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Introduction:
Diabetes mellitus is a chronic metabolic disorder that prevents the body to utilize glucose completely or
partially. It is characterized by raised glucose concentration in the blood and alterations in carbohydrates, protein
and fat metabolism.
TYPE 1: The immune system of the body attacks and destroys the cells that produce insulin. As no insulin is
produced, glucose levels further increases, which can seriously damage the body’s organs. Type 1 diabetes is often
known as insulin-dependent diabetes. It is also sometimes known as juvenile diabetes or early- onset diabetes
because it usually develops before the age 40, often during the teenage years. Type 1 diabetes is less common than
type 2 diabetes.
TYPE 2: Type 2 diabetes is where the body does not produce enough insulin or the body’s cells do not respond
to insulin. This is known as insulin resistance. Type 2 diabetes is far more common than type 1 diabetes.
GESTATIONAL DIABETES: Some women tend to experience high levels of blood glucose as during
pregnancy due to reduced sensitivity of insulin receptors.
Impaired Glucose
≥7.8 (≥140) <7.0 (<126) 6.0–6.4
Tolerance
Diagnosis
Normal Carbohydrates, Normal Protein, Low Calorie (1g/kg), High Fiber (40g/ day), Normal vitamins and
minerals, Normal Fluids.
Foods to be included
Green leafy vegetables, wheat bran, oats, bran, brown rice, tofu, lentils, low fat foods and plantain stem.
Foods to be avoided
Simple sugars, Jaggery, alcohol, nuts, cake, fried foods, candy, dried fruits, roots and tubers.
Nutritional requirement:
High carbohydrate and high fibre diet improve insulin. Binding and increase in monotype insulin receptor
binding. Carbohydrate is maintained to about 60-65 per cent of total calories.
Protein: A diet high in protein is good for the health of diabetes because it supplies essential amino acid needed for
tissue repair.
Fat: Low fat diet increase insulin binding and also reduces LDL and VLDL levels.
Dietary Fiber:
Insulin requirements
Sensitivity
CASE STUDY -1
GENERAL INFORMATION
Name : Mrs.DHANALAKSHIMI
Gender :Female
Age :68
Religion : HINDU
Occupation : HOUSE WIFE
Date of admission :15/12/2022
HOSPITAL DETAILS
MRD No :10729564
Ward No :126
MEDICAL HISTORY
Past Medical History: Diabetes mellitus, Parabinsonism
Present Complaints : lower limb swelling, chest pain, Feaver, cold, cough, bleeding manifestation and
abdominal pain
Diagnosis : Diabetes mellitus
3] Biophysical Assessment
DATE BLOODPRESSUR PULSE RATE RESPIRATION
E RATE
100/70mmhg 94/min 26/min
25/min
4] Clinical Assessment
ORGA OBSERVATION
NS
GENERAL APPEARANCE NORMAL
EYE NORMAL
MOUTH NORMAL
BEHAVIOUR NORMAL
TONGUE NORMAL
EAR NORMAL
NAIL NORMAL
6] DietaryAssessment
Food Habit:non vegetarian
Food Allergy: no
Cereals
Pulses
Green Leafy
Vegetable
Roots tubers
Other vegetables
Others
24 HOURS RECALL
NUTRIENTCALCULATION:
MEDICATIONS
DRUGS DOSAGE
T. ECOSPRIN 150mg
SYP.ASCORIL-D 50 mg
T.PAN 100mg
T.DOLO 650mg
T.ROSUVAS 75mg
SYP.LUPITUSS 10ml
DIET PRESCRIBED: Oral- low fat diabetic diet and iron rich diet.
PRINCIPLE OF DIET: High fluid, high protein, high fibre, moderate carbohydrate, low
fat, liberal vitamins and minerals, low calorie
DIET ORDER
DATE DIET ORDER
15/12/2022 High fibre rich foods are suggested
16/12/2022 Low fats skimmed milk and high fibre foods
are consumed
17/12/2022 High calorie foods are consumed
DIET PRESCRIBED IN HOSPITAL
DAY 1
TIME MENU SERVING SIZE
6:00am Skimmed milk 100 ml
8:00am Chappath 3 no's
i
1 katori
Vegetable
kuruma
10:00am Vegetable soup 100ml
1:00pm Rice 1 cup
Dhal
1 katori
sambar Egg
white 2 no's
Beans
poriyal 1 katori
Rasam 1 katori
Butter 100ml
milk
4:00pm Skimmed milk 100ml
Marie biscuit 2 no's
8:00pm Wheat rava upma 1 cup
Onion chutney 1 katori
10:00pm Milk 100 ml
CALCULATION
Day 2
SUMMARY
The patient Mrs.DHANALAKSHIMI age was 68 years old admitted in the hospital with the
present complaints the h/o pruritus, abdominal pain, worsening in the night. She has the past
history of Diabetes mellitus for 5 years. The BMI (29.3) shows that the patient is obese. The
biochemical assessment shows that the hemoglobin is low. The clinical assessment shows that
the patient was normal. On assessing the dietary habit, it was noticed that the calorie intake was
high. The food frequency shows that the patient's diet included all the food groups. On diagnosis
of the disease and nutritional assessment the patient was given drug and dietary treatment. Drugs
were prescribed by the physician and the diet order prescribed by the dietitian.Oral- low fat
diabetic diet and iron rich diet.