Alia OPD Presentation

NDD 41004 OUTPATIENT DIETETIC TRAINING I
CASE PRESENTATION:
NUTRITIONAL MANAGEMENT OF NEWLY DIAGNOSED DIABETES
MELLITUS AND HYPERTENSION
STUDENT’S NAME ALIA NADHIRAH BINTI ABD RAHIM
NO. MATRIC BHBL17047261
CLINICAL INSTRUCTOR MISS NOR’AIN BINTI SHAARI
PLACE OF ATTACHMENT KLINIK KESIHATAN SEBERANG TAKIR
PRESENTATION OUTLINE
1.0 INTRODUCTION/CASE 5.0 DISCUSSION

BACKGROUND/CHRONOLOGY
6.0 CONCLUSION
2.0 MEDICAL DIAGNOSIS
7.0 REFERENCES
3.0 MEDICATION
4.0 NUTRITIONAL ASSESSMENT

2
1.0 INTRODUCTION
Name Mrs. A
Age/sex/race 56/Female/Malay
Address Kampung Baru, Seberang Takir
Marital status Married
Occupation Housewife
Living situation Lived with husband and 5 children
Smoking Nil
Alcohol consumption Nil
Mobility ADL-independent, engage in dumbbell on fat burning
exercise for 30 mins, 2x/7
Family history Mother (DM)
Medical diagnosis Diabetes mellitus
Hypertension Since 18/10/2020
3
1.0 CASE BACKROUND
DIETETIC’S NEW CASE

Reason of referral Individual counselling on
diabetic diet
Date of consultation 2/12/2020 (12.00 pm)
Date of follow up 12/12/2020 (3.00 pm)
4
1.0 CHRONOLOGY OF CASE
18/10/2020 Referred to 12/12/2020

dietitian for 2/12/2020
Newly dx with individual First f/up, 2nd
First consultation
diabetes mellitus counselling consultation
at KKST
and hypertension diabetic diet through phone call
5
2.0 MEDICAL DIAGNOSIS
» TYPE 2 DIABETES MELLITUS
RISK FACTORS
• Family history • HDL
• Overweight/ • Women with PCOS
• obese • Women with GDM
• Hypertension • Physical inactivity
Source: CPG DM, 2015
Body cell resists to insulin
Glucose cannot be taken up

into body cell
Glucose starts to build up in

the blood
6
Defined as persistent elevation of systolic blood
2.0 MEDICAL DIAGNOSIS pressure (BP) of 140 mmhg or greater and/or
diastolic BP of 90 mmhg or greater, taken at least
twice on two separate occasions.
» HYPERTENSION
Risk factors • High consumption
• Family history of alcohol
• Overweight/ obesity • Smoking
• High sodium intake • Physical inactivity
(CPG Hypertension, 2018) 7

