Dietary Prescription and Nutritional Supplement for Type 2 Diabetes Patient

This article provides a dietary prescription and nutritional supplement for type 2 diabetes patients. It includes a one-day diet sample, key dietary recommendations, and supplement dosages. The article also discusses the importance of calcium, zinc, potassium, and magnesium in the patient's diet.

Running head: ASSESSMENT BRIEF CASE STUDY 2 1
Assessment Brief Case Study 2
Student’s Name
Institutional Affiliation

ASSESSMENT BRIEF CASE STUDY 2 2
Dietary prescription
According to Ali, Debsharma and Jana (2016), it is always advisable that old people be
subjected to a healthy diet because if their vulnerability state. Their low immunity need to be
supplemented with a variety of nutritious foods that will help boost the immunity. McKenzie et
al. (2017) states that low immunity of the body may give an opportunity for a very small
infection like cold because so intense to an extent that it causes severe effects than it is supposed
to. The key recommendations to the patient would focuses more on foods that will improve the
overall health, boost immunity and most importantly foods that are low in fats and sugars
(predisposes to becoming overweight and type 2 diabetes. Snorgaard, Poulsen, Andersen and
Astrup (2017) et al states that in management of type 2 diabetes, it is always essential to be
cautious not to consume foods that predisposes the patient to the same conditions again. For this
reason, the patient would be most subjected to a diet that is well.
According to Tay et al. (2018), it would be advisable that sally consumes a healthy eating
pattern that comprises all foods and beverages that are recorded to be within a recommended
calorie level. The following are some of the key dietary recommendations that will be
appropriate for the patient (Sally) in respect to her condition at hand:
 A variety of vegetable from different origins of all the subgroups. For instance, legumes,
starchy vegetables, red and orange and dark green.
 Fruits particularly the fresh fruits
 Grains whose half should be whole grains.
 Low fat dairy or fat free dairy including lean meats, sea food and poultry, eggs.
 Oils

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Gómez-Ambrosi et al. (2017) also states that for Sally, a healthy eating pattern will limit
saturated fats ad trans fats, sodium and added sugars. They also note that the ley
recommendations that are quantitative are provided for various components of the diet that
should be limited. The specified limits could help individuals achieve their healthy eating habits
patterns that are within calorie limits.
One-day diet sample
According to (meal plans has a lot of things attached to it. Depending on the preferences
of the patient, the type of medications to be administered to her, and the activity in which she
engages in, will a meal plan be designed. Because she is just old and she is not involved in
intensive activities, it would be for a diet with carbohydrate consistency. Paula et al. (2015) add
that it will be profound to eat the same amount of carbohydrates for breakfast, lunch and dinner
to keep the blood glucose from dropping too low or spiking too high. Tay et al. (2015)
recommends 45 grams as an appropriate target for the three major meals of the day. Lower than
30 grams at a meal would mean too hard for all the required nutrients like phytochemicals and
fiber.
Breakfast
A snap having a mixture of hardboiled eggs, seeds, nuts or seeds, cheese stick, peanut or
some substances comprising protein. There could be instant oatmeal that is unsweetened for the
whole grains together with available fruits.
Desired Menu
Eggs and Avocado toast

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Medium orange
French Café au lait made with a 1% milk- equivalent to half a cup
Ingredients of choice:
100% whole grain bread of 1 slice
A fifth avocado
one egg
Pepper and salt
Lunch
Emadian et al. (2015) note that getting two slices of bread (sandwich) could be very easy in
controlling carbohydrates. This could be enhanced through a whole wheat or enjoyment of some
vegetable soup or salad combined with crispbreads in a protein and for a very satisfying afternoon
meal.
Desired Menu
whole wheat Pita combined with watercress tempeh and waldorf
100% whole wheat having between 70 and 90 calories for every serving.
Ingredients

