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Life Style and Behavior

A diabetic person must demonstrate great adaptation capacities to change his life style. The psychological effect must be considered. A good approach can help a patient to understand that it is possible to avoid complications if some changes are brought: a change of life style (better eating habits, the practice of physical activity), better control of the use of medication and regular check-ups.

Presentations listing

Television Viewing Time and Blood Glucose Levels in... - Dr. David Dunstan
The Acute Effect of Various Glycemic Index Dietary... - Dr. Talya Lavi
Communicating Effectively with Patients - Dr. Irene Hramiak
A Practical approach to Treating Obesity - Dr. Barry Simon
The Importance of Carbohydrate Counting in the Management... - Dana Whitham

"Television Viewing Time and Blood Glucose Levels in Australian Adults"

Dr. David Dunstan (biography)
English - 2005-04-15 - 24 minutes
(17 slides)

Summary :
Sedentary behaviours, as well as physical activity, are important determinants of glycaemic control. We examined the associations of television (TV) time with fasting blood glucose (FBG) and 2-hour blood glucose levels (2-hr BG) in Australian adults.

Materials and Methods:
A population-based cross-sectional study (AusDiab) included 9,966 adults aged...

Learning objectives :
After viewing this presentation, participants will be able to discuss:
• The sedentary death syndrome
• The different types of sedentary behaviours
• The association between television viewing time and fasting and 2-hour blood glucose levels

Bibliographic references :
David W. Dunstan, PHD, Jo Salmon, PHD, Neville Owen, PHD, Timothy Armstrong, PHD, Paul Z. Zimmet, MD, Timothy A. Welborn, PHD, Adrian J. Cameron, MPH, Terence Dwyer, PHD, Damien Jolley, MSC and Jonathan E. Shaw, MD on behalf of the AusDiab Steering Committee Physical Activity and Television Viewing in Relation to Risk of Undiagnosed Abnormal Glucose Metabolism in Adults Diabetes Care. 2004 Nov;27(11):2603-9.

David W. Dunstan, Paul Z. Zimmet, Timothy A. Welborn, Maximilian P. de Courten, Adrian J. Cameron, Richard A. Sicree, Terry Dwyer, Stephen Colagiuri, Damien Jolley, Matthew Knuiman, Robert Atkins, and Jonathan E. Shaw The Rising Prevalence of Diabetes and Impaired Glucose Tolerance: The Australian Diabetes, Obesity and Lifestyle Study Diabetes Care 25: 829-834.



"The Acute Effect of Various Glycemic Index Dietary Carbohydrates"

Dr. Talya Lavi (biography)
English - 2005-04-15 - 24 minutes
(19 slides)

Summary :
Postprandial hyperglycemia is as an important risk factor for cardiovascular disease. The current study was designed to explore the acute effect of various glycemic index dietary carbohydrates on endothelial function.

Methods: We prospectively assessed endothelium-dependent flow-mediated vasodilation (FMD) brachial artery vasoreactivity non-invasively in 34 consecutive healthy...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- The effect of oral glucose loading on endothelial function
- The effect of different glycemic index foods on endothelial function

Bibliographic references :
Hiroaki Kawano MD, Takeshi Motoyama MD, Osamu Hirashima MD, Nobutaka Hirai MD, Yuji Miyao MD, Tomohiro Sakamoto MD, Kiyotaka Kugiyama MD, Hisao Ogawa MD and Hirofumi Yasue MDHyperglycemia rapidly suppresses flow-mediated endothelium- dependent vasodilation of brachial arteryJournal of the American College of Cardiology
Volume 34, Issue 1 , July 1999, Pages 146-154.



"Communicating Effectively with Patients"

Dr. Irene Hramiak (biography)
English - 2003-10-17 - 32 minutes
(36 slides)
(1 question)

Summary :
Diabetes is a chronic disease which requires self management. Our role in the diabetes clinic and diabetes education centers is to “educate” or share knowledge with our patients. So why are we tired and frustrated? Why do patients not achieve the goals for glycemic control? This discussion today will teach some strategies that are used in the business and sports worlds. We want to show you how to...

