The
Wellness Centers have
a special interest and
unique management program
for diabetic patients
and for those with insulin
resistance. Thousands
of patients have been
treated at the Center
with great success and
improvement in their general
health and wellness. The
following outlines the
Wellness Center's protocol
for diabetes management.
| I. |
A
Initial History and
Physical is performed |
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*Electrocardiogram
*Blood Chemistries
including: |
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Lipid
Profile
Female/Male Hormonal
Profile
Growth Hormone
Fasting Plasma Glucose
C-Peptide Levels
Homocysteine
Fibrinogen
Glycohemoglobin |
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*Urinanalysis |
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Microalbumin
24 hr. Creatinine
Clearance
Protein
Ketones |
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*Physical
Examination |
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Special
attention to circulatory
system
Blood Pressure determined
Ophthalmoscopic examination
Thyroid palpation
Abdominal examination
Foot examination
Evaluation of pulses
(palpation)
Hand/Finger examination
Skin examination
Height and Weight |
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*Body
Mass Index Evaluation
*Body Composition
Measurements
*Glucose Tolerance
Test with Insulin
Levels when deemed
necessary
*Referral for Optomathology
evaluation |
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| II. |
Recommendation
of a Cardiac Evaluation |
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*Evaluation
of Valvular Status
*Stress Echo Cardiography
*Echocardiogram
*High Resolution Multi-Site
Imaging
*Carotid arteries
*Aorta
*Femoral arteries |
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| III. |
Individual
Meeting with the Doctor
and the Certified
Nutritionist |
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*Evaluation
of the clinical studies
and the laboratory
chemistries performed
*Evaluation of symptoms,
prior glycohemoglobin
records, and home
glucose monitoring
results
*Review of eating
patterns, nutritional
status and weight history
*Review of exercise
history
*Medical Management
Program developed |
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| IV. |
The
Program |
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*Control
the Hypertension
*Introduce an individual
Smoking Cessation
protocol
*Develop a Weight
Reduction Profile
*Establish appropriate
weight loss profile
*Establish a tailored
exercise program
*Utilization of aerobic
activity combined
with weight resistance training
*Behavior Modification
*Food Logs when indicated
*Introduction of Short
and Long term Goals
*Normalization of
Blood Lipids
*Stabilization of
Glucose and Insulin
Levels |
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| V. |
Establish
Individual Patient
Oriented Dietary Goals |
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| VI. |
Incorporate
Appropriate Vitamin
and Mineral Therapy
for Controlling
Glucose and Lipid
Abnormalities |
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*Cholesterol
and Lipid Lowering |
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Magnesium
Niacin (with caution)
Pantathene
Essential Oils
Fiber Complex
Guggalipids
Phytosterols
Garlic
N-acetyl cysteine
Soy Protein
Choline |
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*Insulin
and Glucose Regulating |
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Chromium
Lipoic Acid
Magnesium
Ginseng
Fiber Complex
Probiotics
Vanadium
DHEA
B-Vitamins
Selenium
Fiber Complex |
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| VII. |
Introduce
Pharmacological Therapy
when necessary for
controlling: |
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*Hypertension
*Hyperlipidernia
*Hypertriglyceridemia
*Glycemic Control |
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| VIII. |
Management
of Type 2 Diabetes
Mellitus |
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*Introduction
of Short and Long
term Goals
*Evaluate appropriate
medication necessary
*Develop Medical Nutrition
Program
*Encourage Lifestyle
Changes
*Review and Incorporate
Self Management Education
*Education on new
glucose monitoring
machines
*Evaluate individual
technique
*Obtain Agreement
on Continuing Support
and Follow up |
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| IX. |
Review
of Management Plan |
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*Evaluate
each visit |
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Short
and Long Term Goals
Glycemia
Medications
Weight
Frequency and Severity
of Hypoglycemia
Self Blood Glucose
Monitoring Results
Complications
Control of Dyslipidemia
Blood Pressure
Nutrition Program
Exercise Program
Adherence to Self-Management
Training |
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| X. |
Management
of Type I Diabetes
Mellitus |
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*Evaluation
of Dietary Guidelines
*Review of Self Blood
Glucose Monitoring
*Review of Dietary
and Lifestyle Factors
*Review of Type of
Insulin Used and Frequency
of Use
*Evaluate if Oral
Therapy is Appropriate
in Conjunction with Insulin
Therapy
*Management of Hypo/Hyper
glycemia
*Establish an Appropriate
Exercise Program
*Schedule Monthly
Conferences with the
Doctor and the Certified Nutritionist
*See Review of Management
Plan For Type 2 Diabetes
Mellitust |
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