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Managing Teens and Insulin Resistance Henry Anhalt, DO, CDE Director, Pediatric Endocrinology and Diabetes Saint Barnabas Medical Center Livingston, NJ.

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Presentation on theme: "Managing Teens and Insulin Resistance Henry Anhalt, DO, CDE Director, Pediatric Endocrinology and Diabetes Saint Barnabas Medical Center Livingston, NJ."— Presentation transcript:


2 Managing Teens and Insulin Resistance Henry Anhalt, DO, CDE Director, Pediatric Endocrinology and Diabetes Saint Barnabas Medical Center Livingston, NJ

3 WHAT IS INSULIN RESISTANCE? Long associated with type 2 diabetes –a known risk factor for heart disease –occurs when the body does not properly use insulin to metabolize blood glucose –when insulin fails to enable cells to admit glucose, necessary for cells' energy production. –glucose then builds up in the blood, and additional insulin is required



6 Coping Skills u Accept what I cannot change u Strive to change what I can u Attempt to learn all I can u Set realistic goals u Seek support of others u Hope for new insight

7 Healthy Eating Finding the Right Balance


9 How do we choose our food? uTuTaste and enjoyment uTuTradition and custom uCuConvenience uMuMood uHuHunger uCuCost uHuHealth and nutrition

10 Ask Yourself... u Are you at your best weight? u Are your blood sugars usually within target range? u Is your cholesterol below 200? u Do you have a meal plan which you usually follow? u Is your meal plan varied? Enjoyable?

11 Why is healthy eating important? u Blood sugar control u Reduces risks of complications – Cholesterol – Blood pressure – Kidney disease u Weight control u Feel good

12 Meal planning questions: True or False You cant eat any sugar You must have 3 snacks a day False It is different for everyoneTrue You dont need special foodsTrue It is complicated False

13 General Guidelines u Choose Healthy Foods – limit fat - especially saturated fat – follow the pyramid u Be Consistent – meal times -dont skip meals – amount of food - have a balanced plate – types of foods - control carbohydrates

14 Carbohydrate Protein Fat / Alcohol

15 Your meal plan (carb goal) is…. u Based on the way you usually eat u Designed to help improve your control u Planned to space out carbohydrates u Changeable… if it doesnt work

16 What about fast foods? u Look for healthy choices u Learn what is in the food u Watch out for hidden fats

17 Exercise Moving Toward Better Blood Glucose Control

18 DIABETES TRIAD EXERCISE Medication Nutrition

19 Exercise benefits for diabetes control u Weight loss / Weight control u Helps insulin work better u Uses glucose for energy u Lowers blood glucose (in minutes) u Improves A 1 c (in weeks)

20 Why bother to exercise? u Medical – blood pressure, cholesterol, triglycerides, weight, A 1 c u Quality of life – fitness, strength – need for medication, sleep time u Psychosocial – stress, depression feel better

21 Why exercise? The main reason I am going to exercise is because I want to: ________________________

22 What type of exercise should I do? u Aerobic exercise u Strength training u Flexibility and stretching u Enjoyable and Convenient u SAFE – for diabetes (eyes, feet, kidneys) – for other health concerns (heart, lungs, aches and pains, etc)

23 Aerobic exercise choices u Weight-bearing activities – walking, jog/run, aerobic dance, ballroom/folk/line dancing, sports u Non weight-bearing activities – biking, swimming, water exercise classes, rowing, armchair exercise, video

24 Other options u Strength training u Flexibility and stretching u Exercise options to explore – join a health club; use exercise equipment; join an exercise program; call local schools, colleges, malls, clubs, etc. for more information on what is available

25 My exercise plan... For my exercise program I will ____________________________

26 How Often? For blood glucose control: 3 to 4 times a week For weight loss: 4 to 5 times a week

27 My exercise plan… My goal is to exercise ____ times a week. I will start with ____ times a week.

28 How Long? For blood glucose control: 20 to 30 minutes For weight loss: 45 to 60 minutes

29 My exercise plan... My goal is to exercise for ____ minutes. I will start with ____ minutes. (Plus a ____ minute warm-up and a ____ minute cool down.)

30 What Time of Day? Pick a time that fits into: – daily schedule – lifestyle – diabetes management plan

31 My exercise plan... The time of day I will most likely exercise will be ____ AM / PM.

32 Pre-exercise snack adjustments 30 minutes 15g Carb minutes 15g Carb + 7-8g Protein Long duration 15g Carb per hour and > 2 hoursdecreaseinsulin

33 Summary u Review your reasons to exercise u Review your exercise plan u Be consistent u Enjoy your success!

34 Who Succeeds? u Has a clear and realistic plan u Is prepared for obstacles u Has a strategy for getting support u Knows exactly what the first steps will be

35 Who loses their way? u Has goals that are too vague or rigid u Attempts too large of a lifestyle change u May be overly perfectionistic u Thinks that there will be no obstacles u Is not concerned about obtaining support

36 Developing a clear and realistic plan u Completing the three QuickPlans: – Monitoring – Meal Planning – Making time for exercise

37 Completing the QuickPlans u One self-care behavior at a time u A one month goal u Consider your obstacles u An immediate action plan to: – overcome obstacles – begin new behavior

38 Important principles for completing the QuickPlans u Realistic. Begin with small, achievable targets for change. u Action-oriented. Focus on new actions to begin, not old actions to stop. u Concrete. Know the exact actions which you will take.

39 Obstacles to Exercise u Exercise is boring u Too hard to find the time u May cause hypoglycemia u May cause too much pain/discomfort u Too tired to exercise u No one to exercise with

40 Overcoming Obstacles to Exercise u Try something new u Turn an unpleasant activity into a pleasant one u Modify environment to make exercise more convenient

41 Overcoming Obstacles to Exercise u Pay attention to how exercise positively affects blood glucose u Find an exercise partner / group u Seek out professional advice u Fight back against self-defeating thoughts

42 A Contract for Self-Care u Your action plan for diabetes success u Expect the occasional problems (ongoing problem solving is necessary) u Stay in touch!

43 Empowerment u The granting of power or authority to oneself u People become empowered when they use all their resources, psychological, social, emotional and spiritual, to solve their own problems or achieve their own goals

44 Forces that Threaten Empowerment u Fear u Anger u Ignorance u Hopelessness u Misguided Help

45 4 Pillars of Empowerment u Awareness u Chioce u Freedom u Resposibility

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