I missed last weeks post because I was traveling, but I’m going to go ahead and put it in here, just to get it out of my system.
Having Diabetes: Pathophysiology and Epidemiology
During our “Having Diabetes Week,” we talked a lot about what the risk factors were for diabetes, and how it was diagnosed. This was a ton of information, but it was all super useful. We based a discussion around a case study. The subject was a woman in her late forty’s who was a single parent, Hispanic, lived a sedentary lifestyle, and was overweight. She ate out at least one meal a day, and came into the clinic with labs that looked a lot like a diabetic patient’s would. We determined, that though we were unable to diagnose her, she likely had diabetes and was at the very least at a high risk to develop it. This discussion brought out a lot of information about lab values, and we looked into a lot of risk factors. For example, this person also had high LDL values and low HDL, which is common in diabetic patients. Overall, this week really helped me to understand what to look for in patients as warning signs that the may develop diabetes, and it taught me what to look for in lab values. It was super interesting material, and it caused me to think a lot. I like that there was such a thorough discussion on the topic, because my classmates pointed out information I originally thought irrelevant, like the lipid values.
Medical Nutrition Therapy and Carbohydrate Counting
This week we talked about helping patients to change their diet and live a healthier lifestyle, so that they can manager their diabetes. We did a carbohydrate counting game that I found fun, and informative. I never realized just how many carbohydrates were in our food! They are in almost everything, and it is really important that our patients know this. Knowing how to make smart choices about food affects our diabetic patients in a really big way. Food is not just a social staple, especially for our diabetic patients. Our case study this week was designed around helping a different patient to create a new diet for herself, and whether or not she could be successful. She was also overweight, had children and lead a sedentary lifestyle. She also loved to prepare fried foods for her family. I think that ultimately, we decided she could be successful, but she needs to take small steps. Learning how to prepare meals that her family will enjoy, but that will help their health (and hers) is really important for her. We also need to make sure that the patient understands that fried foods can be a fun treat, but that they should not be a lifestyle. For this patient, lifestyle changes in eating are going to be crucial, and likely difficult. It can be hard to give up those yummy, greasy foods, and her body will not like the changes at first. As the nurse working with her, it is going to be super important to offer moral support and encouragement. It would also be great if she could live a less sedentary lifestyle. Patients and medical professionals alike often struggle to find time to exercise, and when you are tired from a long day, it is easier to sit down and rest. Eating a better diet will not only help lower our patient’s risk for diabetes, but will give her more energy to perk up her lifestyle a little bit. Teaching the patient that baby steps in all aspects of change are important and not to overwhelm herself. Small changes like walking for 15 minutes or giving up soda make a huge difference.
I loved this topic, it was so useful for me in learning how to teach patients and how to support them. I knew that trying to make several changes at once was hard for me, but I think we often through big changes at our patients all at once. It is expensive for them to come in repeatedly though, so perhaps creating a plan of change with the patient that spans time and follow up calls would make the health care more accessible, and ultimately create better outcomes for patients.