Diabetes Nutrition, Case Study Example

My current body weight is 110 pounds, so the calculation I would use to find my REE is:

110 x 10 = 1100.

I am going to multiple that REE x my activity factor (AF) to come up with my caloric needs: since I have a pretty sedentary lifestyle and do not exercise much, I am going to use an AF of 1.3:

1100 x 1.3 = 1430

I will then calculate my caloric intake needs with the equations below, assuming I want 55% of my diet to come from carbohydrates, 25% to come from fat and 20% to come from proteins:

1430 x .55 = 78.6g carbohydrates;

1430 x .25 = 35.7g fat;

1430 x .20 = 28.6g protein.

The HbA1C or A1C test is an important tool for diagnosis of diabetes and also for evaluating how a diabetic patient is responding to (or being compliant with) his or her plan of care.  It calculates the patient’s average blood sugar over the course of the last 3 months, specifically measuring what percentage of the patient’s hemoglobin is glycated.  The higher this number is, the more poorly controlled is the blood sugar (Mayo Clinic, 5).  More and more physicians are using this as a diagnosis tool (though some still use fasting blood sugars) due to the comparative ease of testing and the fact that fasting is not required for the blood draw, making it more acceptable to patients (National Institute of Health, 1).

The breakfast in this example, with 1 cup Cheerios (21g), 2 hardboiled eggs (2g), ½ cup skim milk (6g), and 8 oz. yogurt (18g) would have 47g of carbohydrates.  The lunch, with 4oz baked chicken (0g), a small potato (51g), 1 small salad with vinegar (3g) and 1 cup of steamed broccoli (3g) would have 61mg of carbohydrates.  The dinner, with ½ bagel (15g), 2 tablespoons peanut butter (6g), 1 cup milk (12g), and a small orange (22g) would have 55g of carbohydrates (Heavin, 234-6).

Lispro is a fairly rapid-acting insulin, whose onset is ½ hour to 1 ½ hours after injection, whose peak is 2-3 hours after injection and whose duration is approximately 5-7 hours.  I am also taking a longer-acting insulin, Lente, whose onset is 2-4 hours after injection, whose peak is 6-12 hours after injection and whose duration is 18-24 hours.  (Nursing Drug Handbook, 732). Between the two medications, I am able to keep my blood sugars at a very steady level and avoid dramatic dips or spikes throughout the course of the day.

To calculate my energy needs  I would multiply the number of calories I will need per minute (based on my body weight) times the number of minutes I will be exercising:

11.9 x 30 = 357 calories.

I want these calories to be in carbohydrates, and since there are 4 calories in 1g of carbohydrates, I would use the following equation:

357 / 4 = 89g (Runsweet.com, 1).

Thus, I will need 89g of carbohydrates to cover my activity level and avoid any episodes of hypoglycemia.  I would likely try to get these carbs from healthy sources like whole wheat products or fresh fruit or both.

Works Cited

A1C Test.  Mayo Clinic Website.  2014.  Web. 31 March 2014.

AIC Testing and Diabetes. National Institute of Health Website.  2014. Web. 31 March 2014.

Calculating Energy Expenditure. RunSweet.com Website.  2014. Web. 31 March 2014.

Calorie Need Estimates. University of Arizona Cooperative Extension. 2009. Web. 31 March 2014

Heavin, G. Curves Members Guide. Curves, International Publishing. 2005. Print.

Insulins. Nursing Drug Handbook.  Lippincott, Williams and Wilkins Publishing. 2013. Print.