3.0 MEDICATIONS
Drugs T. Perindopril T. Simvastatin T. Metformin
Dosage 2 mg OD 20 mg OD 500 mg OD
Indication To treat To treat To treat diabetes
hypertension hyperlipidemia mellitus
Adverse Cough, dizziness, Dizziness, fast of Nausea, vomiting,
effects back pain irregular heartbeat, stomach upset,
vomiting diarrhea, weakness
8
4.0 NUTRITIONAL ASSESSMENT - (2/12/2020)
» ADIME - ANTHROPOMETRY
PARAMETER VALUE REMARK
2/12/2020 11/11/2020
Height (cm) 152 Obtain from green book
Weight (kg) 61.9 61.6 Measured using TANITA
BMI (kg/m²) 26.8 26.7 Overweight (BMI 24.9-29.9 kg/m²)
IBW (kg) 52 At BMI 22.5 kg/m²
IWR (kg) 43-58 At BMI 18.5 – 24.9 kg/m²
Body Fat (%) 35.6 N/A High (Normal : 20-27%)
Visceral fat 8 N/A Normal (Healthy level: 1-12)
BMR (kcal) 1138 N/A -
9
» ADIME - BIOCHEMICAL
PARAMETER VALUE/DATE NORMAL INTERPRETATION
11/11/20 21/9/20 VALUE
Lipid TC - 5.3 ≤ 5.2 High due to high intake of fat
profile (mmol/L) and cholesterol food
Tg - 1.7 ≤ 1.7 Normal
(mmol/L)
HDL - 0.9 ≥ 1.1 Low due to high intake of fat
(mmol/L) and cholesterol food
LDL - 3.8 ≤ 2.6 High due to high intake of fat
(mmol/L) and cholesterol food
10
» ADIME - BIOCHEMICAL
11/11/20 21/9/20 VALUE
Glucose FBS 11.7 - 4.4 – 6.1 High due to high intake of
profile (mmol/L) sugary and carbohydrate food
RBS 10.1 - 4.4 – 8.0 High due to high intake of
(mmol/L) sugary and carbohydrate food
HbA1c 8.3 - < 6.5 High due to high intake of
(%) sugary and carbohydrate food
11
» ADIME - CLINICAL
11/11/20 VALUE
Blood pressure 136/96 ≤ 120/80 High normal
(mm/Hg)
Pulse rate 100 60-100 Normal
Temperature 36.5 37 Afebrile
Comment :
• Alert
• Give good cooperation during counselling
• No hypoglycemic event
• Came alone during counselling 12
» ADIME - DIETARY
Meal/time Food/drink Exch CHO Pro Fat Fiber Na Calorie
(g) (g) (g) (g) (mg) (kcal)
BF Biscuit (4 pcs) 1 1/3 20 2.7 0.7 1.3 44 100
9.00 am
Good morning V Halia (1 glass) 18.8 2.4 1.9 3.0 1.1 102
LN White rice(2 scp heap) 3 45 6 1.5 3 10 225
12.30 pm
Fried chicken (2 pcs) 4 - 28 46 - 209 530
Plain water (1 glass) - - - - - - -
DN Mi rebus (1 medium bowl) 2 30 4 6 2 1703 195
8.00 pm
+ Chicken (1 small pcs) 1 - 7 4 69 65
+ Egg (1 nos) 1 0.5 7 6 69 84
+ Mustard leaves + carrot (1/2 cup) - - - - 1 - -
Pineapple (1/2 whiole) 4 60 - - 2.1 182 240
13
» ADIME - DIETARY
Meal/tim Food/drink Exch CHO Pro Fat Fiber Na Calorie
e (g) (g) (g) (g) (mg) (kcal)
Total intake 174.3 57.1 66.1 12.4 2287 1541
Percentage of total intake (%) 46 15 39 ± 1520
Percentage of requirement (%) 85 104 132 50 103
F
High sugar food High salt food
Food/drinks Portion Freq. Food/drinks Portion Freq.
F Kuih bergoreng
Cake
3 pcs
1 slice
3x/7
2x/30
Keropok lekor
Maggi
3 pcs
1 pack
2x/7
2x/30
Q Condensed milk 1 tsp 1x/7 Mayonnaise 2 tbs 2x/7
Sambal belacan 1 tbs 7x/7
14
» ADIME - DIETARY
Dietary comment:
• CHO distribution : 1.3 + 1M/-/2/-/2 + 2F/- = 8.3 exchange
• Proper meal timing
• Pt claimed only eat rice once per day due to usual habit
• Poor consumption of fiber intake as pt only take 12.4 g of fiber throughout the day
• Pt claimed likes to eat half of pineapple, 7x/7 due to preferences
• Already drink Good Morning V Halia since 1 year ago
• Stop drinking sweetened beverages since been diagnosed with diabetes mellitus
• Frequent consumption of high salty food such as sambal belacan, 7x/7
• Lack of knowledge regarding food that contain high salt
• Take capsule Jus Peria for health but already stop since 2 months ago due to
unavailability
• Inadequate plain water as pt only take 1L/day 15
• Married
» Environmental • Housewife
• Blessed with 5 children
• Lived with husband and all her children
» Functional • Engage in dumbbell exercise while stand

on fat burning machine for 30 mins, 2x/7
» Knowledge, • Never seen a dietitian before

