Running head: NUTRITIONAL ASSESSMENT 1

Nutritional Assessment

Steven Michael Martinez

University of South Florida

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Nutritional Assessment

Type II diabetes mellitus has seen a heavy increase in the world population in the past 30

years. Dramatic weight gain and general obesity are two of the most common risk factors for

development of diabetes (Li et al., 2015). Smoking and alcohol consumption are other factors

that increase risk as well. The patient Mr. Luke Skywalker was just recently diagnosed with type

2 diabetes mellitus. It is the nurse’s responsibility to educate the patient on their condition and

one of the most important changes that need to be made to decrease problems with type 2

diabetes mellitus occur with nutritional changes. Mr. Skywalker has been given orders to take an

oral diabetic medication and is soon being discharged so proper education must be disseminated

now.

The disease process for type 2 diabetes mellitus starts with insulin resistance and insulin

deficiency resulting from the risk factors mentioned earlier which involves the body’s cells being

resistant to the insulin produced. Insulin allows cells to take in glucose and if the process isn’t

working properly or not working at all glucose levels in the blood rise, leading to hyperglycemia.

If the body’s cells cannot take in insulin then metabolism of fats, carbohydrates, and proteins

becomes impaired.

To combat type 2 diabetes, two of the most important changes that need to be made

involve diet and exercise. Changes for Mr. Skywalker will need to be made in how much fats,

carbohydrates, proteins, and electrolytes he consumes. Fats need to be limited, especially the

saturated fats. Fats contain the most calories per gram out of the macro nutrients and reducing

saturated fat intake subsequently leads to reduced caloric intake which will help with weight

management in the fight against type 2 diabetes mellitus. Fat intake should primarily come from

polyunsaturated and monounsaturated fat, saturated. When it comes to carbohydrates, the total
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amount consumed is more important to focus on rather the types of carbohydrates (Dyson, 2015).

Sugars are derived from carbohydrates and these are also the body’s primary fuel source.

Evidence has shown that glycemic effects of different types of carbohydrates do not differ much,

so the most important aspect is substitute or limit heavy carbohydrate loaded foods to prevent

weight gain. In the United States most people already eat more protein than the required levels.

People with type 2 diabetes mellitus do require more protein than those without the disease, but

they are usually already taking in an adequate amount of protein to combat the catabolism of

protein due to hyperglycemia from their disease. Dyslipidemia and hypertension usually develop

in patients with type 2 diabetes mellitus, so it is also important that Mr. Skywalker limits his

cholesterol and sodium intake too.

To begin heading toward a positive prognosis Mr. Skywalker must first compare his

current diet to the recommended diet for a person with type 2 diabetes mellitus. Fats should

sparingly come from processed foods, snacks, or fried food. Instead foods such as fish,

avocadoes, peanut butter, and olive oil should be recommended as these choices contain

polyunsaturated and mono unsaturated fats instead of saturated fats. Since Mr. Skywalker has

been informed that what is most important is the caloric amount of carbohydrates he consumes

instead of the type foods such fruits, vegetables, breads that are whole grain, and low or non-fat

milk are recommended. These foods not only contain lower caloric amounts even with more

food, but also provide more micronutrients that will aide in a healthy lifestyle. A proper fiber

intake should also be maintained to prevent further disease complications and promote gut

motility (Dyson, 2015). Protein intake does not need to be limited if an adequate amount is

already met, but if eating meat Mr. Skywalker should opt for more lean cuts.
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Patient education for Mr. Skywalker will not only be conducted with him, but also family

members. Encouragement to maintain discipline in a proper diet is crucial and will help to

combat the disease and lose excess weight. The types of foods that should and should not be

eaten will be thoroughly discussed with the patient. Once Mr. Skywalker is told about what

dietary changes need to be made, ask him to list foods primarily in each nutrient category that are

recommended so it shows that he can demonstrate that the knowledge was received well.

Type 2 diabetes mellitus is a disease that effects a staggering number of individuals

today. If education about diets to combat the disease and giving information about how the

disease process works to people affected by it is used, then there is a better chance to help those

suffering from type 2 diabetes mellitus. Other factors that must be noted are financial, social,

spiritual, and environmental factors that could become barriers to attaining the preferred diet.
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References

Li, R., Qu, S., Zhang, P, et al. (2015). Economic Evaluation of Combined Diet and Physical

Activity Promotion Programs to Prevent Type 2 Diabetes Among Persons at Increased

Risk: A Systematic Review for the Community Preventive Services Task Force. Annals

of Internal Medicine, 163(6), 452. doi:10.7326/m15-0469

Dyson, P. (2015). Prevalence, public health aspects and prevention of diabetes. Advanced

Nutrition and Dietetics in Diabetes, 1-8. Diabetes (eds L. Goff and P. Dyson), John

Wiley & Sons, Ltd, Chichester, UK. doi:10.1002/9781119121725.ch1