NutritionAssessment

NutritionalAssessmentofLukeSkywalker
TiffanyTran,SN,SBN
UniversityofSouthFloridaTGH

NutritionAssessment

NutritionalAssessmentofLukeSkywalker
AlthoughMr.Skywalker,recentlydiagnosedwithtype2diabetesmellitus(DM),
isbeingdischargedwithoraldiabeticmedication,itisimperativethathelearnsto
managehisDMnutritionallyaswell.Thispaperhighlightsthetypeofpatienteducation
necessarytoequipMr.Stodosoashereturnstohiseverydaylife.
Type2DMischaracterizedbybothgeneticandenvironmentalfactors.While
geneticscaninfluencecertainfactors,suchasMr.Ssbetacellfunctionorinsulin
receptorsensitivity,alargepartofwhatdrivesthepathophysiologicalprocessisinsulin
resistance.Insulinresistanceisgenerallyassociatedwithachronicstateof
hyperinsulinemiaduetotheexcessiveintakeofcarbohydratesandfatsseeninpoordiets
thatarecommonlyassociatedwithobesity.Compensatingforconsistenthyperglycemia,
thebodyoverproducesinsulin.Overtime,theinsulinreceptorsbecomedesensitizedto
insulinanditisnolongerabletoeffectivelymanagehyperglycemia.Earlyon,thebody
willstillproduceinsulin,butisresistanttoitseffects.Astimeprogresses,however,the
secretionofinsulinwilldecline(Huether&McCance,2012,p.462).Oralmedications
canbetakentoaidincontrollingglucoselevelsandincreasingsensitivityofinsulin
receptors,however,individualsmustlearntomanagetheirdiseasenutritionallyaswell.
AType2diabetic,likeMr.S,shouldaimforwellroundedmeals,3timesdaily,
containingapproximatelythesameproportionofcarbohydratesandfatsineachmeal.
Carbohydratesshouldcompriseofwholegrains,ratherthanrefinedcarbohydrates.
Further,lessstarchyvegetables(thedarkgreenanddeepyellowones)shouldbe

NutritionAssessment

incorporated.Proteinsshouldbeincluded,takingcaretoremoveanyexcessfatand/or
skin.Ifoilsorfatsareemployedinfoodpreparation,polyunsaturatedormonounsaturated
fatsshouldbechosenovertransorsaturatedfats.Additionally,vitaminsB,CandE
shouldbeintegrated.Lastly,sweetsandalcoholshouldbelimitedifnoteliminated
altogether.Ifalcoholisconsumed,itshouldbetakenwithmeals(Chang&Halter,2009).
Thedietoutlinedabovedecreasestheamountofeasilyprocessedcarbohydrates
availabletothebody.Refinedgrainsandsugars,starchyvegetables,alcoholandsweets
allpossesseasilydigestedcarbohydrates,whichwouldcausehyperglycemicfluctuations,
makingitdifficultforaninsulinresistantbodytocompensate.Ontheotherhand,whole
grainscontainfiber,whichdecreasestheabsorptionofglucose,allowingimproved
controlofbloodglucose(Chang&Halter,2009).
StudieshaveshownthemajorityofpatientsdiagnosedwithType2DMhave
positiveexpectationsregardingtheirabilitytoadapttheirnutritionalhabits(Oftedal,Bru,
&Karlsen,2011,p.741).Ithasbecomeapparent,however,thatalackofknowledgeand
understandingofhowtoimprovenutritionpresentsabarrier(Booth,Lowis,Dean,
Hunter,&McKinley,2013,p.301).Thus,itwouldbeessentialtospendtimewithMr.S,
priortohisdischarge,discussingtheaforementioneddietaryguidelines,including
informationregardinghisdiseaseprocess,howitrelatestoeachfooditem,andwhyitis
necessarytoincludeorexclude.Moreover,providingMr.Swithmaterialsaligningwith
thiseducationwouldfurnishhimwitheasilyaccessiblereferencesashemakeshis
dietarydecisions.Finally,includingMr.Ssfamilyintheeducationprocesscouldfurther
increasethelikelihoodofhiscompliancetoandsuccesswithhisnewdietaryrestrictions.

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Ultimately,providingpatienteducationisequallyimportantasformulatingthe
dietaryrestrictionsthemselves.EmpoweringMr.Swiththeproperknowledgetobea
partofhiscareincreasestheprobabilitythathewillmaketheefforttoadjusthislifestyle.
References
Booth,A.O.,Lowis,C.,Dean,M.,Hunter,S.J.,&McKinley,M.C.(2013).Dietand
physicalactivityintheselfmanagementoftype2diabetes:barriersand
facilitatorsidentifiedbypatientsandhealthprofessionals.PrimaryHealthCare
Research&Development,14(3),293306.
Chang,A.M.,&Halter,J.B.(2009).Chapter109.DiabetesMellitus.InHalter,J.B.,
Ouslander,J.G.,Tinetti,M.E.,Studenski,S.,High,K.P.,Asthana,S.(Eds),
HazzardsGeriatricMedicineandGerontology,6e.RetrievedJune20,2016from
http://accessmedicine.mhmedical.com.ezproxy.hsc.usf.edu/content.aspx?
bookid=371&Sectionid=41587730.
Huether,S.E.,&McCance,K.L.(2012).UnderstandingPathophysiology(5thEdition
ed.).St.Louis,MO:ElsevierMosby.
Oftedal,B.,Bru,E.,&Karlsen,B.(2011).Motivationfordietandexercisemanagement
amongadultswithtype2diabetes.ScandinavianJournalofCaringSciences,25
(4),735744.