Diabetes Case Study

Diabetes Case Study

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles. An estimated 14.6 million people have been diagnosed with diabetes. There are 20.8 million children and adults in the United States, or 7% of the population, who have diabetes (American Diabetes Association 2006).

In order to be diagnosed as a diabetic a Fasting Plasma Glucose Test (FPG) must reveal a level of 126 mg/dl or higher. Another way to prove a diagnosis would to be to have an OGTT or Oral Glucose Tolerance Test that reveals a blood glucose of 200 mg/dl or higher after a fast and two hours time.

There are two primary types of diabetes, Type I and Type II. Typically Type I diabetes is most commonly diagnosed in children and young adults. Type I was previously known as juvenile diabetes. In type I diabetes, the body does not produce insulin. Conditions associated with type I diabetes include hyperglycemia, hypoglycemia, ketoacidosis and celiac disease. The most common type of diabetes is type II. With this type of diabetes the body does not produce enough insulin or the cells are resistant to the insulin. Insulin allows glucose to cross over into the cells for energy.

Management of diabetes usually includes emphasis on managing short-term as well as long-term diabetes-related problems. Major factors in effective management include patient education, nutritional support, self glucose monitoring, as well as long-term glycemic control and in some cases insulin administration is necessary either by subcutaneous injection or by the use of an insulin pump. Management is needed to help reduce the risk of long term complications. Many individuals with diabetes have been shown to have higher risks of cardiovascular disease and lifestyle changes must be implemented to control blood pressure and cholesterol by exercising more, smoking cessation, and consuming an appropriate diet.

Nutritional recommendations

from the American Diabetes Association in 2006 are as follows:

Eat lots of vegetables and fruits. Choose whole grain foods over processed grain products. Include fish in your meals 2-3 times a week. Choose lean meats. Choose non-fat dairy. Choose liquid oils for cooking instead of solid fats that can be high in saturated and trans fats. Cut back on high calorie snack foods and desserts and also watch your portion sizes.

In the case of Abigail it would be very important for her to take an active part in her own meal planning and also to snack throughout the day (protein plus 15 gm carbohydrate snacks) if she is having symptoms of low blood sugar. Abigail is at an age where she is capable of counting carbohydrates and can take a proactive role in her own disease management.

Abigail is also at an age when psychosocial implications should be a major consideration. “The biological, social, and cognitive changes of adolescence pose special challenges to the successful management of type 1 diabetes. Biological changes, such as the introduction of pubertal hormones, heighten the risk for poor glycemic control, making the disease more challenging to manage. Furthermore, self-management of type 1 diabetes often declines during adolescence. Because of increased desires to fit in with peers coupled with a growing need for autonomy over