenging Food Situations
Meaghan Anderson presented on challenging food situations for people with diabetes. She discussed macronutrients and their impact on blood glucose, how to calculate carbohydrates and estimate insulin needs. She explained glycemic index and load, and emphasized the importance of chewing food and using carb counting to estimate blood sugar impact of meals.
Count Your Carbs & Eat Them Too!
This document provides information on counting carbohydrates for managing blood sugar levels for those with diabetes. It discusses that carbohydrates have the greatest effect on post-meal blood sugar, and counting carbs allows for better glucose control and more flexibility. Standard serving sizes are outlined for various food groups containing carbohydrates like breads, fruits, milk, and starchy vegetables. Artificial sweeteners and proper portion sizes are also discussed as important factors for blood sugar management.
Social media 032415
This document discusses the benefits and cautions of using social media related to diabetes. It provides examples of social media platforms and blogs for connecting with others about diabetes experiences and education. Key benefits highlighted include accessing real-time support, educational content, and humor from others dealing with diabetes. However, cautions mentioned include varying treatment needs between individuals, relying too heavily on social media, and potential online safety issues.
Getting support 032415
This document discusses types of support for managing diabetes and provides suggestions for building a supportive network. It identifies emotional and hands-on support, potential support people like family, friends, and care teams, and recommends asking supports to help with specific diabetes tasks. The document also notes that communicating treatment needs calmly, praising behavior, and problem-solving together are most helpful, while blaming, shaming, nagging or denying worries are not supportive. It encourages expressing experiences to gain support and finding balance through fun family activities and self-care.
Living well 032415
This document discusses the challenges of managing diabetes and the toll it can take on families. It notes that while behavior is important for blood glucose control, many other factors also influence levels. Parents often feel responsible for blood glucose numbers outside of their control. The document acknowledges that distress, burnout, conflicts and feeling overwhelmed are common experiences for families dealing with diabetes. However, it provides suggestions for improving diabetes management and quality of life, such as focusing on strengths, catching children being good with their management, using praise over criticism, setting realistic goals, and finding humor.
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This is a presentation authored and presented by my friend and colleague at Baylor College of Medicine, Dr. Barbara Anderson. This is a module in the 2014 Advanced Diabetes Seminar at Texas Lions Camp.
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Diabetes Family Teamwork with Teens: What is Success?
This is a presentation authored and developed by my friend and colleague Dr. Barbara Anderson of Baylor College of Medicine. The presentation is a module in the 2014 Advanced Diabetes Seminar, hosted by Texas Lions Camp.
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How, When and Why to Use Advanced Insulin Pump Features
- 1. How, When and Why to Use Advanced Insulin Pumping Tactics Meaghan Anderson, MS RD LD CDE
- 2. How to use the temp basal and bolus options When to use these options Why to use these options Learn the other bells and whistles on your pump Objectives
- 3. What is it? Allows you to immediately increase or decrease your basal rate, for the temporary time you set Set for 30 minutes to 24 hours in 3o minute increments Can be canceled Temporary Basal Rate
- 4. Percent of basal a percentage increase or decrease of current basal rate(s) Rate can be reduced to 0% and increased up to 200% Max sure you max basal rate is set to be double your highest basal rate Insulin rate a fixed basal in units per hour (U/H), which is independent of current basal rate Temp Basal Rates can be set based on preference:
- 5. When to use… Increase Illness Menstrual cycle Steroids Decrease in activity Stress Decrease Exercise Increased activity Fasting labs Surgery
- 6. There is a decreased need for insulin when we are more active, basal rates are set for a “typical day” There is an increased need for insulin when we are stressed, ill or less active Keep in mind the peak action of insulin when setting a decreased basal rate Why to use…
- 7. Basketball Practice George has a 2 hour basketball practice His blood glucose 1 hour before practice is 136 mg/dl He has noticed a trend in low blood sugars during practice Recommentation… Reduce basal rate to 50% for 4 hours Set the reduction to start 1 hour before practice Monitor hourly to see if it is working
- 8. What if… Hour BG Pre 136 1 hr 122 2 hr 167 3 hr 184 4 hr 192 Consider reducing percent decrease… Temp basal set for four hours and reduce to 65% of usual rate
- 9. Sick Day Kate as been ill for the last 24 hours and blood glucose is consistently >200 What could she try to get blood sugars closer to normal? Increase basal by 20% for four hours, continue to increase in 20% increments until blood glucose levels are closer to normal Monitor frequently
- 10. Sick Day Increase basal by 20% Hour BG 1 226 2 208 3 215 4 234 Increase basal by 40% Hour BG 1 195 2 187 3 154 4 142
- 11. 1. Normal 2. Square/Extended 3. Dual Wave/Combo Three Types of Boluses…
- 12. NORMAL BOLUS Bolus amount delivers as soon as amount is confirmed Used for meals with average fat and carb content Also used for correction boluses
- 13. Square/Extended Bolus The bolus amount delivers evenly over the period of time you set Primarily used by those who have delayed digestion (gastroparesis) Used when eating carbs over an extended period of time
- 14. Dual/Extended Bolus Bolus amount is split Used for meals both high in fat and carb, which may delay digestion (ie pizza, Chinese or Mexican food) Percent you set to deliver now and as a square wave will vary based on meal content as well as premeal blood glucose
- 15. Mamacita’s Frank has added up his carbohydrates and he is going to eat 105 gm of carb (fajitas, rice, beans, chips) His premal glucose is 110 mg/dl What should Frank do? Program a dual/extended bolus 50-50 split for 2-4 hours Monitor frequently so he know next time if this was the best way to deliver the insulin
- 16. Results Hour BG Pre 110 1 70 2 110 3 145 4 170 Since one hour post meal BG is low consider giving less insulin upfront (25/75 split More insulin delivered later should also help 3 and 4 hour BGs be closer to target
- 17. FRUIT LOOPS Sara is going to eat 70 grams worth of cereal with milk. Her current glucose is 105 mg/dl What is her best bolus option? Normal bolus Remember to take insulin 15-20 minutes prior to eating to prevent abrupt spike in blood sugar
- 18. Results Hour BG Pre 105 2 155 4 116 Perfect! Two hour post prandial glucose is expected to be 40-60 points higher the pre meal glucose
- 20. Alarm clock Set it for normal eating times to remind you to check blood sugars and bolus Missed Bolus Reminder Eat at noon Set reminder from 1130 to 1230 BG Reminder Available on both pumps and glucose meters Tools for the forgetful…
- 21. A great tool for those who have varied lifestyle for greater than 24 hours Examples Sleep in on weekends Active weekday, couch potato weekend MWF Schedule for T/Th Menstrual cycle Basal Patterns
- 22. Average blood sugar Carb intake Total Insulin Basal units and percentage Bolus units and percentage Number of correction and food boluses Daily Totals