Learning objectives :
The participant will learn about specific challenges encountered in the communication between the physician and the diabetic patient, and how to overcome them in order to improve management of the disease.



"A Practical approach to Treating Obesity"

Dr. Barry Simon (biography)
English - 2002-01-19 - 32 minutes
(36 slides)

Summary :
Psychological overview of overweight diabetes patients. Exposé on how to understand their dilemma, helping them find solutions and achieve a better comprehension of their decision-making power.

Learning objectives :
Upon completion of this presentation, participants should be able to:
1.Better understand how to use motivational interviewing (Miller et al) and lifestyle counseling for the purpose of encouraging lifestyle change.
2.Identify the common triggers for lapses and relapses in their Type 2 Diabetic patient.
3.Better understand the role of the Transtheoretical Model in the assessment of compliance in their Type 2 diabetic patients.

Bibliographic references :
The management of obesity in type 2 diabetes mellitus.

Valsamakis G, Chetty RK, Kumar S.

Diabetes Centre, Birmingham Heartlands Hospital, Bordesley Green East, UK.

Prevalence of obesity in the United Kingdom has tripled in the last 20 years and this is driving an epidemic of type 2 diabetes. Indeed, today the vast majority of patients with type 2 diabetes are overweight or obese. Effective weight management leading to modest weight loss to the order of 5-10% of body weight can lead to significant clinically meaningful benefits provided it can be maintained. Thus weight management can lead to improved glycaemic control, better blood pressure control and lipid control in addition to other benefits. Management of diabetic patients who are obese requires management also of other associated co-morbid conditions and it is important to ensure that glycaemic control does not deteriorate during weight management. An integrated approach to weight management in the diabetic patient is recommended which helps to promote lifestyle modification for all patients. Drug therapy may be appropriate for many obese patients who do not reach target weight loss with lifestyle modification alone. Surgery should be reserved for those with BMI >40 only after failed medical therapy.

Curr Med Res Opin 2002;18 Suppl 1:s75-81



"The Importance of Carbohydrate Counting in the Management of Diabetes"

Dana Whitham (biography)
English - 2002-01-19 - 20 minutes
(19 slides)

Summary :
Eating habits based on a carbohydrate breakdown. How to help patients in their everyday dilemma of healthy eating. Proper eating does not mean that one must eat differently than non-diabetics persons.

Learning objectives :
Upon completion of this presentation, participants should be able to:
1.Define carbohydrate counting.
2.Identify the benefits of carbohydrate counting compared to traditional meal planning approaches.
3.Describe characteristics of a patient who would do well with carbohydrate counting.

Bibliographic references :
Insulin resistance: concepts, controversies, and the role of nutrition.

Sievenpiper JL, Jenkins AL, Whitham DL, Vuksan V.

Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON.

Insulin resistance is a prevalent condition, in which insulin loses its normal physiological action. Since people were first classified as insulin resistant over 60 years ago, one of the main discoveries has been that insulin resistance clusters with other risk factors such as obesity, elevated triglycerides, and low high-density lipoprotein cholesterol, increasing cardiovascular disease risk. Although insulin resistance appears to manifest first in the periphery and then in the liver, other sites, such as the brain and the pancreatic &b.beta-cell, may play pathogenic roles. Factors contributing to insulin resistance at these sites include perturbations in free fatty acids, glucose, and hormone-signalling, some of which may be linked to various genetic polymorphisms. Appropriate nutritional treatment for insulin resistance is controversial. Two main approaches are drawn from diabetes recommendations: i) a high-carbohydrate, low-fat, high-fibre diet emphasizing low glycemic-index foods and ii) sharing calories between monounsaturated fat and complex carbohydrate at the expense of saturated fat. Recent interest in insulin resistance has prompted the development of new guidelines. Promising data have also emerged, showing that a high-carbohydrate, high-fibre, low-fat diet plus exercise programs maintained through intensive counselling can decrease diabetes risk by over 40%. Additional research is required to confirm the sustainability of this approach and sort out the determinants of insulin resistance so that more effective nutritional interventions will result.

Can J Diet Pract Res 2002 Spring;63(1):20-32


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