Question

Diabetes Mellitus Clinical Scenarios Old Krause Text Ellen is a 15 year old girl with newly diagnosed type 1 diabetes referred for diabetes nutrition education She is S ft 2 in tall, weighs 1154 and is active in cheerleading and basketball in high school. Her physician will be regulating the dosage and timing of her insulin regimen. Her grandmother has diabetes and is supportive of Ellen's need for education. Ellen's parents are divorced, and she now lives with her grandmother. Nutrition Diagnosis: Food and nutrition related knowledge deficit related to adjustment of meals and insulin as evidenced by new diagnosis of type 1 diabetes mellitus 1. What assessment information do you need to determine a nutrition diagnosis? 2. Write a nutrition diagnosis (PES Statement) for Ellen. 3. What meal planning system would be helpful for Ellen? 4. What guidance should you offer regarding Ellen's sports activities? 5. What signs and symptoms of lack of diabetes control must Ellen understand to manage her disease? Which problems is she more likely to experience - hyperglycemia or hypoglycemia, explain. What food and meal planning Information needs to be shared with the health care team as insulin therapy is integrated into Ellen's normal eating and exercise habits? 2 How will you monitor and evaluate Ellen's progress? 6.

Answer 1

1.Assessment

The assessment for nutritional diagnosis in the above case include the following

• A diagnosis with type 1 diabetes mellitus and the medical records
• Dietary pattern followed
• Knowledge about the health problem
• Family support

2.PES statement

Imbalanced nutrition related to improper glucose metabolism evidenced by elevated blood glucose levels.

3.Meal plan

The points in planning meal for Ellen are the following

• Assess the dietary pattern she is following.
• Reduce the amount of carbohydrate containing food like rice, roots and tubers
• Restrict sugar intake
• Include more fiber containing food like leafy and fresh vegetables
• Drink more water
• Avoid fast food.
• Follow food plate method that means in a plate divide the areas for carbohydrate, protein, fruits and vegetables.

4.Ellens sports activities

The following are advice for sports activities

• Can involve in sports as before.
• It is said that she is a basketball player she can continue that.
• Sports will maintain body fitness and makes the person energetic.
• While in sports she should be careful of not getting injured.
• There is chance of lowering blood glucose levels during extreme activities so should take precautions like having a candy always with.

5.Signs and symptoms of poor diabetic control

• Blood sugar level remains high.
• Fatigue
• Thirst and hunger.
• Increased urine out put
• Frequent infections

Ellen is likely to get hypoglycemia because she is in her active age group and also she is getting insulin, so does not adjusted accordingly chance of hypoglycemia.

6.Ellen should share with the healthcare team the following regarding diet:

• Diet she followed before diagnosis of disease
• Changes made in diet after diagnosis
• Her dietary preferences
• Her food source
• Who prepares food for her.
• Her exercise pattern

7.We can monitor Ellen's pprogress in the following ways :

• Assessing the blood sugar
• Assessing the progress of symptoms
• Verbally from her how she feels
• Her weight and body mass index