Keisha is a 42-year-old black female with a BMI of 29. She was recently diagnosed with diabetes and hypertension. Her mother and two sisters also have type 2 diabetes. She is the mother of three children, who each weighed more than 10 pounds at birth. Although she knows she should exercise, she doesn’t have time in her busy schedule.
The doctor gave her a 1500-calorie diet and told her if her glucose does not improve, she will have to go on medication and, possibly, insulin. She has tried the “diet” but finds it too restrictive: it tells her to eat things she doesn’t like (such as milk) and won’t let her eat the things she loves (like sweetened tea and fast foods). She is scared of the potential for needing insulin and the complications associated with diabetes.
What risk factors does Keisha have for type 2 diabetes?
Is a 1500-calorie diet appropriate for her? Should it promote weight loss or maintain her current weight?
What would you tell Keisha about weight and diabetes management?
What would you tell her about drinking milk? What about sweetened tea and fast foods?
What approaches would you take to improve compliance yet increase her satisfaction with eating?
What other lifestyle changes would you propose to Keisha to manage diabetes and reduce the risk of complications?
1. Which statement indicates the patient understands nutrition recommendations regarding carbohydrate intake? a. “People with diabetes should avoid sugars and foods that contain sugars.” b. “It is important to consume the proper balance of starch, sugar, and fiber at each
meal.” c. “It is important to consume the correct amount of carbohydrate at each meal and
snack.” d. “Carbohydrates must be balanced in relation to the amount of protein and fat
consumed.” 2. The client with type 1 diabetes asks if she can have a glass of wine with dinner on the
weekends. Which of the following would be the nurse’ s best response? a. “It is better to have wine between meals than with meals so that it doesn’t interfere
with your normal food intake.” b. “People with diabetes cannot have alcohol because it raises blood glucose levels
very quickly .” c. “A mixed drink would be better than wine because the mixer will help slow the
absorption of the alcohol.” d. “An occasional glass of wine with dinner will not cause any problems. Be sure to
limit yourself to one serving.”