Mrs. Folley is a 51-year old African American female who works as a bookkeeper for an insurance company. Her father and brother have type 2 diabetes mellitus, and have had severe complications because of poor control of blood glucose.
She is 5'4" tall and weighs 174 pounds with a medium-build frame. She has a history of obesity, hypertension, hypothyroidism, and frequent urinary tract infections, and is currently taking propranolol hydrochloride and synthroid.
Mrs. Folley complains of constant fatigue over the past two months and has lost 8 pounds, although she is thirsty, hungry and eats constantly. She is concerned that she may have another UTI because she has frequent urination and pain in her lower abdomen. Her physician ordered some fasting blood tests and the results show the following: Glucose at 380 mg/dL, HbA1c at 7.6%, serum LDL at 270 mg/dL, triglycerides at 290 mg/dL. She is diagnosed with type 2 diabetes and started on a 1200-kcal diet and glyburide. She is also scheduled to see a CDE at the end of the week for further counseling.
1. What symptoms of type 2 diabetes does Mrs. Folley manifest? Explain the pathophysiology of these symptoms.
2. What is the relationship between being overweight or obese and having diabetes?
3. What is the HbA1c test and how is it used to monitor diabetes?
4. In view or her other laboratory results, what other dietary counseling will Mrs. Folley need?
5. What is the difference between the two different meal planning strategies utilized in diabetes education? Which strategy do you think the CDE will teach Mrs. Folley and why?