VIII.

Discharge Plan
Medications:
Metformin 500 mg 1 tablet 2 x a day
Euglodin 5 mg 1 tablet 2 x a day
Bernacin 100mg 1 tablet once a day
Humulin mix 25 Kwikpen; 15 u SQ 15 min. a.c BF and 10 u SQ 15
mins a.c
dinner
Exercise and Activity:
A major benefit of exercise on patients with Type 2 Diabetes Mellitus
has an
effect on the heart and the associated reduction in death from heart disease. In
addition
to lowering the risk of heart disease in type 2 diabetes, exercise helps to
decrease the
chances of developing diabetes. This can be especially important for
those with
borderline diabetes. In one study, the risk of developing diabetes was reduced by
24%
(based on an energy expenditure of 2000 calories per week through
exercise). This
protective effect of exercise was seen the most in the group at highest
risk for
developing type 2 diabetes. The mechanism for this benefit is that
exercising muscles
are more sensitive to circulating insulin.
In addition to its benefits on muscle insulin sensitivity, aerobic
exercise also
improves blood cholesterol levels and blood pressure control. This benefit
occurs
regardless of weight loss. In one study, patients with type 2 diabetes
on a 3 month
exercise program reduced their triglyceride levels by 20%, increased their
good
cholesterol (HDL) by 23%, and decreased their blood pressure to better levels too!
The benefits of exercise in patients with diabetes, and in those at
high-risk for
developing type 2, may include the following:
Reduced heart disease
Prevention of diabetes in those at high risk
Improved muscle sensitivity to insulin
Better blood sugar control
Better blood cholesterol profiles
Better blood pressure control
Potential weight loss
Improved general sense of well being
Treatment:
The goal of treatment at first is to lower the high blood glucose levels of a
client.
Long-term goals are to prevent problems from diabetes. The goals in caring for
patients
with diabetes mellitus are to eliminate symptoms and to prevent, or at
least slow, the
development of complications. Micro vascular Complications (ie, eye and
kidney
disease) risk reduction is accomplished through control of sugar and
blood pressure;
Macro vascular (ie, coronary, cerebrovascular, peripheral vascular) risk
reduction,
through control of lipids and hypertension, smoking cessation, and
metabolic and
neurologic risk reduction, through control of glucose in the blood.
Oral medication plus Insulin Some people with type 2 diabetes require only
oral medications for treatment. Other people will need to add insulin or
another
injectable medication because their blood sugar levels are not controlled.
Using a combination of treatments (oral medication plus insulin)
generally
means that the person can take a lower dose of insulin, compared to if
insulin
treatment is used alone. There may also be a reduced risk of weight
gain if
combination therapy is used. Insulin is usually given once a day, either
in the
morning or at bedtime. Small insulin doses are generally recommended when
treatment first begins; the dose is adjusted over days, weeks, and months, once
the body's response to insulin treatment is known.
Managing/Controlling Blood Sugar Levels Most people with type 2
diabetes need to monitor their blood sugar levels at home. This is especially true
if the person uses a medication for diabetes that can cause low blood
sugar
levels (eg, insulin). Blood sugar control is often measured by checking the level
before the first meal of the day (fasting).
Diet and Weight Control
Exercise/Physical Activity
Health Teachings:
Take medication regimen
Monitor the Blood Glucose Levels once or twice a week
Foot care - Check and care for your feet every day. Diabetes can decrease the
blood supply to the feet and damage the nerves that carry sensation.
These
changes put the feet at risk for developing potentially serious complications such
as ulcers. Foot complications are very common among people with diabetes, and
may go unnoticed until the condition is severe.
Quit Smoking
Limit Alcohol Intake
Exercise
Proper Nutrition or Diet
Out-Patient
Follow up checkup after 1 week of discharge (February 20, 2014)
Diet
Keep track of carbohydrates (sugar and starchy foods): Your blood sugar
level can get too high if you eat too many carbohydrates.
Eat low-fat foods: Some examples are skinless chicken and low-fat milk.
Eat less sodium (salt): Some examples of high-sodium foods to limit are soy
sauce, potato chips, and soup. Do not add salt to food you cook. Limit your use
of table salt.
Eat high-fiber foods: Foods that are a good source of fiber include vegetables,
whole grain breads, and beans.

Sample Meal Plan

Breakfast Lunch Dinner
Beverages
1 cup milk/ 1 cup of
corn coffee
Water Water
Fruits medium papaya 1 medium Banana 1 slice of Pineapple
Grains 1 cup Rice 1 cup Rice 1 Cup Rice
Viand Oatmeal Pork Sinigang Fried Bangus