CONTENTS OF THE 16 WEEKS COACHING

To be done by the maritime medical clinic at start.
The medical clinic does the usual lab analysis including weight, height, HbA1c, total cholesterol, LDL, HDL, and TG The Clinic selects a possible participant that complies with the inclusing criteria (A1c- 5.7-6.4%) The seafarer is informed that he/she has been diagnosed with pre-diabetes, that can be reversed to normal blood sugar by following a healthy meal plan and physical activity in a "Coaching program". The seafarer is invited to participate in the 16 weeks coaching program The clinic completes the results in the Google Forms
The first meeting online or physical with the seafarer and the coach
Information on the objectives and the content of the program Access to wifi, mobile phone and lap-top during the next 4 months Learn how to complete the Questionario weekly, e.g. every Saturday)^[1]. Agreement on the start and end day of the program. Agree to buy and bring on board:Glucometer,^[2] Blood pressure monitor ^[3], Wrist trip counter and Fitness rubber resistance bands Exchange of contact information on e-mail, mobile WhatsApp/Messenger Select a DIETARY PROGRAM ^[4]There are several ways to promote healthy blood sugars: Exercise, Drink Water, Get Enough Sleep, Aim Fiber-rich whole-grains. Select an ACTIVITY PROGRAM ^[5] Get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week. Add moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) on at least 2 days per week. Spend less time sitting. Even light-intensity activity can offset some of the risks of being sedentary. Gain even more benefits by being active at least 300 minutes (5 hours) per week. Increase amount and intensity gradually over time as advised by the American Heart Association.
To be done by the Seafarer at start, week 1.
Own measurements	Learn to use Glucometer & Blood pressure monitor.
Laboratory tests	The start including A1c, total cholesterol, LDL, HDL, TG from the medical exams to Excel scheme^[6].
Personal measures	Waist Circumference, cm - How to measure: ^[7]
Excel report scheme	Learn to use the Excel scheme to report the actual status of physical activity, healthy eating and goals
The seafarer completes tests (repeated after 16 weeks)
Knowledge test	Test of knowledge on T2D and pre-diabetes (Fitzgerald et al.)
IPAQ START test	The seafarer completes the IPAQ test https://docs.google.com/forms/d/1EEVxRypFxzmnGF3q7MsCpNNFGKNozMMq4zfi_bakLx8/edit
FFQ START test	The seafarer complete15-Item Food Frequency Questionnaire and the Coach register the result^[8]https://docs.google.com/forms/d/1pMFSEYMJU-LRtHAPAuQ0Pz6hLFLA7RBAC37q9AYiBUM/edit
STRESS test	Do the stress test at the start, in the middle and at the end https://docs.google.com/forms/d/1XgB5zdCM4ka4hnINhkZLcs2FtDn5TrgDedxbrbJwxzg/edit
To be done by the Seafarer and the Coach every week
To be done by the Seafarer:	Complete the Excel file with the results at the end of each week. Measure Blood pressure self-test on two selected days a week Make the Glucosemeter Fasting self test and Blood Pressure on a fixed day in the week, e.g. Saturdays. Add all the results to the Excel sheet on Saturdays.Read and be orientated on the educative materials marked with A for each week.
To be done by the Coach:	Get the name and mobile number for the seafarer who wants to join Invite the seafarer for a short orientation Zoom meeting Stay orientated on the seafarers results and the goals in Excel file Send WhatsApps on all Mondays to the participant and acknowledge the goals and the results. Select important readings with an adequate size to be (skimmed) read by the seafarer - marked with an "A"Readings marked with "B" are optional
To be done by the Seafarer at start, after 16 weeks and after 1 year
Laboratory tests	Get the lab analysis done including A1c, and Total cholesterol, LDL, HDL, TG (report in the Excel)
Personal measures	Weight kg and Hip Circumference, cm
Knowledge test	Multiple choice test
IPAQ END test	The seafarer completes the IPAQ test
FFQ END test	The seafarer complete15-Item Food Frequency Questionnaire
STRESS-self test	STRESS-self test^[9]

