Case Study: Type 2 Diabetes Mellitus Assignment Instructions
The pancreas is an amazing organ with many responsibilities. So, when the pancreas does not work properly, many body processes are impacted. T2DM is historically characterized by either insufficient insulin production or insulin resistance. Thankfully, with the right care, we can help eliminate the presence of insulin resistance. Nutrition methods to reduce insulin resistance have varied over the years. We will explore past recommendations as well as current ones in this week.
You will find the case study in Medical Nutrition Therapy: A Case Study Approach 6th ed.- Case study 15 in text – Type 2 Diabetes Mellitus.
Answer the questions below.
- What is currently understood regarding the etiology of type 1 diabetes mellitus (T1DM)?
- Describe the multifactorial etiologies for type 2 diabetes mellitus. What do you see in Ms. Herrera’s history that increases her risk for diabetes?
- Explain the basic pathophysiology of type 2 diabetes mellitus. What is the primary difference between T1DM and T2DM?
- Using the American Diabetes Association treatment guidelines, how should T2DM be diagnosed? Is there adequate information in Ms. Herrera’s record to make this diagnosis?
- Ms. Herrera’s physician’s note addressed cardiac function and renal function. Why are these organ systems a component of the evaluation for someone with diabetes? Using the laboratory results from her record, please describe her cardiac and renal disease risk. Using the American Diabetes Association treatment guidelines, what other evaluations are recommended for an individual with newly diagnosed DM?
- Ms. Herrera’s mother has T2DM. She is currently having problems with vision and burning in her feet. What is she most likely experiencing? Describe the pathophysiology of these complications. You can tell that Ms. Herrera is worried not only about her mother but also her own health. Explain, using the results of the Diabetes Control and Complications Trial (DCCT) as well as any other pertinent research trials and data, how she can prevent these complications.
- Ms. Herrera was prescribed metformin for her T2DM. What is the mechanism for this medication? What are the potential side effects? The ADA treatment guidelines indicate that the next line of medication would be the SGL2. What is the mechanism for this medication? Ms. Herrera tells you that her mother is on glipizide. How does this medication differ from metformin?
- How does physical activity affect blood glucose levels? Describe the physiological process that occurs when physical activity impacts blood glucose.
- Outline the basic principles for Ms. Herrera’s nutrition therapy to assist in control of her DM. How will you combine the nutrition therapy for both hyperlipidemia and her diabetes without overwhelming her?
- Assess Ms. Herrera’s height and weight. Calculate her BMI.
- Identify any abnormal laboratory values measured upon her admission. (You may assume a normal c-peptide). Explain how they may be related to her newly diagnosed DM.
- Determine Ms. Herrera’s energy and protein requirements. Be sure to explain what standards you used to make this estimation. Would you recommend that she lose weight?
- Determine Ms. Herrera’s initial medical nutrition therapy prescription using her usual intake as a guideline, as well as your assessment of her energy requirements that you determined in question 10. What nutrition education material would you use to teach Ms. Herrera about her nutrition therapy interventions?
- Using the ADA guidelines, what are the recommendations for Ms. Herrera’s self–blood glucose monitoring? What would be appropriate fasting and postprandial target glucose levels for Ms. Herrera?
- Ms. Herrera comes back to the clinic one month after her diagnosis. List the key questions you will ask her in order to plan the next steps for providing any additional education that she needs.
- What is a Bible verse you could share with and individual making dietary changes that would be an encouragement to his/her? Explain how this verse is appropriate for the situation.