ASSESSMENT BRIEF CASE STUDY 2 5
1 tbsp curry powder
⅜ cup vegan mayonnaise or light may
1 apple, cored and diced
8 oz tempeh
½ cup water
1 ½ 100% cut in half whole wheat pitas,
2 tbsp golden raisins
3 cups watercress
¼ cup chopped cashews
Packing snack
Mottalib et al. (2018) advises that there should be integration of some snacks to fill
nutritional gaps in her main meals. He recommends some of the favorite snacks:
Apple and peanut butter
V-8 juice
Cottage cheese with diced tomatoes, black pepper and basil
Portobello pizza

ASSESSMENT BRIEF CASE STUDY 2 6
Dinner
Ebrahimpour-koujan et al. (2018) notes that it would be very be appealing to find some
recipes that are always heavy on vegetables to add to the repertoire. This could be combined with a
big batch that could be frozen for a quick weeknight meal. Soup that is served from such a meal is
very fulfilling (usually about two cups)
Menu
Seltzer with lime
Chicken Tortilla Soup
Ingredients
A half tsp salt
crushed tomatoes, 14.5 oz can
1 tbsp olive oil
1 green bell pepper, diced
One quarter lbs skinless, boneless chicken breasts
1 tbsp chili powder
2 tsp cumin

ASSESSMENT BRIEF CASE STUDY 2 7
One 15-oz can no-sodium black beans, drained and rinsed
One medium onion, diced
4 cloves garlic, minced
5 corn tortillas, sliced into strips
two avocados, cut into cubes
eight oz shredded light cheddar cheese
four tbsp green chiles
32-oz reduced-sodium chicken stock
one cup containing chopped cilantro
cut in wedges consisting 2 limes
Nutritional supplement prescription
Practitioner only iron supplement is an example of supplement that could be
administered to the patient because it contains the active form of folate, essential for forming
healthy red blood cells to help in beefing up the circulatory system. This is also evident from the
physical examination of the nails. The nails demonstrate that Sally would be lacking some good
amount of blood. it is not up to the mark or rather the required level. therefore, ay supplement

ASSESSMENT BRIEF CASE STUDY 2 8
that will help boot the activity of the red blood cells and hence boost bold would be appropriate
for Sally.
Silva, Oliveira and Duarte (2016) observes that there are general effects that are
associated with using such formula in question. They found out that the advice impact of the
supplements was reasonable for a significant number of people ending up in the emergency
department. There are possibilities that overly use of supplements could also have a significant
impact in an individual’s life. Costello, Dwyer and Bailey (2016) note that it is important facts
for the nursing practitioners to be aware of some of the important elements or key points before
they can choose to administering supplements.
It is important that the health care providers ask the patient in the use of over the counter
drugs or natural dietary supplements. Without this crucial information, the health care providers
might not realize that any of the signs and symptoms that the patents could be having are
associated with these products. Even though some dietary supplements are beneficial because of
their active ingredients- the molecules that interact as receptors in our body and cause
physiological changes. However, Sally’s case, it is the doctor wo will be recommending the
supplements and thus safety is guaranteed.
Calcium alongside vitamin D and magnesium have acritical role they play in patients
with type 2 diabetes. They particularly reduce the risk of the disease through their role in insulin
resistance modulation, the functioning of beta-cell function and inflammation. Huhmann et al.
(2016) indicates in their study that calcium has the potency to reduce accumulation of fat cell
lipid and adiposity.

