Running

head: DISCHARGE PLANNING 1

Nutritional Discharge Planning Project

Morgan McMahon

University of South Florida

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Discharge Planning Project

The patient, Luke Skywalker has recently been diagnosed with type 2 diabetes mellitus

(DM), and needs patient teaching on a new diet appropriate with his diabetes management.

Literary Review

Pathophysiology

DM is a disease in which there is a flaw in the metabolism of fats and carbohydrates. It

occurs when the pancreas cannot make enough insulin or when the body does not effectively

respond to insulin. When the body has an error in its response to insulin, the cells cannot

adequately absorb glucose from the blood, resulting in high blood sugar (Staff, 2014). Risk

factors for developing DM include being overweight, sedentary lifestyle, family history,

increased age, African American, Native American, Hispanic, and Asian American. The chances

of developing DM are raised significantly when a person has prediabetes (Staff, 2014).

Dietary Restrictions and Rational

In order to manage their DM, the patient needs to adhere to a specific meal plan. One of

the main concerns in a diabetic diet is keeping track of how much carbohydrates the patient is

eating because carbohydrates break down into glucose. Patients should try to include legumes,

whole grains, low fat dairy products, fruits, and vegetables in their carbohydrate intake to ensure

the intake of more complex carbohydrates. The patient should try and avoid more simple

carbohydrates such as baked goods, soda, table sugar, and syrups because they have little

nutritional value with a high amount of calories (Spritzler 2012). Regarding fats, the patient

should avoid foods high in trans fat, saturated fat, and cholesterol because they increase

cholesterol blood levels, and can be a factor in the development of heart disease. Diabetics

should try and eat more unsaturated foods such as avocados, almonds, and canola oil because
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they can lower LDL (bad cholesterol) levels (Evert, A., Boucher, J., Cypress, M., Dunbar, S.,

2013). Some of the best protein choices in a diabetic diet are plant-based proteins, chicken, fish,

as well as cheese and eggs. Protein choices should be lean and low in fat for the best nutritional

value. One of the main electrolytes that diabetics should reduce is sodium intake. The American

Diabetes Association recommends that diabetics should have no more than 2300mg of sodium

per day to decrease the risk of complications like heart disease associated with high sodium

(Evert, A., Boucher, J., Cypress, M., Dunbar, S., 2013).

Patient Teaching

One important aspect of patient teaching is showing he patient how to choose appropriate

meals. The American Diabetes Association provides one method for planning out meals called

the plate method. They suggest to have one-half of the plate with non-starchy vegetables, one-

quarter with a protein, and the last quarter with a starchy or whole-grain item with an additional

serving of fruit (American Diabetes Association, 2016). This helps ensure a well rounded diet,

and a system for choosing a meal. Another important point to teach the patient is to eat three

meals with a day at regular, consistent times with interval snacks in order to maintain insulin

secretion. Another teaching principle for the patient is to educate them on what a glycemic index

is, and how to utilize it in their carbohydrate choices (American Diabetes Association, 2016).

Conclusion

The patient, Luke Skywalker has been informed of his type 2 diabetes, and has been educated on

how the disease process affects his nutrition and food choices. As a result of his teaching, Mr.

Skywalker now knows that he has to watch his food intake of carbohydrates, proteins,

electrolytes, and fats in order to effectively manage his type 2 diabetes mellitus.
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References

American Diabetes Association (2016, September 14). Create Your Plate. Retrieved from

November 04, 2016, from https://owl.english.purdue.edu/owl/resource/560/01/

Diabetes: MedlinePlus. (2015, August 12). Retrieved November 04, 2016, from

https://medlineplus.gov/diabetes.html

Evert, A., Boucher, J., Cypress, M., Dunbar, S., Franz, M., Mayer-Davis, E., Neumiller, J.,

Nwankwo, R., Verdi, C., Urbanski, P., Yancy, W. (2013, December 19). Nutrition

Therapy Recommendations for the Management of Adults With Diabetes. Retrieved from

November 04, 2016, from

http://care.diabetesjournals.org/content/37/Supplement_1/S120.article-info

Staff, B.M., (2014, July 31). Diabetes. Retrieved November 04, 2016, from

http://www.mayoclinic.org/diseases-conditions/diabetes/basics/definition/con-

20033091

Spritzler, F. (2012, November 25). A Low-Carbohydrate, Whole-Foods Approach to Managing

Diabetes and Prediabetes | Diabetes Spectrum. Retrieved November 04, 2016, from

http://spectrum.diabetesjournals.org/content/25/4/238