Diabetes Teaching

You work in a diabetes treatment center. The first patient you meet is KW, 35-year-old female, who presented 2 years ago with symptoms of severe fatigue and blurred vision. She thought this was due to long hours of working at a computer. The doctor who examined her told her she had “borderline diabetes”, gave her a 1200 calorie ADA diet, and told her to lose weight. Her medical record from that visit indicates the following: Wt 190 lbs, ht 5’5”, bp 140/90, urine normal, random blood glucose 155 mg/dL.

— KW did not think she had a problem and ignored the doctor’s advice. Three days ago, KW went to see the doctor after a month of severe fatigue, headaches, nocturia, thirst, and some burning and tingling in her feet. She smokes and does not exercise. She states she does not have time to cook, so most of her meals are at fast-food restaurants.

— Labs: random glucose 205, fasting glucose 140, HbA1c 9.5, chol 310, trig 700, HDL 30, LDL 140,

— Other: wt 204 lbs, BP 160/96

Teach KW about the following items (write in your teaching plan for each item):

Include psychosocial and spiritual aspects into your care and teaching

— Identify important content to be included under medical nutrition therapy.

— Identify important content to be included under exercise. Address potential benefits, precautions, and recommendations.

— Identify important content to be included under pharmacologic therapy, including anti-diabetic agents.

— How would you educate KW about neuropathy? Foot care?

— How would you educate KW about reducing risk of macro-vascular disease (CVA, CAD, PVD)?

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