Attitude &
Practices
16
Patient aware
with her
current
condition and
ready to
change her
dietary intake
in order to
improve her
health
17
» ADIME – DIAGNOSIS
1. Excessive fat intake (NI-5.5.2) related to food and nutrition
related knowledge deficit concerning appropriate amount of
fat intake as evidenced by estimated fat intake 66.1 g/day
(132% from fat requirement)
2. Inadequate fiber intake (NI-5.8.5) related to food and

nutrition related knowledge deficit concerning desirable
quantities of fiber as evidenced by estimated fiber intake
12.4 g/day (recommended 20-30 g/day)
18
» ADIME – INTERVENTION
Parameter Calculation Remarks
Weight for calculation 55 kg Adjusted body weight using ADA 1996
Height for calculation 152 Obtain from green book
Stress factor 1.0 Non-stress
Activity factor 1.2 Light
Energy requirement HBE → TEE = 1446 kcal/day Chosen energy 1500 kcal/day for weight lose 0.5-1kg
Schofield →TEE = 1563 kcal/day per week
QM → TEE = 1548 kcal/day
Energy range 1446-1563 kcal

Protein requirement 1.0 g/kg BW @ 55 g @ 15% → 4 exc HBV Based on RNI 2017 : 0.8 – 1.0 g/kg BW
CHO requirement 206 g @ 55% → 14 exc CHO Based on RNI 2017 : 50 -60%
Fat requirement 50 g/d @ 30% → 6 exc Fat Based on RNI 2017 : 25-30%
Fluid requirement 1650 – 2200 ml/day 30-40 ml/kg BW
Fiber requirement 20-30 g/d Based on RNI 2017
Sodium requirement <2000 mg Based on MOH 2018
19
Short-term Goals
Goals Principles
1. To attain and 1. Educate on diabetic diet
maintain normal ‒ Proper meal timing (3 main meals)
blood glucose ‒ Explain on types of carbohydrate
profile or as ‒ Educate on CHO exchange and distribution :
close as normal 2 +1M/2/2.5 + 1F/2/2.5 + 1F/- = 14 exchange
range. ‒ Continue limit intake of sweetened beverages
‒ Emphasize on healthy plate method
‒ Limit intake of high fat food such as ayam goreng and keropok lekor
‒ Suggest healthier cooking method such as boiling, grilling and baking
‒ Suggest to change Good Morning Vhalia to low fat milk
‒ Increase intake of plain water from 1L/d to 2L/d
20
Short-term Goals
Goals Principles
2. To provide 1. Educate on adequate fiber intake
adequate fiber ‒ Emphasize on adequate fiber intake especially soluble fiber by
intake, 20-30 consuming 2 servings of fruit and 3 serving of vegetables
g/d. ‒ Suggest to choose wholegrain product such as wholemeal bread, oats
and brown rice to increase fiber intake.
21
Long-term goals
Goals Principles
1. To attain and 1. Educate on diabetic diet
maintain normal ‒ Proper meal timing (3 main meals)
HbA1c level or ‒ Explain on types of carbohydrate
as close as ‒ Educate on CHO exchange and distribution :
normal range 2 +1M/2/2.5 + 1F/2/2.5 + 1F/- = 14 exchange
(HbA1c : <6.5%) ‒ Continue limit intake of sweetened beverages
‒ Limit intake of high fat food such as ayam goreng and keropok lekor
‒ Suggest healthier cooking method such as boiling, grilling and baking
‒ Increase intake of plain water from 1L/d to 2L/d
22
Long-term goals
Goals Principles
2. To promote 1. Educate on healthy balanced meal
healthy weight ‒ Eat small and frequent
loss 0.5-1kg per ‒ Continue limit sweetened beverages
week ‒ Increase fiber intake from wholegrain products, vegetables and fruits
‒ Limit intake on fat food and choose healthy snack such as fruits, roasted
peanuts and kuih kukus (apam,pau,popia basah)
‒ Increase intake of plain water 2L/d
2. Encourage to increase physical activity

