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Nuts and Bolts: Track 1 - July 8th, 2019

This track is intended to update all professionals on some of the essential aspects of diabetes care in a weight-neutral way.

Michelle May, M.D.

Level 1: Implementing National Guidelines from a Weight-Neutral Lens
Providing DSMT and MNT from a weight-neutral perspective requires professionals to synthesize myriad national guidelines in the context of weight-inclusive care. Dr. Michelle May will speak about how she updated her diabetes self-management training program to be weight-neutral. She’ll provide specific examples of the revisions made in her book, Eat What You Love, Love What You Eat with Diabetes and in the Am I Hungry? Mindful Eating for Diabetes consumer program and professional training.
Learning Objectives
  • Participants will identify at least three weight-focused diabetes guidelines and state specific reasons these recommendations are problematic.
  • Participants will state weight-inclusive guidelines that may form the foundation of diabetes care.
  • Participants will identify DSMT/MNT counseling messages that may contribute to disordered eating, shame, and/or weight stigma and develop alternate DSMT/MNT counseling messages that support a weight-inclusive, non-restrictive approach.

 

 

Holly Paulsen RD, CEDRD-S, LD

Level 2: Gentle Nutrition in the Prevention and Treatment of Type 2 Diabetes
Individuals at risk for developing diabetes and those already diagnosed are often fearful and discouraged, believing that an overly restrictive, sugar-free, fat-free, pleasure-free way of eating is the only means to stave off or manage the disease. This belief can even keep some patients stuck in a cycle of restrictive eating and binge eating. At the same time, many health practitioners are becoming aware of the benefits of a mindful eating or an intuitive eating approach but stop short of recommending their use in patients with diabetes. Is there really a way to maximize blood sugar control while enjoying food? Is there a way to put guidelines into practice without triggering overeating or binge eating? Absolutely! This session will outline the benefits of implementing a “gentle nutrition” perspective to normalize eating, enjoy food, and provide hope to those managing diabetes.
Learning Objectives
  • Examine the relationship between disordered eating and diabetes
  • State benefits of a flexible, intuitive or mindful eating approach in preventing and managing Type 2 diabetes
  • Apply specific language, strategies and techniques to engage and guide patients/clients in following internal cues for eating

 

 

Laurie Klipfel RN, MSN, ANP-BC, CDE, WCC

Level 3: Insulin Resistance: Signs, Symptoms, and Causes
It is very often assumed that weight gain “causes” insulin resistance and that insulin resistance leads to diabetes. Weight loss is therefore often recommended to “prevent” diabetes. While an association can make it look like a causal effect, we actually have no evidence of a causal relationship between weight and diabetes. In reality, diabetes is actually a multifactorial disease with a strongly genetic pathogenesis. Less than 5% of people can lose more than 5% of their weight and keep it off. Regardless of weight loss, healthy behavior can benefit insulin resistance and therefore delay the onset of diabetes. Unsuccessful weight loss efforts can lead to increased stress/depression and decrease motivation for healthy behavior. Evidence shows that it is more beneficial to focus on healthy behavior rather than weight. We are gathering more evidence that improving insulin resistance leads to decreased weight rather than decreasing weight leading to improved insulin resistance.
Learning Objectives
  • List 5 things that can improve insulin resistance
  • Describe3 benefits of recognizing genetic component of insulin resistance
  • Assess benefit vs risk for medications that increase insulin resistance

 

 

Rahaf Al Bochi RDN, LD

Level 3: Clinical Implications of Faith-Based and Dietary Fasting with Diabetes
Fasting is a traditional practice of many faiths which involves abstaining from food, drink or both. Intermittent fasting has also become an increasingly popular trend in the last few years. Fasting may offer several health and spiritual benefits, however it may pose a risk for some people with diabetes. One of the most commonly studied faith-based fasting with diabetes is in Muslim populations fasting for Ramadan. There are Clinical Practice Guidelines for healthcare practitioners to support patients with diabetes during Ramadan. As the diversity of North America’s ethnic population continues to increase as well as the emerging research on intermittent fasting, dietitians are more likely to see clients fasting with diabetes. This presentation will help dietitians understand the current clinical and nutrition recommendations to best support patients fasting with diabetes.
Learning Objectives
  • Learn about the different types of fasting.
  • Understand the clinical and nutritional guidelines for people fasting with diabetes.
  • Increase competency for the role of the dietitian counseling clients fasting with diabetes.

 

 

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