Question

Dietary Needs for Patient with Diabetes

Assignment Overview

For this assignment, you will answer questions about a client named Mrs. Ritchie. You will analyze the dietary needs and risks for patients who have Type 2 diabetes. Using your textbook and the internet you will identify the best recommendations, risks, and needs of a patient in Mrs. Ritchie’s condition, based on the questions asked. You are required to include citations of your references.

This assignment is intended to explore differences between macronutrient and micronutrient concepts and describe their physiological functioning. Additionally, you will apply human nutritional theories and relevant research to formulate nutritional assessments and describe nutritional requirements corresponding to stages in the life span. You will also examine how effective nutritional counseling is contingent upon collaboration, organization, and concurrence among the members of the health care team.

Case Study:

Mrs. Cynthia Ritchie is a 45-year-old female, 5 feet 2 inches tall and weighs 245 lbs. She has gained 50 pounds in the past year. She has been diagnosed with Type 2 diabetes. Testing revealed that her A1c is 10.2. Her blood pressure is 135/90. She complains of blurry vision. Mrs. Ritchie typically skips breakfast, eats lunch and a large dinner. Her favorite foods include pasta, rice, and fruit. She eats many meals “on-the-go” as a result of a busy schedule. Mrs. Ritchie meets with her physician and is started on metformin and is referred to a dietitian for nutritional counseling. She would like to explore dietary interventions to improve her health and reduce her A1c.

Assignment Details:

Assignment Worksheet:

Respond to the following in the spaces provided:

• Based on what you learned about Mrs. Ritchie in your interview, briefly explain her modifiable risk factors for Type 2 diabetes.

[Write your response here…]

• Based on your client’s A1c, what does this tell you about her blood sugar control? Define a normal A1c.

[Write your response here…]

• Create a healthy breakfast option for your client that includes a carbohydrate, protein, and heart healthy fat. Explain the importance of eating all three macronutrients. How does this influence blood sugar?

[Write your response here…]

• What complications could arise if your client does not seek treatment for her Type 2 diabetes?

[Write your response here…]

• List three interventions that would improve your client’s blood sugar control.

[Write your response here…]

Answer 1

1Modifiable risk factors are

Obesity-The highest risk of getting Type 2 diabetes is Obesity ,but this can be dealt by lowering the body weight by 5 to 7 percent.

Physical inactivity-One of the modifiable risk factors for prediabetes and type2 diabetes is Physical inactivity.Therefore measures should be taken to walk 150 minutes per week and perform moderate-intensity aerobic physical activity or walking 75 minutes per week of vigorous-intensity aerobic physical activity or a combination of the two with muscle-strengthening atleast two days per week.

High Blood Pressure is another factor,as it cause damage to the cardiovascular system,untreated high blood pressure has been linked to the development of diabetes.

Abnormal cholesterol levels-Low HDL i.e good cholesterol or high triglycerides can increase the risk of Type 2 Diabetes.

2 Haemoglobin A1c keeps blood glucose levels in acceptable range.it transports oxygen from lungs into tissues.During high glucose levels,glucose molecules enter redblood cells,bind to haemoglobin forming HbA1c which is glycated haemoglobin.Amount of HbA1c is proportional to amount of glucose in blood because average life span of blood cell is 60 days.Fasting glucose level indicates how well patient has glucose under control at the time the specimen is taken.HbA1c is the best evaluator for risk of damage to nerves,small blood vessels in the eyes and kidneys.The reduced levels of HbA1c in diabetics to below 7% ,will prevent the development of further progression of complication from diabetes.Normal relationship between HbA1c% and average blood glucose values are 61-92 average whole blood glucose and 65-100 average plasma glucose.Target relationship between HbA1c% and average blood glucose values are>188 average whole blood glucose and >205 average plasma glucose.

When glucose attaches to the RBC ,RBC is alive for 120 days,test for diabetic compliance,below 7 is normal is A1c

3 Nutrition ,meal planning and weight control are the foundations of diabetic management.The most important objectives in the dietary and nutritional management of diabetes are control of total caloric intake to attain or maintain a reasonable body weight ,control of blood glucose level and normalization of lipids and blood pressure to prevent heart disease.Nutritional management includes

• Providing all the essential food constituents necessary for optimal nutrition.
• Meeting energy needs.
• Achieving and maintaining a reasonable weight
• Preventing wide daily fluctuations in blood glucose level ,with blood glucose level as close to normal as is safe and practical to prevent or reduce the risk for complications.
• Decreasing serum lipid levels,if elevated,to reduce the risk for macrovascular disease.

4 Short term complications are

• Hypoglycaemia.
• Hyperosmolar hyperglycemic non ketotic syndrome

Long term complications are

• Diabetic retinopathy.
• Nephropathy.
• Diabetic neuropathy
• Macrovascular problems.

5 Interventions are

• Excercise decreases blood sugar and increases production of insulin and as a result lowers glucose level .
• Check blood glucose before excercise.
• Reduce body weight and adhere to strict dietary regimen.