‒ Suggest to increase frequency of physical activity from 2x/7 to 5x/7
‒ Suggest to do physical activity that involve movement such as jogging, brisk
walking or aerobics.
23
» ADIME – MONITORING & EVALUATION
Aspect Focus Goal
Anthropometry Monitor weight in a weekly Monthly : 2-4 kg/month
basis Target : 59.9 – 57.9 kg in a month
Biochemical Review back To ensure that biochemical value
• Lipid profile is in normal range or as close as
• Glucose profile normal range
Clinical Review back To ensure that the value is in

• Blood pressure normal range
• Dscan
Dietary Monitor pt’s dietary intake To ensure that pt comply to the

and compliance dietary modification have made
24
» FIRST FOLLOW UP THROUGH PHONE CALL
Anthropometry data
• No latest data since patient don’t have any weighing scale at
home
Biochemical data
• No latest data since patient next appointment is on January 2021
Clinical data
• No latest data since patient don’t have sphygmomanometer and
glucose meter at home
25
» ADIME - DIETARY
Meal/time Food/drink Exch CHO Pro Fat Fiber Na Calorie
(g) (g) (g) (g) (mg) (kcal)
BF Wholemeal bread (2 pcs) 2 30 4 1 2 206 150
9.00 am
Milo kosong (2 tbs) 2 20.1 3.5 3.0 1.4 45 124
LN White rice (2 scp) 3 45 6 1.5 3 10 225
12.30 pm
Roasted chicken(1 pcs) 2 - 14 13 - 63 175
Ulam-ulaman (1 cup) - - - - 2 - -
Pineapple (2 slices) 2 30 - - 2 81 120
+ kicap ABC (2 tbs) 1 15 1 - - 716 63
AT Jemput-jemput pisang (3-4 pcs) 1½ 26.4 2.4 4.6 0.4 50 156
4.00 pm
DN Green bean porridge (1 small bowl) 2 34.0 9.0 8.0 2 184 244
8.00 pm
Plain water (1 glass) - - - - - - - 26
» ADIME - DIETARY
Meal/ti Food/drink Exch CHO Pro Fat Fiber Na Calorie
me (g) (g) (g) (g) (mg) (kcal)
Total intake 200. 39. 34.5 12.8 1355 1257
5 9
Percentage of intake (%) 63 13 24 ± 1273
Percentage of requirement (%) 97 73 69 51 84
27
» ADIME - DIETARY
Dietary comment:
• CHO distribution : 2/-/3 + 2F/1.5/2/- = 10.5 exchange
• Proper meal timing
• Followed previous advised to increase fiber intake such as change white bread to
wholemeal bread.
• However, still poor consumption of fiber intake as pt only take 12.8 g of fiber
throughout the day
• Pt already reduced portion of pineapple from eat ½ whole to 2 slices of pineapple
• Already stop taking sambal belacan everyday
• Sodium intake already reduce from 2285 mg to 1355 mg
• Practice healthier cooking method such as baked chicken using air fryer
• Still continue limit drinking sweetened beverages
• Increase plain water consumption from 1L/d to 2L/d
28
» ADIME – DIAGNOSIS
1. Excessive fat intake (NI-5.5.2) related to food and nutrition
related knowledge deficit concerning appropriate amount of
fat intake as evidenced by estimated fat intake 66.4 g/day
(133% from fat requirement) (RESOLVED)
2. Inadequate fiber intake (NI-5.8.5) related to lack of value

for behavior change due to inability to increase fiber intake
as evidenced by estimated fiber intake 12.8 g/day
(recommended 20-30 g/day)
29
Parameter Calculation Remarks
Weight for calculation 55 kg Adjusted body weight using ADA 1996
Height for calculation 152 Obtain from green book
Stress factor 1.0 Non-stress
Activity factor 1.2 Light
Energy requirement HBE → TEE = 1446 kcal/day Chosen energy 1500 kcal/day for weight lose 0.5-1kg
Schofield →TEE = 1563 kcal/day per week
QM → TEE = 1548 kcal/day
Energy range 1446-1563 kcal

