How to have the High Ground with Type 2 Diabetes Mellitus 1

Nutritional Assessment: How to have the High Ground with Type 2 Diabetes Mellitus

Alyssa Nixon

University of South Florida

How to have the High Ground with Type 2 Diabetes Mellitus 2

r. Luke Skywalker has been diagnosed with type 2 diabetes mellitus and was started on

oral diabetic medication. He is scheduled to discharge later this afternoon. For any patient with

diabetes, education about diet and dietary restrictions is essential; it is especially pertinent for

those who are newly diagnosed to receive education on dietary recommendations and

restrictions. Mr. Skywalker recently was diagnosed and is soon to be discharged, so giving him

easy to digest information and planning to continue patient education would be best.

Diabetes mellitus type two can be the result of either insulin resistance accompanied by

relative insulin deficiency, or a secretory defect accompanied by insulin resistance. Either way,

we are dealing with a disorder that revolves around having insulin resistance. For this type of

diabetes, insulin levels are still sufficient to stabilize fat and protein metabolism; fat and protein

are not being metabolized for energy. However, insulin levels are not sufficient to stabilize

carbohydrate metabolism, which can result in hyperglycemia.

It goes to say that if metabolism is not being maintained properly, then it is quintessential

to regulate this patient’s diet. Those with type 2 diabetes mellitus should avoid consuming large

amounts of red meat, sweets, fried food, and food or beverages that contain high fructose corn

syrup. Instead, they should try to switch to a plant-based diet as it is high in fiber, antioxidants,

and magnesium, all of which have shown to promote insulin sensitivity. (McMacken & Shah,

2017)

The reason why a plant-based diet would benefit the patient is that fiber, which is only

found in plant foods "improves the glucose response, insulin signaling, and insulin sensitivity.”

(McMacken & Shah, 2017) Antioxidants found in this diet also may “inhibit glucose absorption,

stimulate insulin secretion, reduce hepatic glucose output, and enhance glucose uptake.”
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(McMacken & Shah, 2017) In other words, a plant-based diet could drive the patient further

from hyperglycemia and even act as a method of health preservation. If increasing sensitivity is

positive, it would not make sense to consume food and beverages that have the inverse effect.

Sami et al. (2017) states that “high intake of red meat, sweets, and fried foods, contribute to the

increased the risk of insulin resistance” (p. 6), and “diet soft drinks contain glycated chemicals

that markedly augment insulin resistance.” (p.6)

If I were to educate Mr. Skywalker on nutrition as related to his type 2 diabetes mellitus,

then I begin to explain plant-based diets to him. It will be positive for a newly diagnosed patient

if I provide a dietary recommendation that not only manages their diabetes but could potentially

improve it after recently being diagnosed. Of course, I would not try to make any promises and

would be honest about the need for more education. While I could go through and list all the

things to avoid in his diet, that could be an overwhelming experience, leaving the patient

wondering what they can still eat. However, I would stress the importance of avoiding

consuming large amounts of red meat, sweets, fried food, and food or beverages that contain

high fructose corn syrup. Giving Mr. Skywalker something that is manageable and does not

focus purely on what he can no longer have is my goal for patient education.

It is not impossible to improve your condition with diabetes, but it can be a lot to take in.

While having type 2 diabetes mellitus will not be easy for Mr. Skywalker to adjust to, he can

always obtain the high ground by focusing on health promotion alongside health management.

Especially in his case, diet is the key to living a life that is as normal and healthy as possible.
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References

McMacken, M., & Shah, S. (2017). A plant-based diet for the prevention and treatment of type 2

diabetes. Journal of geriatric cardiology: JGC, 14(5), 342–354.

https://doi.org/10.11909/j.issn.1671-5411.2017.05.009

Sami, W., Ansari, T., Butt, N. S., & Hamid, M. (2017). Effect of diet on type 2 diabetes mellitus:

A review. International journal of health sciences, 11(2), 65–71.