Lifestyle intervention programs should be intensive and have frequent follow-up to achieve reductions in excess body weight.
“Children and adolescents with type 1 or type 2 diabetes or prediabetes should engage in 60 min/day or more of moderate
Screens for prediabetes and risk for future diabetes in asymptomatic adults
Testing for prediabetes considered in adults of any age, but who are overweight or obese
Starts testing all adults age 45 onwards regardless of their weight or risk factors
If diabetes is diagnosed, Dr. Alur will treat based in best case possible. If diet-related, will recommend changes in diets. Will prescribe medication, if necessary.
Communicates with patients in a person-centered manner while actively listening and assessing barriers to optimal health outcomes.
Dr. Alur evaluates for diabetes complications and potential comorbid conditions and then develops a continuing care plan. A follow-up will be scheduled to exam and assess treatment targets.
If patient has autoimmune disease:
“Consider screening patients with type 1 diabetes for autoimmune thyroid disease and celiac disease soon after diagnosis.”
If patient has Cognitive Impairment:
“In people with a history of cognitive impairment/dementia, intensive glucose control cannot be expected to remediate deficits. Treatment should be tailored to avoid significant hypoglycemia.”
“Moderate alcohol intake does not have major detrimental effects on long-term blood glucose control in people with diabetes. Risks associated with alcohol consumption include hypoglycemia (particularly for those using insulin or insulin secretagogue therapies), weight gain, and hyperglycemia (for those consuming excessive amounts). People with diabetes can follow the same guidelines as those without diabetes if they choose to drink.”
“Diabetes is associated with increased risk of cancers of the liver, pancreas, endometrium, colon/rectum, breast, and bladder. The association may result from shared risk factors between type 2 diabetes and cancer (older age, obesity, and physical inactivity) but may also be due to diabetes-related factors, such as underlying disease physiology or diabetes treatments. Patients with diabetes should be encouraged to undergo recommended age- and sex-appropriate cancer screenings and to reduce their modifiable cancer risk factors (obesity, physical inactivity, and smoking).”
“Management and reduction of weight is important for overweight and obese people with type 1 and type 2 diabetes. Lifestyle intervention programs should be intensive and have frequent follow-up to achieve significant reductions in excess body weight and improve clinical indicators. There is strong and consistent evidence that modest persistent weight loss can delay the progression from prediabetes to type 2 diabetes and is beneficial to the management of type 2 diabetes (see Obesity Management for the Treatment of Type 2 Diabetes section).”
“Children and adolescents with type 1 or type 2 diabetes or prediabetes should engage in 60 min/day or more of moderate- or vigorous-intensity aerobic activity, with vigorous muscle-strengthening and bone-strengthening activities at least 3 days/week.” “All adults, and particularly those with type 2 diabetes, should decrease the amount of time spent in daily sedentary behavior. B Prolonged sitting should be interrupted every 30 min for blood glucose benefits, particularly in adults with type 2 diabetes.” “Flexibility training and balance training are recommended 2–3 times/week for older adults with diabetes. Yoga and tai chi may be included based on individual preferences to increase flexibility, muscular strength, and balance.”