Group 6 Output:

Members:
Amber Leigh Crystal [Question 6]
Joshua Lim [Questions 4 & 5]
Kriss Lynn Lorenzo [Question 1]
Jiez Ryll Ocariza [Question 7]
Tristan Josh Retuerto [Question 2 & 3]

DIRECTIONS: You are randomly grouped together. As a group, answer the following
questions and submit it in a document or PDF file.

Questions:

1. What is Diabetes and why does it occur?

Diabetes is the condition in which the body does not properly process food for use as
energy. It occurs when your blood glucose, also called blood sugar, is too high. Blood
glucose is your main source of energy and comes from the food you eat. Insulin, a hormone
made by the pancreas, helps glucose from food get into your cells to be used for energy.
2. What are the different types of Diabetes?
- The 3 major types of diabetes:
1. Type 1 Diabetes
● An autoimmune reaction triggered by inherited genetics or environmental
factors that attacks insulin-producing cells in the pancreas.. Most common in
childhood or adolescence.
● Signs/Symptoms: Increased thirst, frequent urination, extreme hunger,
unintended weight loss, and fatigue and weakness.

2. Type 2 Diabetes
● The most common form of diabetes. Type 2 diabetes most commonly affects
those over the age of 45. In type 2 diabetes, your body's cells can't react to
 insulin just as they ought to. In later phases of the illness, your body may
likewise not produce sufficient insulin.
● Signs/symptoms: Increased thirst, fatigue, blurred vision, slow-healing sores,
frequent infections, and numbness or tingling of the hands or feet.
3. Gestational diabetes
● Gestational diabetes can develop in pregnant women who do not currently
have diabetes. Gestational diabetes is high blood sugar (glucose) that is
developed during pregnancy and typically disappears in the wake of
conceiving an offspring.
● Pregnancy causes some insulin resistance.
● Warning signs: sugar in the urine, unusual thirst, fatigue, nausea, blurred
vision, and vaginal, bladder and skin infections

3. How does Carbohydrate Intake affect Hypoglycemia and Hyperglycemia?

When people consume carbs, the digestive system breaks down the digestible
carbohydrates into sugar, which is then absorbed into the bloodstream. Your pancreas
releases insulin to help your cells absorb glucose after your body breaks down those carbs
into glucose. It is called hyperglycemia, when someone’s blood sugar is too high than the
normal level. This occurs when the body does not have enough insulin to absorb the sugar
(glucose) in the blood, or when the cells in your body do not adequately react to the insulin
released, resulting in excess glucose in the blood. Hypoglycemia, is also known as low blood
(glucose) which is caused by a lack of carbs in one's diet, or a medication imbalance. In
short, because the carbs we eat affect our blood sugar levels, causing Hypoglycemia or
Hyperglycemia, balance is the key to a healthier body.

4. What is the Glycemic Index Level of Food and how does this relate to Diabetes?
Glycemic Index Level of Food | It is an eating plan based on how foods affect your
blood sugar level. It is also a system of assigning a number to carbohydrate-containing
foods according to how much each food increases blood sugar.
 The glycemic index classifies carbohydrate-containing foods according to their
potential to raise the blood sugar level. Foods with a high glycemic index value tend to raise
your blood sugar higher and faster than do foods with a lower value.

5. What are the hormones that affect Blood Glucose Levels?

The main hormones of the pancreas that affect blood glucose include insulin,
glucagon, somatostatin, and amylin.
● Insulin | They are formed in pancreatic beta cells. It lowers BG levels, whereas
glucagon (from pancreatic alpha cells) elevates BG levels.
● Somatostatin | It is formed in the delta cells of the pancreas and acts as the
“pancreatic policeman,” balancing insulin and glucagon. It helps the pancreas
alternate in turning on or turning off each opposing hormone.
● Amylin | It is a hormone, made in a 1:100 ratio with insulin, that helps increase
satiety, or satisfaction and state of fullness from a meal, to prevent overeating. It also
helps slow the stomach contents from emptying too quickly, to avoid a quick spike in
BG levels.
● Glucagon | A peptide hormone secreted by the pancreas, raises blood glucose levels.
Its effect is opposite to insulin, which lowers blood glucose levels. When it reaches
the liver, glucagon stimulates glycolysis, the breakdown of glycogen, and the export
of glucose into the circulation.