The specific tasks to be done by the seafarer week by week - for evaluation we ask for multiple choice tasks WhatsApp groups.
	Goals for type of eating and for training and for weight
Week 1	Prevention of Pre-diabetes	A Youtube: Pre-diabetes can be reversed 4 min;^[10]ASÍ REVIERTES LA PREDIABETES^[11]A Pre-diabetes is a serious health condition: What you need to know (Safety4Sea)^[12] A How to prevent type 2 diabetes ^[13] B What is pre-diabetes type 2 & how to stay healthy(CDC)^[14]
Week 2	Prevention by keeping Physical fit	^[15]A How to stay fit? ^[16] Good exercises for prediabetes B How to do a proper workout on board^[17] Do resistance bands really work?^[18] Rubber resistance bands for muscle strength training^[18] ^[19] in the Excel scheme, write down your actual weekly scheme for physical activity* and which goals you have.*
Week 3	Prevention by Healthy eating	A Youtube: Healthy eating 4 min ^[20]A How can I reduce my risk of type 2 diabetes and Hypertension?^[21] A: By Healthy Eating and stay healthy fit^[22] B BCH Lecture: How to Stop Pre-diabetes from Becoming Diabetes^[23] B No-sugar meal plan for prediabetes ^[24] Should you have diabetes diet even if you dont have diabetes^[25] in the Excel scheme, write down your actual weekly scheme for your eating style* and which goals you have for your food pattern and physical training*
Week 4	Prevention of High Blood pressure.	A What is blood high blood pressure?(Hypertension) ^[26]A Drug-free approach to lowering high blood pressure^[27] A Controling hypertension at sea, Gard^[28]
Week 4	Blood glucose	A Normal Values of blood glucose^[29]A Diabetes Home Testing^[30] A How to use the Glucometer? ^[31] ^[32]
	Diabetes & work	A Supporting seafarers with pre-diabetes on board ^[33]
Week 5	Welbeing on board	A Welbeing courses for seafarers ^[34] A How to manage seafarers’ mental health challenges^[35].
Week 6	Overweight.	A What is overweight, the health risks and how to prevent^[36]
Week 7	Obesity	A What is obesity, the health risks and how to prevent? ^[37]
	Tablets for T2D	A Tablets (Metformin) is not the first choice of prevention^[38]^[39]
Week 8	Sleep and rest	A How to cope with sleep and nightwork ^[40]
Week 9	Healthy food	A Healthy Eating Diabetes, online Harvard University ^[41]^[42] B Cooking course for young seafarers ^[43]
	Seafood and Diabetes T 2	A What is the best seafood for Diabetes Type 2 (T2D)?^[44]
	Meats	A Meats for T2D ^[45]
Week 10	Snack	A Type 2 Diabetes-Friendly Snacks for When You’re Short on Time ^[46]
Week 11	Drink type	A What to drink as prediabetic ^[47]
Week 12	Alcohol	A Alcohol and diabetes 2^[48]. A Calories in different types of alcohol ^[49] A What should my daily intake of calories be? ^[50]
Week 13	Fibers in the food	A Best high fiber snacks for diabetes^[51]
Week 14	Dental care	A Dental care for seafarers ISWAN ^[52]
Week 15	Social welbeeing	A ISWAN Seafarers welfare, fitness to prevent Diabetes type 2 ^[53]
Week16	Evaluation and accreditation	The seafarer present the goals and the results by using the Excel sheet to the Coach. Were the goals obtained? Multiple choice test on their knowledge on T2D is repeated The Coach sign a Certificate for the Seafarer for having completed the16 weeks' course with coaching

INVITATIONS TO SEAFARERS AND THE MARITIME MEDICAL CLINICS

[1] ttps://docs.google.com/spreadsheets/d/12Xubw8FX20xI3QJ9Z2sXD4bHidjRxm3g/edit?usp=sharing&ouid=108580480582522419049&rtpof=true&sd=true

[:6-2] ttps://www.girodmedical.es/diagnostico-medico/medicina-general/glucometro.html?gclid=CjwKCAiAsIGrBhAAEiwAEzMlCz636IZl6_pYjqjyYxrciMvfindOYEuoGMp45kCW1z766IozzJ_rqhoCuJEQAvD_BwE

[:9-3] ttps://www.promofarma.com/en/blood-pressure-monitors/c-539

[4] ttps://www.eatingwell.com/category/4291/meal-plans-for-diabetes/

[5] ttps://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults#:~:text=Get%20at%20least%20150%20minutes,least%202%20days%20per%20week.

[6] ttps://docs.google.com/spreadsheets/d/12Xubw8FX20xI3QJ9Z2sXD4bHidjRxm3g/edit?usp=sharing&ouid=108580480582522419049&rtpof=true&sd=true

[7] ttps://www.disabled-world.com/calculators-charts/waist-circumference.php

[8] ttps://docs.google.com/forms/d/1pMFSEYMJU-LRtHAPAuQ0Pz6hLFLA7RBAC37q9AYiBUM/edit

