Situation 1: Covina Is A 16-Year-Old Girl With Newly Diagnosed Type 1 Diabetes. She Is

Situation 1: Covina is a 16-year-old girl with newly diagnosed Type 1 diabetes.
She is
5ft 2 in. tall, weighs 115 lbs and is active in taekwondo and the choir in school. She
often participates in interschool competitions. Her attending physician is in the process of
regulating the dosage and timing of her insulin regimen. She is to check and record her
blood sugar level each morning 30 minutes before taking her medications/breakfast.
Presently, she is prescribed Metformin 250 mg one tablet 30 minutes before breakfast and
Tojou 10 units at bedtime. As her parents are both working abroad, she lives with her
Grandmother, who is supportive of her studies and interests. Covina expressed worry
about keeping up with her peers and how diabetes will affect her performance level in
taekwondo. She signified willingness to modify her diet as necessary but would prefer that her
food be steamed rather than fried. She has a schedule to see you for her diabetic Dietary
Therapy.
Describe the state of evidence regarding diet therapy in the management of diabetes.
What guidance can you offer for Covina? What signs and symptoms of diabetes control must
Covina understand to manage her condition? What should she do to correct the
hypoglycemicstates she may experience? Using the table below, design a diet therapy and
teaching-learning sessions to address Covina’s needs.
I.State of evidence to the diet planned:
Nutritional recommendations to patients with diabetes type 1 induced an improvement in

glycemic control and lipid profile and subsequently a reduction in ROS generation which could
help to prevent diabetic long-term complications. A person with diabetes should eat more of the
foods in the bottom of the pyramid (grains, beans, vegetables) than those on the top (fats and
sweets). the need to define new nutritional approaches for improving overall nutrition quality.
GRADE Ranking Recommendation of the Research Studies
HIGH:
“Dietary Habits and Biochemical Parameters Evolution in Type 1 Diabetic Patients after Health
Care Orientations”
-High GRADE rank because it is a good recommendation where the panel agrees the
positive effects of obedience to a recommendation outweigh the negative effects. This can be
both for and against interference.
http://pubs.sciepub.com/jnh/5/1/2/index.html
MODERATE:
“Dietary strategies for adult type 1 diabetes in light of outcome evidence”
-This Article supports the evidence just right that is why it is moderate in rank. Desirable
effects can include beneficial health outcomes, reduced burden and savings. Adherence to this
recommendation is a reasonable measure of good-quality care.
https://diabetes.ufl.edu/outreach/resources/nutrition/type-1-diabetes/?
fbclid=IwAR1cMekqcIhWwTKKz6B4V3rMI5I4N6iUq0OavTQnz3Puud3Mr4_LHgI3w78
LOW:
“The Evidence for Medical Nutrition Therapy for Type 1 and Type 2 Diabetes in Adults”
-Explicit consideration after first considering whether there are health benefits.
Limitations in the consistency of the research, major inconsistencies in the findings or confusion
about the directness of the data may reduce the degree of data.
https://sci-hub.tw/https://www.sciencedirect.com/science/article/abs/pii/S0002822310014902?
fbclid=IwAR3lxogGAHKkn4LTh_yFn5QY2Kf-e9XUlyzhtk05euYwb6f2-JWXwM5QaQY
VERY LOW
“Type 1 Diabetes Nutrition”
-Based on the lowest quality of evidence for any of the outcomes that are critical to
making a decision. We’re not that confident to recommend this because of the uncertainty or
variation in how different individuals value the outcome of this research study.
https://www.nature.com/articles/ejcn2014214?fbclid=IwAR3lxogGAHKkn4LTh_yFn5QY2Kf-
e9XUlyzhtk05euYwb6f2-JWXwM5QaQY
Patient: Covina Gender/Age/Civil Status: Female/ 16yrs old/Single

Ht: 5’2” Wt: 52 Kg DBW: 52 Kg Allergies: N/A
Medication/s: Metformin 250mg/ 30mins qa.m and Tojou 10units q.h.s
Diet: 1820 Kcal/day
Activity Level: X Sedentary/light work __Mod. Work __ Heavy work ___ Very Heavy Work
Remarks (Food Preferences): Steamed Food
Goal of Care:
The patient will be able to exceed awareness to perform self-monitoring of blood glucose
level to keep it as normal as possible using a blood glucose meter as evidenced by demonstration
of the technique to the nurse or nurse practitioner.
Best Nutritional Intervention:
A healthy diet for all people with diabetes includes reducing the amount of calories if you are
overweight:
Encourage patient to participate in the dietary management
Educate patient to replace saturated fats (eg. cream, cheese, butter) with unsaturated fats (eg.
avocado, nuts, olive and vegetable oils)
Educate patient to eat dietary fibre (eg. fruit, vegetables, whole grains), and avoiding tobacco
use, excessive alcohol and added sugar.
Encourage and teach parents and child on how to operate a portable insulin pump to regulate
insulin delivery
Encourage appropriate and nutritious food with a balanced diet and exercise.
Advise the patient to prevent skin breakdown that can lead to infection
Include as many family members there in teaching sessions on the patient as possible.

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Situation 1: Covina is a 16-year-old girl with newly diagnosed Type 1 diabetes.

I.State of evidence to the diet planned:

Nutritional recommendations to patients with diabetes type 1 induced an improvement in

GRADE Ranking Recommendation of the Research Studies

Patient: Covina Gender/Age/Civil Status: Female/ 16yrs old/Single

Best Nutritional Intervention:

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