6. How does Excessive Carbohydrate Intake lead to Obesity?

Carbohydrates are defined as the main source of energy for the body. They are the
sugars, starches, and dietary fiber that occur in plant foods and dairy products, while
obesity is defined as abnormal or excessive fat accumulation that presents a risk to health.
Even though genetic, metabolic, cultural, social and as well as environmental factors are
linked with obesity, the major cause of obesity is the excessive consumption of
carbohydrates, high calorie foods, such as fats and sugars with the addition to decreased
physical activity. This results in an energy imbalance or an excess of energy, which is stored
in the body as fat. The high glycemic index in those kinds of food causes a sudden increase
in blood sugar. If the increased blood sugar is not utilized by the body then it eventually
builds up as fat.

7. As a healthcare provider, how can you manage Obesity and Diabetes?

According to research studies, obesity and the onset of diabetes are strongly
correlated thus healthcare providers must be updated on the latest approaches in
managing the two conditions to provide accurate interventions (“Diabetes and Obesity”,
2019). Since both management are complex, it requires a holistic and individualized
approach done with a multidisciplinary team.

Belleza (2020) & Panuganti et al. (2021) discussed the following are major medical
approaches in the management of obesity:
A. Identification of Inappropriate Behaviors
The nurse should review the individual cause for obesity as well as explore
and discuss emotions and events related to eating. Eating techniques that
modify behavior are also helpful in avoiding diet failure.
B. Preparation of Diet Plan
The nurse should encourage healthy eating by recommending low-calorie
diets. A meal plan (food and drink diary) should be formulated according to
the patient’s height, body build, age, gender, and his or her eating patterns,
energy, and nutrient requirements (Brown, 2012). Also, fad diets must be
avoided as much as possible. After all, the nurse should emphasize the
importance of adherence to the diet.
C. Determination of Nutritional Knowledge
The nurse should educate the obese patient about the harms of obesity by
developing an appetite reeducation plan. To determine the patient’s caloric
and nutrient requirements for weight loss, the nurse should consult with a
dietitian. It is important that the calorie requirements are being reassessed
every 2 to 4 weeks.
D. Administration of Anti Obesity Medications
 If indicated, the nurse should provide medications such as
appetite-suppressant drugs (e.g. diethylpropion, mazindol, and Sibutramine),
hormonal therapy (if hypothyroidism is present), Orlistat (Xenical), vitamins,
and mineral supplements. To minimize complications, aggressive therapy and
support may be significant.
E. Provision of Behavior Modification Strategies
Aside from diet, the nurse should encourage positive self-talk, proper
exercise and social activities to enhance the patient’s sense of well-being.
Also, opportunities for pleasure and relaxation such as talking with a good
friend as it helps restrain old patterns and establish new means to deal with
feelings. More importantly, the nurse along with the patient must focus on
long-term lifestyle changes and ongoing support.
F. Intervention on Surgery
The nurse should consider surgery if the medical methods are unsuccessful.
He or she must be prepared for surgical interventions (gastric partitioning or
bypass) especially when obesity is already life-threatening.