Protein requirement 1.0 g/kg BW @ 55 g @ 15% → 4 exc HBV Based on RNI 2017 : 0.8 – 1.0 g/kg BW
CHO requirement 206 g @ 55% → 14 exc CHO Based on RNI 2017 : 50 -60%
Fat requirement 50 g/d @ 30% → 6 exc Fat Based on RNI 2017 : 25-30%
Fluid requirement 1650 – 2200 ml/day 30-40 ml/kg BW
Fiber requirement 20-30 g/d Based on RNI 2017
Sodium requirement <2000 mg Based on MOH 2018 30
Short-term Goals
Goals Principles
1. To attain and 1. Re-educate on diabetic diet
maintain normal ‒ Educate on CHO exchange and distribution :
blood glucose 2 +1M/2/2.5 + 1F/2/2.5 + 1F/- = 14 exchange
profile. ‒ Continue limit intake of sweetened beverages
‒ Re-emphasize on adequate fiber intake by consuming 2 servings of
fruit and 3 serving of vegetables
‒ Continue limit intake of high fat food
‒ Continue in applying healthy cooking method such as baked using air
fryer
‒ Suggest to change milo kosong to low fat milk
‒ Continue drink plain water up to 2L/d
31
Long-term goals
Goals Principles
2. To promote 1. Re-educate on healthy balanced meal
healthy weight ‒ Eat small and frequent
loss 0.5-1kg per ‒ Continue limit sweetened beverages
week ‒ Increase fiber intake from wholegrain products, vegetables and fruits
‒ Continue limit intake on fat food and choose healthy snack such as
fruits, roasted peanuts and kuih kukus (apam,pau,popia basah)
2. Re-encourage to increase physical activity

‒ Suggest to increase frequency of physical activity from 2x/7 to 5x/7
‒ Suggest to do physical activity that involve movement such as
jogging, brisk walking or aerobics. 32
» ADIME – MONITORING & EVALUATION
Aspect Focus Goal
Anthropometry Monitor weight in a weekly Monthly : 2-4 kg/month
basis Target : 59.9 – 57.9 kg in a month
Biochemical Review back To ensure that biochemical value
• Lipid profile is in normal range or as close as
• Glucose profile normal range
Clinical Review back To ensure that the value is in

• Blood pressure normal range
• Dscan
Dietary Monitor pt’s dietary intake To ensure that pt comply to the

and compliance dietary modification have made
33
MENU PLANNING FOR 1500 KCAL/DAY
Food group Exch. CHO Pro Fat Kcal BF MT LN AT DN
(g) (g) (g)
Low fat milk 1 12 8 5 125 1
Fruits 2 30 - - 120 1 1
Cereal, grains 11 165 22 5.5 825 3 1 3 1 3
Meat/poultry 2 - 14 8 130 2
Fish 2 - 14 2 70 2
Fat 6 - - 30 270 2 2 2
Total (g) 207.0 58.0 50.5 1540
Total (kcal) 828 232 455 ± 1515
Percentage (%) 55 15 30
34
MENU SUGGESTION
Meal time Menu suggestion Menu suggestion Menu suggestion
Weekday 1 Weekday 2 Weekend 1
BF • Wholemeal bread (3 pcs) + Soft • Bihun goreng (3 scoop) • Roti bakar (3 pcs) + soft
8.00 am margarine (2 tsp) • Low fat milk (1 glass) margarine (2 tsp)
• Low fat milk (1 glass) • Low fat milk (1 glass)
MT • Apam (1 pcs) • Bun (1 pcs) • Popia basah (1 pcs)
10.00 am • Teh o without sugar (1 cup) • Teh o with lime (1 cup) • Teh o with ginger (1 cup)
LN • White rice (3 scoop) • White rice (3 scoops) • White rice (2 scoops)
12.00 pm • Ayam tomyam (1 piece) • Ayam panggang (1 piece) • Sup ayam (1 piece)
• Stir-fry mustard leaves (1/2 cup) • Ulam-ulaman (1 cup) • Sayur campur goreng(1 cup)
• Orange (1 whole) • Pineapple (1 slice) • Pear (1 whole)
• Plain water (1 glass) • Plain water (1 glass) • Plain water (1 glass)
AT • Wholemeal biscuit (3 pcs) • Pau kentang (1 nos) • Wholemeal biscuit (3 pcs)
4.00 pm • Kopi o without sugar (1 cup) • Kopi o without sugar (1 cup) • Kopi o without sugar (1 cup)
DN • White rice (2 scoop) • White rice (2 scoops) • White rice (2 scoop)
7.00 pm • Ikan singgang (1 piece) • Ikan stim halia (1 piece) • Ikan bakar (1 piece)
• Ulam-ulaman (1 cup) • Stir-fry spinach (1/2 cup) • Sawi tumis air (1 cup)
• Apple (1 whole) • Grapes (8 nos) • Watermelon (1 slice)
• Plain water (1 glass) • Plain water (1 glass) • Plain water (1 glass) 35
5.0 DISCUSSI0N
1st visit 1st follow up
Nutritional Compliance to diabetic diet:

