Running head: DIABETES DISCHARGE TEACHING 1

Diabetes Discharge Teaching

Kakra Agyen

University of South Florida

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Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by the body's

inability to use insulin. In a healthy adult, pancreatic beta cells secrete adequate amount of

insulin. The main function of insulin is to open cells and allow glucose into the cells, in turn

lowering glucose level. However, when the function of the beta cells are deficient, glucose level

rise and hyperglycemia occurs as a result. Consequently, diabetic patients overtime become

overweight, hyperglycemic, and face complex comorbidities. Likewise, with Mr. Skywalker

diagnosis of T2DM, lifestyle changes and drug therapy are key elements in treating the disease

and preventing future complications (Bajorek & Morello, 2010, p. 1787).

Diet and exercise are lifestyle changes required to effectively manage the T2DM. Diet

management involves planning and choosing proper food group. It is essential to teach Mr.

Skywalker the types of carbohydrates that can influence his glucose level. Grains, legumes,

vegetables, and fruits are all good sources of carbohydrates; however, not all carbohydrates

contain the same amount of glucose. Therefore, a healthy way of measuring the amount of

glucose in food, is by utilizing the glycemic index (GI) (American Diabetes Association, 2014).

GI ranks carbohydrate in two categories: high glycemic and low glycemic. Low GI food

category contain natural fibers that help lower blood glucose and cholesterol levels. Low GI

foods includes legumes, most dark colored fruits and vegetables, and whole-grains. Starchy

vegetables such as sweet potatoes are also considered low GI if not processed (American

Diabetes Association, 2014).

On the opposite spectrum of the glycemic index are high GI foods . High GI foods are

composed of processed and or refined foods, added sugars, and natural fruits with high sugar

content. This category should be limited in diet because of its ability to raise blood glucose and

cholesterol levels. In addition, limiting low-density lipoproteins (LDLs) intake will reduce
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cholesterol level. LDLs are found primarily in saturated and trans fats. Fatty foods are causative

factors of cardiovascular diseases, stroke, and obesity. Also, it is advised to limit certain

electrolytes such as sodium. Increased sodium intake is linked to hypertension. Conversely, fats

that are healthy are known high-density lipoproteins (HDLs). HDLs include monounsturated

and polyunsaturated fats. Overall, Mr. Skywalker's nutritional discharge teaching should

emphasize eating the proper food group in moderation (Treas & Wilkinson, 2014).

As previously stated, drug therapy is of the key elements in T2DM management. Upon

discharge Mr. Skywalker should receive teaching on oral diabetic medications. To promote

medication safety, the patient should be made aware of hypoglycemia. Oral diabetic medications

are created to lower blood glucose levels, hence if not taken with meals, it has the potential to

cause hypoglycemia. To reduce the probability of hypoglycemia, it is vital to teach Mr.

Skywalker how to monitor blood glucose levels before administering medication and how to

detect signs and symptoms of hypoglycemia.

Furthermore, it would be recommend that Mr. Skywalker engage in 30 minutes of

moderate intensity exercise daily (Hayashino et all., 2012). Physical activity is a great way to

burn calories and help maintain a healthy weight. Exercise has shown to be effective in reducing

risk of cardiovascular diseases, obesity, and dyslipidemia (Hayashino et all., 2012). The only

caution is hypoglycemia. Vigorous exercise can cause low blood sugar, thus Mr. Skywalker will

be taught how to monitor and how to combat hypoglycemia by eating small snacks that will

replenish his glucose.

In conclusion, diet modification, drug therapy, and physical activity are the three key

elements necessary in type 2 diabetes mellitus discharge teaching. These elements are absolutely

essential for effective management of T2DM.

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References

American Diabetes Association. (2014). Understanding Carbohydrates: Glycemic Index and

Diabetes. Virginia, United States.

http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/understanding-

carbohydrates/glycemic-index-and-diabetes.html?referrer=https://www.google.com/

Bajorek, S. A., & Morello,C. ( 2010). Effects of Dietary Fiber and Low Glycemic Index Diet on

Glucose Control in Subjects with Type 2 Diabetes Mellitus. Annals

ofPharmacotherapy,44(11),1786-1792. doi: 10.1345/aph.1P347

Hayashino, Y., Jackson, J., Fukumori, N., Nakamura, F., & Fukuhara, S. (2012). Effects of

supervised exercise on lipid profiles and blood pressure control in people with type 2

diabetes mellitus: A meta-analysis of randomized controlled trials. Diabetes Research &

Clinical Practice, 98(3), 349-360. doi:10.1016/j.diabres.2012.10.004

Treas, L., & Wilkinson, J. (2014). Nutrition. In Basic nursing: Concepts, skills, & reasoning (pp.

900-904). Philadelphia, PA: F.A. Davis Company.