[9] ttps://www.healthcentral.com/quiz/stress-test

[10] ttps://www.youtube.com/watch?v=KiK1QrKUdXE

[11] ttps://www.google.com/search?q=AS%C3%8D+REVIERTES+LA+PREDIABETES%5B&rlz=1C5CHFA_enPA1007PA1007&oq=AS%C3%8D+REVIERTES+LA+PREDIABETES%5B&gs_lcrp=EgZjaHJvbWUyBggAEEUYOTIJCAEQIRgKGKABMgkIAhAhGAoYoAEyCQgDECEYChigATIJCAQQIRgKGKAB0gEJMzIzNWowajE1qAIAsAIA&sourceid=chrome&ie=UTF-8#fpstate=ive&vld=cid:6954009e,vid:KiK1QrKUdXE,st:0

[:19-12] Prediabetes is a serious health condition what you need to know https://safety4sea.com/cm-prediabetes-is-a-serious-health-condition-what-you-need-to-know (Safety4sea)

[:20-13] ttps://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/preventing

[:0-14] ttps://www.cdc.gov/diabetes/index.html

[:10-15] Reversing Prediabetes, retrieved 2024-01-23

[:11-16] ttps://nfa.dk/da/Vaerktoejer/Andre-vaerktoejer/Smaaoevelser

[:18-17] ttps://safety4sea.com/how-to-do-a-proper-work-out-on board/%20How%20to%20do%20a%20proper%20work%20out%20on%20board

[:8-18] 18.0 ^18.1 https://www.youtube.com/watch?v=o0TX-SETl8g

[:17-19] ttps://www.fitterfly.com/blog/best-exercises-for-prediabetes/

[20] ttps://www.youtube.com/watch?v=SuNc0QRTvGA

[21] ttps://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/can-diabetes-be-prevented

[22] ttps://www.nhs.uk/live-well/eat-well/how-to-eat-a-balanced-diet/eight-tips-for-healthy-eating/

[23] ttps://www.youtube.com/watch?v=ujr9aMX1D1w

[:14-24] -sugar-meal-plan-for-prediabetes

[:15-25] ttps://www.carepartnersct.com/wellness/should-you-have-diabetes-diet-even-if-you-dont-have-diabetes

[:21-26] ttps://www.cdc.gov/bloodpressure/about.htm.

[:22-27] ttps://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045206

[:23-28] ttps://www.gard.no/web/articles?documentId=34050827

[:24-29] ttps://www.preving.com/ca/glucemia-postprandial/

[:25-30] ttps://www.healthline.com/health/diabetes/home-tests

[:26-31] ttps://www.accu-chek.com/blog/glucose-meter-accuracy#:~:text=FDA%3A%20Readings%20are%2095%20percent,has%20proven%20to%20be%20accurate

[:27-32] ttps://www.frederiksen-scientific.dk/webshop/biologi/fysiologi/blod/glucometer-contour-next

[:1-33] ttps://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/employment/employers

[34] ttps://www.missiontoseafarers.org/wecare/training

[35] ttps://safety4sea.com/american-club-how-to-manage-seafarers-mental-health-challenges/

[36] ttps://www.seafarerswelfare.org/seafarer-health-information-programme/overweight/overweight-a-guide-for-seafarers

[37] ttp://handbook.maritimemedicine.com/index.php/obesity

[38] ttps://www.johnmuirhealth.com/health-education/conditions-treatments/diabetes-articles/managing-pre-diabetes-preventing-diabetes.html

[39] ttps://www.gard.no/web/articles?documentId=30704649

[40] ttps://shw.dk/nyheder/2023/9/6/nyt-at-sea-magasin-stort-tema-om-svn-og-natarbejde

[:5-41] ttps://pll.harvard.edu/course/healthy-eating-type-2-diabetes

[42] ttps://www.lark.com/resources/what-to-eat-for-prediabetes

[:3-43] ttps://shw.dk/madlavningskursus?locale=en

[44] ttps://www.everydayhealth.com/type-2-diabetes/diet/the-best-seafood-for-diabetes/

[45] ttps://www.medicalnewstoday.com/articles/meats-for-diabetes

[46] ttps://www.healthline.com/health/type-2-diabetes/grab-and-go-snacks#nuts

[47] ttps://www.healthline.com/health/diabetes/drinks-for-diabetics

[48] ttps://diabetes.org/health-wellness/alcohol-and-diabetes

[49] ttps://medlineplus.gov/ency/patientinstructions/000886.htm

[50] ttps://www.nhs.uk/common-health-questions/food-and-diet/what-should-my-daily-intake-of-calories-be/#:~:text=An%20ideal%20daily%20intake%20of,women%20and%202%2C500%20for%20men.

[51] ttps://www.eatingwell.com/article/8048547/best-high-fiber-snacks-for-diabetes/

[52] ttps://www.seafarerswelfare.org/seafarer-health-information-programme/dental/dental-care-a-guide-for-seafarers

[:4-53] ttps://www.seafarerswelfare.org/seafarer-health-information-programme/fit-on-board

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