The teaching plan for the patient’s nutritional needs should focus on realizing maximum metabolic outcomes associated with glycemia, lipid profiles and blood pressure levels by maintaining a healthy diet comprising manifold servings of fruits, low and intermediate carbohydrate vegetables, whole grains, bread, low-fat dairy products, fish, lean meats, and poultry.
Although the food plan should be anchored on the appetite of the patient and other sociocultural considerations, it is important to ensure he consumes 40 Kcal/kg of calories per day and a consistent day-to-day carbohydrate intake at meals and snacks to have a positive impact on glycemia (Essien et al., 2017). Lastly, the patient should increase his consumption of insoluble and soluble globular fiber to about 50 grams per day with the view to delaying glucose absorption, attenuating the postprandial serum glucose peak, and helping to lower the high triglyceride intensities usually associated with uncontrolled diabetes (Burns, Dunn, Brady, Starr, & Blosser, 2013).
The patient should be educated on how to use a blood glucose monitoring device to monitor his blood glucose before and after the consumption of food with the view to assisting him to make informed food choices based on how his body is responding to particular food items. Additionally, the patient needs to be educated on how to interpret the data from the blood glucose monitoring device and how to record the values on a log sheet with the date, time, and any associated signs and symptoms that he might be experiencing at the time of taking the values (Burns et al., 2013).
Such symptoms may include uncontrolled hyperglycemia (polyuria, polydipsia, and polyphagia), blindness, foot wounds, and diabetic neuropathy. It is also important to ensure that the patient is made aware of the importance of continuing to take his insulin and other oral antidiabetic medications while ill and even when unable to eat to prevent the occurrence of a serious medical condition known as diabetic ketoacidosis. Lastly, the diagnostic workup for the patient should include a fingerstick glucose test to confirm if plasma glucose concentration is equal to or higher than 200 mg/dL for random specimens and 126 mg/dL for fasting specimens (Essien et al., 2017).
References
Burns, C.E., Dunn, A.M., Brady, M.A., Starr, N.B., & Blosser, C.G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier Saunders.
Essien, O., Out, A., Umoh, V., Enang, O., Hicks, J.P., & Walley, J. (2017). Intensive patient education improves glycaemic control in diabetes compared to conventional education: A randomized controlled trial in a Nigerian tertiary care hospital. PLoS ONE, 12(1), 1-12. doi: 10.1371/journal.pone.0168835.
Hoshino, Y., Machida, M., Shimano, S., Taya, T., Imai, S., Matsuura, Y., & Hasegawa, A. (2016). Unilateral leg swelling: Differential diagnostic issue other than deep vein thrombosis. Journal of General and Family Medicine, 17(4), 311-314.
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