Question

case study

SV is a 45 year old woman who was diagnosed with type 2 Diabetes 5 years ago. She has not been back to her doctor since then. She decided to return at this time because of chronic fatigue and blurry vision. Her A1c level is 8.3%, Triglycerides are 275mg/dL. Her height is 5’4” and her body weight is 175# (BMI is 30). She states that she hasn’t returned for any follow-up visits because the only advice she gets “is to lose weight and not eat sugar”, neither of which she is able or wanting to do.

How should you deal with her negative feelings about food/meal planning?

What are possible initial educational topics?

What are short term nutrition strategies to get her started?

How can continued education and counseling be planned and provided?

type out answer please

Answer 1

Dealing with her negative feelings about food or meal planning

First of all explain her what is the importance of doing so.This is possible only by a detailed health education regarding what is diabetes,how it occurs and what are the physiological process happening in our body to maintain the sugar level also very important to explain what is happening with this physiolpogical process in a patient with diabetes.It is important to explain her that by controlling the obesity or by loosing the weight the work load of the pancreas will be less and the insulin which her pancreas produce will be sufficient to manage her sugar level and she meed not to take any medicine.Also regarding food controll tell her that she can manage her diabetis without any medicine and this can improve her life expectancy.

The educational topics should include what is diabetis,what is the proper physiology of diabetis,comparison of normal healthy person's sugar consumption in the body with diabetic patient,management of diabetis with the help of medicine and by the diet controll and the weight management.The better outcome of managing the diabetis with diet control and the weigtmanagement.The other important thing is the complications such as insulin dependance,diabetic retinopathy,diabetic nephropathy that can occur if she doesnt manage her diabetis well.And these things should be explained to her in her own language and make sure she understood the contents by asking questions and by clarifying her doubts.

The short term nutritional strategy for this client in her starting include low protein diet,low sugar doet like sugar free tablets,include certain foods that can control the appetite or that will help to loose the appetite.Avoid extra fat in the food and to add saturated fat in the food,in a controlled manner.

Continued educationcan be provided for her by constantly monitoring her by identifying her follow up day.For this includ her family members too in her plan of care and treatment.Maintain a record with her whcich should includ her periodic sugar values,HbA1C value,her next follow up day and the diet plan.Make an arrangement with the local health care team in follow up.Make an arrangement to include her in programmes and campains conducts regarding the diabetis.Appreciate her in doing good diet control and support her to do the diabetic control well.