DM Full Guideline (2010) - VA/DoD Clinical Practice Guidelines Home

Version 4.0
General principles to be reviewed are:
BASIC DIET GUIDELINES
• Eat at regular times—distribute CHO food intake throughout the day.
• Define CHO, protein, and fat.
• Describe which foods affect blood sugar the most (e.g., CHO).
VA/DoD Clinical Practice Guideline
for the Management of Diabetes Mellitus
• Emphasize the importance of eating a variety of foods, increasing fiber, and a hypocaloric diet—if
overweight, e.g., decreasing fat intake and controlling portion sizes.
• Sick day management
• When to seek further medical assistance
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Additional resources are available at:
SPECIAL CIRCUMSTANCES
• Take Charge Of Your Diabetes. Third edition. Can be downloaded from the CDC web site:
http://www.cdc.gov/diabetes/pubs/tcyd/index.htm
• What I Need To Know About Eating And Diabetes. Can be obtained free from the National Diabetes
Clearing House (301) 654-3327 or at http://www.ndic@info.niddk.nih.gov/
• www.ndep.nih.gov
CORE COMPETENCIES AND DIABETES SELF-MANAGEMENT EDUCATION (DSME)
Diabetes self-management education (DSME), including medical nutrition therapy, is an interactive, collaborative,
ongoing process involving people with diabetes and educators. As opposed to didactic education, DSME is skillbased
learning. The four-step process comprises:
• Assessment of the individual’s educational needs
• Identification of individual’s specific self-management goals
• Education and behavioral interventions aimed at meeting individual’s goals
• Evaluation of the individual’s progress towards goals
The revised standards identify the following as essential curricula components for DSME:
• Describing the diabetes disease process and treatment options
• Incorporating appropriate nutritional management
• Incorporating physical activity into lifestyle
• Using medications (if applicable) for therapeutic effectiveness
• Monitoring blood glucose, monitoring blood or urine ketones (when appropriate), and using the results to
improve control
• Preventing, detecting, and treating acute complications
• Preventing (through risk-reduction behavior), detecting, and treating chronic complications
• Goal setting to promote health; problem-solving for daily living
• Integrating psychosocial adjustment into daily life
• Promoting preconception care, management during pregnancy, and gestational diabetes management (if
applicable)
• Diabetes overview
• Stress and psychological adjustment
• Family involvement and social support
• Nutrition
Module M: Self-management Page 119