- Discussion Prompt………
- Discuss the pathophysiology of type 1 and type 2 diabetes.
- Develop a nutritional education plan for a person with type 1 diabetes and a person with type 2 diabetes.
- In your educational plan, include the nutritional considerations and medication interactions for at least one oral medication and one type of insulin.
Use evidence from one scholarly source other than your textbook or ATI book to support your answer. Use APA Style to cite your source.
reply 1
- Discuss the pathophysiology of type 1 and type 2 diabetes.
Diabetes mellitus is characterized from one of the following: abnormal insulin production, impaired insulin uses or both. This is a disorder of glucose metabolism related to absent or insufficient insulin supply and/or poor use of the available insulin (Harding et al., 2020). Type 1 diabetes is considered an autoimmune disease in which the body develops antibodies against insulin which results in a depletion in insulin that is not enough for an individual to survive. In type 2 diabetes there is an inadequate insulin secretion and insulin resistance. Insulin resistance is a condition in which the body tissues do not respond to the action of insulin because insulin receptors are unresponsive. When insulin is not being properly used, the introduction of glucose into the cell is inhibited resulting in hyperglycemia (Harding et al., 2020).
- Develop a nutritional education plan for a person with type 1 diabetes and a person with type 2 diabetes.
The meal plans will generally be similar but are according to the type of insulin the patient is prescribed. For carbohydrates, we want to encourage our diabetic patients to consume more fruits, vegetables, grains, legumes, and low-fat milk and fiber intake at 25-30 g/day. Protein is an individualized goal for each patient, but we want to educate that higher amount of protein is not recommended for weight loss. We want to encourage our patients to minimize trans-fat, maintain dietary cholesterol < 200mg/day, and 2/> servings of fish per week to provide the necessary fatty acids.
- In your educational plan, include the nutritional considerations and medication interactions for at least one oral medication and one type of insulin.
Along with eating healthy foods and staying active it is important to monitor blood glucose levels and adhere to medication prescriptions by the provider. An oral antidiabetic medication I know about and have been able to administer in the clinical setting is metformin. When taking metformin, it is important the patient takes it how it is prescribed and follows the diet the provider has recommended. There are many different types of insulins such as short-acting and long -acting ones. Lantus (insulin glargine) is a long-acting insulin that is clear in appearance. When administering Lantus just like any other insulin it is important to check the blood glucose levels before administration (Jones & Bartlett Learning, 2019). Lantus is contaminated with hypoglycemic patients.
References:
Harding, M., Kwong, J., Roberts, D., Hagler, D., & Reinisch, C. (2020). Medical-surgical nursing: Assessment and management of clinical problems (11th ed.). Elsevier, Inc.
Jones & Bartlett Learning. (2019). 2011 Nurse’s drug handbook. Jones & Bartlett Learning.
reply 2
Type 1 diabetes pathophysiology:
Type 1 diabetes is an insulin dependent disease where the body does not produce enough insulin to meet the bodies requirements. “Type 1 diabetes mellitus results from a cellular-mediated autoimmune destruction of the insulin-secreting cells of pancreatic ß-cells.” Since insulin is synthesized in the pancreas destruction of these islet cells in the pancreas can lead to decreased levels of insulin to supply the body with in order to lower blood sugar levels.
Nutritional education plan:
With an insulin dependent disease such as type 1 diabetes you need to make sure to supply your body with complex carbohydrates. Complex carbohydrates are items such as brown rice, quinoa, oatmeal, lentils, vegetables over simple carbohydrates. A diet plan that is suggested for type 1 diabetics is called the Mediterranean diet. This diet contains nutrient dense foods with plant fats like nuts and oils, along with vegetables, and sardines and other proteins. (Medicinenet, 2021). Aside from taking insulin a type 1 diabetic may also use Symlin/ pramlintide, which helps keep blood sugar levels at bay after food. This medication should be taken before meals and “The meal must contain at least 30 grams of carbohydrate.” (UCSF, 2021).
Type 2 diabetes pathophysiology:
Type 2 diabetes is the more common out of the two. This used to be called adult onset type diabetes but with how rapid young children and being diagnosed with type 2 recently its not called that as often. Over time the body has been producing high levels of insulin and eventually the muscles, liver, and fat become resistant to insulin. What this does is make it difficult for the pancreas to produce insulin in order to control the blood sugar levels.
Nutritional education plan:
Medications commonly used for this type of diabetes along with insulin would be metformin. This drug helps the body more effectively use insulin. This medication works best as an adjunct with diet and exercise. Contrast dye such as iodine can have interactions with this drug as well which is why it is so important to clarify current medications with patients during hospital visits. A diet plan for an individual with type 2 diabetes would be to reduce starch like vegetables and simple sugars and consume more non starch vegetables such as spinach, broccoli, and green beans. According to CDC, the plate method is a good option for type 2 diabetics. This is divided into 4 categories: 1/2 plate with vegetables, 1/3 complex carbs, 1/3 protein and then one glass of a 0-calorie drink or water. (CDC, 2021). The biggest take away from meals is to reduce carbohydrate intake because that is where most amount of sugar comes from in our diets.
Center for Disease Control. (2021). Diabetes. Diabetes Meal Planning. https://www.cdc.gov/diabetes/managing/eat-well/meal-plan-method.html
Cunha, J. (2021). Metformin. RXlist. Retrieved from https://www.rxlist.com/consumer_metformin/drugs-condition.htm
University of San Francisco. (2020). Diabetes Education Online. Type 1 Non Insulin therapies. Retrieved from: https://dtc.ucsf.edu/types-of-diabetes/type1/treatment-of-type-1-diabetes/medications-and-therapies/type-1-non-insulin-therapies/#:~:text=Pramlintide%20is%20an%20injected%20medicine,help%20control%20mealtime%20blood%20sugars.&text=Pramlintide%20is%20an%20injected%20medicine%20for%20people%20with%20type%201,blood%20sugar%20levels%20after%20eating.
Pharmaceutical Journal (2020). Diabetes. Type 2 diabetes. Retrieved from: https://pharmaceutical-journal.com/article/ld/type…
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