To prevent the development of diabetes mellitus among obese patients, an

appropriate management of lifestyle must be implemented (Nurselabs, 2020). Here are
some nursing interventions that should be carried out in managing diabetes mellitus:
A. Restoration of Fluid/Electrolyte and Acid-Base Balance
First, the nurse must discover the behavioral factors that contribute to
overeating. The nurse should be keen enough to provide accuracy on the
treatment of fluid and volume imbalances. In addition, moderate alcohol
intake for women should be one alcoholic beverage per day and two alcoholic
beverages for men. Shepherd (2011) entails that fluid balance and hydration
assessment have three elements: (i) clinical assessment, body weight and
urine output, (ii) review of fluid balance charts, and (iii) review of blood
chemistry.
B. Management of Nutrition
 An adequate nutritional intake considers the patient’s food preferences,
lifestyle, meal patterns, cultural background, and other factors. Consistency
of the approximate time intervals between meals with the inclusion of snacks
or refreshments helps in maintaining the overall blood glucose control. In
this aspect, the most important role of the nurse is to be a good
communicator and facilitator especially during thorough review of the
patient’s diet history and education of consistent eating habits together with
the link between food and insulin.
C. Establishment of the Specific Plan
The therapeutic plan must involve the management of nutrition, meal
planning, and weight control. Also, it is important for the patient to consult
with a dietitian along with the nurse to understand more on diabetes
management. Nurses must also be knowledgeable enough on nutritional
therapy and be supportive of patients to increase the likelihood of
individualized nutritional and lifestyle changes.
D. Prevention of Complications
The nurse should help with the normalization of the blood glucose levels to
lessen the development of vascular and neuropathic complications.
Therefore, behavior modification strategies are being included to help
patients achieve their goals in reducing weight and participating in
appropriate exercises.
E. Provision of Self-Care Behaviors
Not only should the nurse provide positive self-care behaviors, but he or she
should reinforce those habits including supportive food choices, proper
exercises, smoking cessation, and others (“How Can Nurses Help Diabetes
Patients?”, 2021). The patient must be taught to check on his or her body
parts especially on the feet if it has wounds that might require medical
attention.
F. Administration of Antidiabetic Medications
The nurse must also teach the patient how to self-administer insulin shots
aside from taking diabetes medications. The patient must also know how to
 deal with an insulin reaction as well as how to recognize certain symptoms of
high and low blood glucose and what to do during its occurrences.

References:
A. (2021, August 13). How Can Nurses Help Diabetes Patients? Lamar University Online.

https://degree.lamar.edu/articles/nursing/how-can-nurses-help-diabetes-patients/

Belleza, R. M. N. (2020, June 4). Diabetes Mellitus. Nurseslabs.

https://nurseslabs.com/diabetes-mellitus/

Contributor, N. T. (2019a, August 3). Measuring and managing fluid balance. Nursing Times.

https://www.nursingtimes.net/clinical-archive/nutrition/measuring-and-managing-flu

id-balance-15-07-2011/

Contributor, N. T. (2019b, December 6). Managing obesity in adults. Nursing Times.

https://www.nursingtimes.net/clinical-archive/public-health-clinical-archive/managin

g-obesity-in-adults-22-11-2012/

Editor. (2019, November 21). Editor. Diabetes.

https://www.diabetes.co.uk/diabetes-and-obesity.html

Panuganti Et Al. (2021). Access denied - NCBI Bookshelf. NCBI.

https://www.ncbi.nlm.nih.gov/books/NBK568702/

Vera, M. B. (2020, December 5). 4 Obesity Nursing Care Plans. Nurseslabs.

https://nurseslabs.com/4-obesity-nursing-care-plans/

Zambon, V. (2020, May 5). What are the different types of diabetes? Medical News Today.

https://www.medicalnewstoday.com/articles/types-of-diabetes
Aul, D. S. (2018, July 18). Carbohydrates and Its Role in Obesity. Retrieved from

https://www.medindia.net/patients/patientinfo/carbohydrates-and-its-role-in-obesity.

htm

Pietrangelo, A. (2020, June 18). Understanding Type 2 Diabetes. Healthline.

https://www.healthline.com/health/type-2-diabetes

ATrain Education (n.d.). Regulation of Blood Glucose. Retrieved from

https://www.atrainceu.com/content/4-regulation-blood-glucose

Castro, M. (2020, June 5). Glycemic index: A helpful tool for diabetes?. Retrieved from

https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/diabetes/

faq-20058466

Get Smart On Carbs | ADA. (n.d.). American Diabetes Association. Retrieved September 21,

2021, from https://www.diabetes.org/nutrition/understanding-carbs

U.S. Department of Health and Human Services. (n.d.). What is diabetes? National Institute of

Diabetes and Digestive and Kidney Diseases. Retrieved September 21, 2021, from

https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes.