Running head: NUTRITION ASSESSMENT 1

Nutrition Assessment

Alexis Daubney

University of South Florida College of Nursing

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Nutritional plans ensure patient success throughout their hospital stay and after. Various

types of nutritional plans exist for all types of patients with conditions such as diabetes, renal

disease, and cardiovascular failure. A patient, Luke Skywalker, is being discharged today. He has

been newly diagnosed with type 2 diabetes mellitus (DM), and is currently prescribed an oral

diabetic medication. For this patient’s progress, it is essential to teach him about his new

diagnosis, his newly prescribed oral medications, and his nutritional plan.

Disease Process of Type II Diabetes

The progressive decline of pancreatic β-cell function is at the center of the mechanism of

action for type 2 diabetes mellitus. This decreased ability of cells leads to a decrease in the

amount of insulin that the pancreas produces, leading to an increase in blood glucose. This leads

to increased insulin resistance affecting multiple aspects of the body, advancing additional

metabolic abnormalities. Consumption of foods higher or lower in sugars influences the blood

sugar level for the patient. (Kolterman, Kim, Shen, Ruggles, Nielson, Fineman, & Baron, 2005)

Nutritional Plan

A nutritional plan directly impacts the long-term management of type 2 diabetes. The

American Diabetes Association recommends consuming nutrient dense, high fiber

carbohydrates. Minimizing the consumption of sucrose-containing foods allows for healthier

food choices and healthful planning. Lean protein sources and meat alternatives are also

recommended. (Standards of Medical Care in Diabetes, 2016)

Nutrient dense carbohydrates permit for higher nutritional intake with smaller food

intake. There is currently mixed initiative in what is the ideal intake of carbohydrates along the

glycemic index. However, it is widely encouraged to replace refined carbohydrates and added

sugars with whole grains, vegetables, and fruits. This is related to sugars, which are broken down
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more slowly in the body. Increasing dietary fiber has multiple benefits for a type 2 DM patient; a

study found that “increased fiber content decreases the glycemic index of foods” (Journal of the

American Board of Family Medicine, 2012).

Patient Teaching

Nutritional changes should be made in an individualized manner to fit the patient. A

nutritionist should be recommended to the patient or consulted to assist in developing an

individualized plan. It will be important to emphasize lifestyle change rather than a diet that may

accomplish a goal, but be discontinued. This is a condition that he or she will need to monitor for

the rest of their life. Stressing the aspect of lifestyle change will aid in the long term monitoring

of this condition. It would be valuable to engage the patient in creating a meal plan for a full day.

Creating this plan will engage the patient in forming his or her own meal plans, as well as a

grocery list. Utilizing a meal plan that he or she finds appetizing and attractive makes the meal

plan more appealing to the patient leading to greater adherence to the plan. The oral diabetic

medication will need to be taken according to the prescription and physician guidelines. It will be

imperative to follow the prescription explicitly to ensure that it will adequately accompany the

nutritional plan that he or she is following.

Conclusion

Patient education and teaching is essential for maintaining a nutritional intake that

correlates with the condition for which they are being treated. Type 2 diabetes nutritional diet

plan focuses on complex carbohydrates and consuming nutrient dense foods. When the patient is

educated regarding their condition, the way in which the nutritional plan will be more understood

along with the application of their knowledge. The involvement of the patient in planning is

essential for patient adherence to the nutritional plan.

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References

Alison, E. B., Boucher, J. L., Cypress, M., Dunbar, S. A., Franz, M. J., Mayer-Davis, E. J., &

Yancy, W. S., Jr. (2014). Nutrition Therapy Recommendations for the Management of

Adults with Diabetes. American Diabetes Association : Diabetes Care. Retrieved from

http://care.diabetesjournals.org/content/37/Supplement_1/S120

Goldstein, B. J., MD, PhD. (2002, September 5). Insulin resistance as the core defect in type 2

diabetes mellitus. The American Journal of Cardiology, 90(5), 3-10. Retrieved June 29,

2016, from

http://www.sciencedirect.com.ezproxy.lib.usf.edu/science/article/pii/S000291490202553

Kolterman, O. G., Kim, D. D., Shen, L., Ruggles, J. A., Nielsen, L. L., Fineman, M. S., … &

Baron, A. D. (2005, January 15). Pharmacokinetics, pharmacodynamics, and safety of

exenatide in patients with type 2 diabetes mellitus. American Journal of Health-System

Pharmacy, 62, 173-181. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15700891

Post, R. E., Mainous, A. G., III, King, D. E., & Simpson, K. N. (2012, February). Dietary Fiber

for the Treatment of Type 2 Diabetes Mellitus: A Meta-Analysis. Journal of the

American Board of Family Medicine, 16-23. Retrieved

http://www.jabfm.org/content/25/1/16.full

Standards of Medical Care in Diabetes--2016. (2016, January). American Diabetes Association :

Diabetes Care, 39. Retrieved from http://professional.diabetes.org/content/clinical-

practice-recommendations