Problems:
• Inadequate fiber intake management • Practice healthier cooking
• High intake of fat food method
• Frequent consumption of Diabetic diet • Limit intake of fat food
• Reduce consumption of
salty food (sambal and physical salty food
belacan, 7x/7)
• Consume supplement activity • Stop consume Good
such as capsule peria Morning VHalia
(already stopped) and Problems:
good morning V Halia • Inadequate fiber intake
36
5.0 DISCUSSI0N
1st visit Limit intake of fat food
• Fat & free fatty acid (FFAs) →
Problems: impair insulin sensitivity & ↑
Limit intake of salty food
• High intake of fat food hepatic glucose production.
• A reduction in dietary
• Frequent consumption of (Wolpert, Atokov-Castillo, Smith,
salt intake has been
salty food (sambal & Steil, 2013)
documented to lower
blood pressure belacan, 7x/7)
(Frisoli, Schmieder, • Inadequate fiber intake Adequate fiber intake (20-30 g/d)
Grodzicki, & Messerli, 2012) • Consume supplement • Increased fiber content
such as capsule peria decreases the glycemic index
(already stopped) and of foods.
good morning V Halia • Decreased glycemic index
Low-fat dairy foods was found would lead to smaller
to be associated with a increases in blood glucose, and
significantly lower risk of 18% thus reduced blood glucose
in T2DM development. and HbA1c levels
(Tong, Dong, Wu, Li, & Qin, Suggest to change to low fat milk
(Post, Mainous, King, & Simpson,
2011) 2012) 37
• Suggest to change Good Morning V Halia with low fat milk
1 A diet that is low in carbohydrate
could lower both the fasting and
the postprandial blood glucose in
people with type 2 diabetes
(Dyson, 2015;Tay et al. 2014)
RM 43.00 RM 6.19
Energy (kcal) 98
Energy (kcal) 102
Carbohydrate (g) 11.2
Carbohydrate (g) 18.8
Protein (g) 6.8
Protein (g) 2.4
Fat (g) 2.8
Fat (g) 1.9
2 It contains non dairy creamer which is not suitable for

