Type-2 Diabetes Nutritional Intervention

Introduction

Diabetes is a biological disorder that causes glucose in the blood to spike to abnormal levels. This condition is equivalent to hyperglycemia. There are two types of diabetes- type 1 and 2. Type-2 is the most frequently detected form of diabetes. Type-2 diabetics are faced with the problem of the improper physiological use of insulin whereby the pancreas produces either excess or less insulin than the body requires for proper functioning. This disorder is termed as insulin resistance. Initially, the pancreas makes surplus insulin compensate the extra body requirement. Then, a drop in the blood glucose level occurs because the pancreas cannot cope with the high demand of insulin the body requires (DaVita HealthCare, 2004). This paper will discuss the case of the patient diagnosed with type-2 diabetes.

A Summary Diet for Type-2 Diabetes Patients

Adherence to a healthy diet is paramount for type-2 diabetics; this is instrumental in the maintenance of the disease at a manageable level. Carbohydrates are regarded as detrimental to diabetics; however, research has discovered that it is essential to the body if consumed correctly. Carbohydrates are the building blocks for the blood sugar, and hence, should be discretely ingested. A good meal ought to contain low glycemic index which is the measure of glucose level in carbohydrates. There are various types of low glycemic index foods, namely sweet potatoes, whole grain brown bread, brown rice, fruit, low-fat milk, and so on. Fiber is another important element in a diabetic diet. Type-2 patients are advised to take large quantities of whole grains, fruits and vegetables since they provide the body with fiber, vitamins, and minerals. Besides, protein is vital for diabetes patients, especially type-2 diabetics who tend to contain a high metabolic turnover for protein, and therefore, their body requires it in large volumes (American Diabetes Association).

Mr. D’s Dialysis and End Stage Renal Disease (ESRD) Report

According to the Hemodialysis Center report, Mr. D’s blood sugar levels have raised over the 15 years since he was diagnosed with type-2 diabetes. The continuous increase in blood glucose led to the development of kidney complications resulting in renal disease.

The subsequent kidney failure is common in patients with fluctuating blood glucose levels. Non-compliance to medication and doctor’s advice promote blood sugar imbalance in type-2 patients. Therefore, kidney failure is inevitable in such conditions. In cases of kidney failure, the patient is put under dialysis treatment as a maintenance therapy (Diabetic Kidney Disease). Consequently, Mr. D’s ESRD developed because of long-term glucose fluctuation which required him to commence hemodialysis.

Various factors are known that put Mr. D at a higher risk of developing ESRD. For example, poor maintenance of glucose level made him more susceptible to ESRD. Moreover, the obesity as well as the fact that he had diabetes for a long period may have increased his risk of acquiring ESRD. High alcohol consumption may have contributed to a great possibility of ESRD. Finally, studies indicate that men are at a higher risk of developing end stage renal disease.       

Extreme loss of weight is a common symptom among diabetes patients.  Important to mention, type-1 diabetes patients are more affected by this problem than type-2 diabetics. In this disease, there is insufficient production of insulin by the pancreas; hence, the body’s cells are unable to source enough from the glucose in the blood. Consequently, the body begins to burn calories from muscle as well as fat for obtaining energy, which results in the general decrease of the body weight. Therefore, this explains why Mr. D experienced excessive reduction in body weight due to the development of diabetes. In addition, according to Hemodialysis report, it is evident that Mr. D encountered 15% weight loss during his one-year dialysis treatment. The drastic drop in weight resulted from non-adherence to insulin medication therapy. The patient was accused of skipping insulin doses regularly during his dialysis treatment program. Failure to administer insulin shots in type-2 diabetics can possibly lead to the sudden loss of weight.

Patients undergoing dialysis treatment can be subjected to high protein metabolism, which would cause high protein requirement by the body. This phenomenon explains the high protein demand by type-2 patients.  With the current condition of Mr. D, he is required to increase his calorie intake by 20% and also raise protein ingestion by 30%.

Protein is the most important nutritional problem for Mr. D. because the metabolism in patients on dialysis therapy tends to demand large quantities of protein. Besides, protein is essential in maintaining the patient’s dry weight - which fluctuates at a high rate during dialysis treatment. Therefore, Mr. D ought to increase the protein intake to cater for the high demand by the body.

There are various community programs that may assist Mr. D in the maintenance of his diabetic conditions and complications. The American Diabetes Association has developed numerous programs to support patients in maintaining their conditions at manageable levels. Through these programs, it would be possible to monitor the dietary and medication compliance by Mr. D.

Various methods can be applied in the assessment of Mr. D’s adherence to medical treatments and nutritional programs. For instance, he should be under constant weight watch and blood sugar monitoring. These methods are fundamental in identifying the compliance of the patient to dietary programs. Additionally, it is important to keep records of the patient’s dialysis treatment visits. This would help in keeping track of Mr. D’s compliance to medical therapies.