1 / 13

Type 2 DM - Case Study

2/18/00. Type 2 DM - Case Study. Jean Kerver, MS, RD, CDE kerverje@pilot.msu.edu. DR is a 45 y.o. male; Ht : 5’9”; Wt : 215 lbs Present complaint : polydipsia, polyuria, fatigue. Past med hx : Type 2 DM x 5 yrs. Meds : None; NKDA. Labs : No SBGM; serum glucose=285 mg/dL 1 hr ppd;

bufford
Download Presentation

Type 2 DM - Case Study

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. 2/18/00 Type 2 DM - Case Study Jean Kerver, MS, RD, CDE kerverje@pilot.msu.edu

  2. DR is a 45 y.o. male; Ht: 5’9”; Wt: 215 lbs • Present complaint: polydipsia, polyuria, fatigue. • Past med hx: Type 2 DM x 5 yrs. • Meds: None; NKDA. • Labs: No SBGM; serum glucose=285 mg/dL 1 hr ppd; urinary glucose=2+; temp=98.8 F.

  3. Family med hx: Grandma type 2 DM at age 60 yrs • Social hx: architect; lives alone; nonsmoker; no regular physical activity. • Diet hx: no known food allergies; no supplements (vit/min or other); no special diet; drinks 2 beers qd after work; brkfst at home; lunch out—fast food or deli type; dinner at home —cooks or orders take-out food; seldom snacks.

  4. Breakfast 2 cups raisin bran 1 lg banana 1 cup whole milk 8 oz orange juice Lunch 4 oz corned beef 1 oz swiss cheese 2 slices rye bread ½ cup cole slaw 2 tbsp russian dressing 1 small bag potato chips

  5. Dinner 1 cup fried rice 4 oz Hunan chicken (fried) 4 oz shrimp and cashews 2 bottles beer 1 lg orange Total kcals: 3411 Protein: 14% Fat: 40% Carb: 46%

  6. How Many kcals Should He Have? • Ht: 5’9”; Wt: 215 lbs • IBW: 106 lbs + (9” x 6 lbs) = 160 lbs • % IBW = 215 lbs /160 lbs = 134% • AdjBW = 0.25 (215-160) + 160 = 174 lbs (79 kg) • 25 kcals/kg = 25 x 79 = 1975 kcals/d • 24-hr = 3411 kcals – 500 kcals= 2900 kcals

  7. Calculation of Dietary Pattern • Total kcals = 2000 • 50% CHO = 0.50 x kcal = 0.50 x 2000 = 250 g CHO 4 kcal/g CHO 4 • 20% PRO = 0.20 x kcal = 0.20 x 2000 = 100 g PRO 4 kcal/g PRO 4 • 30% FAT = 0.30 x kcal = 0.30 x 2000 = 67 g FAT 9 kcal/g FAT 9

  8. ADA Exchanges

  9. Negotiate, then Convert CHO

  10. Convert PRO

  11. Convert FAT

  12. Diet Pattern Totals:

  13. Diabetes Education • Tell patient what to expect • Individualize-always give choices • Be systematic-prioritize • Discuss coping strategies • Special situations

More Related