diabetic pt as it can raise blood sugar level due to
containing of corn syrup (simple sugar) 38
Emphasize on physical 1st follow up
5.0 DISCUSSI0N activity
Compliance to diabetic diet:
• Practice healthier cooking
method
1st visit • Limit intake of fat food
• Reduce consumption of
Do physical activity at least 150 mins per salty food
week • Stop consume Good
• Improving glycemic control, reducing Morning VHalia
the need for noninsulin Problems:
antihyperglycemic agents and insulin, • Inadequate fiber intake
and producing modest but sustained
weight loss (Sigal et al., 2018)
Re-educate on adequate fiber intake (20-30 g/d)
• Intake of fiber especially soluble fiber is associated with
improved blood glucose level & insulin sensitivity since
soluble fiber delays the absorption of glucose.
(Asif, 2014; MNT for Types 2 Diabetes Mellitus, 2013; Wolfram,
& Ismail-Beigi, 2011)
39
6.0 CONCLUSION
• Patient was newly diagnosed with pre-diabetes mellitus and this can
be prevent from worsening by making sure the patient comply with
nutrition counseling and lifestyle changes (dietary and physical
activity).
• In a nutshell, lifestyle modification including healthy diet and regular
physical activity plays a major role in preventing progression of type
2 diabetes mellitus and indirectly managing obesity.
40
7.0 REFERENCES
• Dyson, P. (2015). Low Carbohydrate Diets and Type 2 Diabetes: What is the Latest Evidence? Diabetes Therapy, 6(4), 411–
424. https://doi.org/10.1007/s13300-015-0136-9
• Frisoli, T. M., Schmieder, R. E., Grodzicki, T., & Messerli, F. H. (2012). Salt and hypertension: Is salt dietary reduction worth
the effort? American Journal of Medicine, 125(5), 433–439. https://doi.org/10.1016/j.amjmed.2011.10.023
• Post, R. E., Mainous, A. G., King, D. E., & Simpson, K. N. (2012). Dietary fiber for the treatment of type 2 diabetes mellitus: A
meta-analysis. Journal of the American Board of Family Medicine, 25(1), 16–23.
https://doi.org/10.3122/jabfm.2012.01.110148
• Tay, J., Luscombe-Marsh, N. D., Thompson, C. H., Noakes, M., Buckley, J. D., Wittert, G. A., … Brinkworth, G. D. (2014). A very
low-carbohydrate, low-saturated fat diet for type 2 diabetes management: A randomized trial. Diabetes Care, 37(11), 2909–
2918. https://doi.org/10.2337/dc14-0845
• Tong, X., Dong, J. Y., Wu, Z. W., Li, W., & Qin, L. Q. (2011). Dairy consumption and risk of type 2 diabetes mellitus: A meta-
analysis of cohort studies. European Journal of Clinical Nutrition, 65(9), 1027–1031. https://doi.org/10.1038/ejcn.2011.62
• Asif M. (2014). The prevention and control the type-2 diabetes by changing lifestyle and dietary pattern. Journal of education
and health promotion, 3, 1. https://doi.org/10.4103/2277-9531.127541
• Wolfram, T. and Ismail-Beigi, F. (2011) Efficacy of High-Fiber Diets in the Management of Type 2 Diabetes Mellitus. Endocrine
Practice, 17, 132-142. https://doi.org/10.4158/EP10204.RA
• gal, R. J., Armstrong, M. J., Bacon, S. L., Boulé, N. G., Dasgupta, K., Kenny, G. P., & Riddell, M. C. (2018). Physical Activity and
Diabetes. Canadian Journal of Diabetes, 42, S54–S63. https://doi.org/10.1016/j.jcjd.2017.10.008
41
THANK
YOU!
42

Alia OPD Presentation

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Alia OPD Presentation

Uploaded by

Copyright:

Available Formats

NDD 41004 OUTPATIENT DIETETIC TRAINING I

1.0 INTRODUCTION/CASE 5.0 DISCUSSION

4.0 NUTRITIONAL ASSESSMENT

DIETETIC’S NEW CASE

18/10/2020 Referred to 12/12/2020

Body cell resists to insulin

Glucose cannot be taken up

Glucose starts to build up in

(CPG Hypertension, 2018) 7

» Functional • Engage in dumbbell exercise while stand

» Knowledge, • Never seen a dietitian before

2. Inadequate fiber intake (NI-5.8.5) related to food and

Energy range 1446-1563 kcal

2. Encourage to increase physical activity

Clinical Review back To ensure that the value is in

Dietary Monitor pt’s dietary intake To ensure that pt comply to the

2. Inadequate fiber intake (NI-5.8.5) related to lack of value

Energy range 1446-1563 kcal

2. Re-encourage to increase physical activity

Clinical Review back To ensure that the value is in

Dietary Monitor pt’s dietary intake To ensure that pt comply to the

Nutritional Compliance to diabetic diet:

2 It contains non dairy creamer which is not suitable for

You might also like