ASSESSMENT BRIEF CASE STUDY 2 9
The other essential nutrient that plays a significant role is zinc. Valdés-Ramos et al.
(20115) observes that zinc plays a vital role in the biosynthesis of insulin which is usually part of
the hexametric structure of the hormone. This is done through stimulation of receptors on insulin.
Additionally, potassium and calcium helps regulate channels that are dependent on voltage in
pancreatic B-cells which are very essential for exocytosis of insulin. Magnesium is also essential
for the function of the Beta cells and it acts as enzyme’s cofactor involved in metabolism of
glucose. For this reason, Yan and Khalil (2017) et al notes that inadequate intake of these
nutrients would consequently have negative impact on insulin synthesis. Signaling of pathways
and secretion. It is essential therefore that the dietary intake of the patient be richly supplied with
thee micronutrient. There is a great role that they play and have the capability to make the whole
difference in some of the minor health issues that are usually evident in individuals.
The following dosages are appropriate for the supplements in Sally’s general life to cope up with
her current connection:
magnesium
Typical dosage - 250 to 350 mg once a day
It lowers blood sugar
Magnesium deficiency can worsen high sugar in blood and resistance of insulin. The
research into determining whether magnesium supplementation improves functioning if the
insulin is still inconclusive Barbagallo & Dominguez. (2015). However, the study by Yan et al.
(2017) establishes that taking magnesium may reduce the risk for type 2 diabetes in the adults of
middle age that are at a higher risk for the disease. Yan et al. (2017) recommends that in case of

ASSESSMENT BRIEF CASE STUDY 2 10
a diabetic case, it is advisable that the patient check with the doctor for deficiency before
supplementation otherwise, more harm could be done than repair.
How the supplement should be taken
When taking, it is advisable that it should be taken alongside a meal. It is also important
that precaution be taken when using the supplement. One should avoid magnesium oxide
because it increases the risk of diarrhea. Most of magnesium supplements however, interact well
with various medications like some diuretics and antibiotics. It is essential therefore for a patient
to check with their doctor before using supplements.
Chromium
used to lower blood sugar level
dosage: 200 micrograms per day
How the supplement should be taken
It is notable that chromium form that is likely to be absorbed best is picolinate. It is
important to take note that some drugs like antacids and some prescribed for heartburn could
easily decrease the level of absorption of chromium. Therefore, when using, one needs to be
careful not to be using the drugs.
Yan et al. (2017) shows that type 2 diabetes have a strong belief that taking chromium will
enhance wellness in individuals with type 2 diabetes. It is useful not only in management but
also in reducing the risk for the disease.

ASSESSMENT BRIEF CASE STUDY 2 11
Alpha lipoic acid
It improves insulin sensitivity
Dosage: 600-1200 mg
How the supplement should be taken
It shoud be noted that high doses of the supplement can cause hypothyroid disease or
interfere with hyperthyroid therapies. Large doses should also be avoided for individuals who
have vitamin B1 deficiency or have a problem with abandoning alcoholism.
Vitamin D
It improves the functioning of the pancreatic cells that makes insulin and increases the body’s
responsiveness to insulin.
How the supplement should be taken
It is important first, to ask the doctor for a vitamin D test to establish whether in deed
there is a deficiency and determine what could be the best dose for you as a person. The active
form is usually D3, or cholecalciferol and are found in the supplement bottles. It’s also important
to be cautious while using the supplement because its usage may trigger mild to moderate
reactions with various types of medication. Thus, there is need for guidance on the appropriate
usage of the same.

ASSESSMENT BRIEF CASE STUDY 2 12
References
Ali, S. K., Debsharma, B., & Jana, D. (2016). Health Status of the Oldest Old people of a
Municipal Town. Asian Man (The)-An International Journal, 10(1), 84-88.
Barbagallo, M., & Dominguez, L. J. (2015). Magnesium and type 2 diabetes. World journal of
diabetes, 6(10), 1152.
Costello, R. B., Dwyer, J. T., & Bailey, R. L. (2016). Chromium supplements for glycemic
control in type 2 diabetes: limited evidence of effectiveness. Nutrition reviews, 74(7),
455-468.
Ebrahimpour-koujan, S., Gargari, B. P., Mobasseri, M., Valizadeh, H., & Asghari-Jafarabadi, M.
(2018). Lower glycemic indices and lipid profile among type 2 diabetes mellitus
patients who received novel dose of Silybum marianum (L.) Gaertn.(silymarin)
extract supplement: A Triple-blinded randomized controlled clinical
trial. Phytomedicine, 44, 39-44.
Emadian, A., Andrews, R. C., England, C. Y., Wallace, V., & Thompson, J. L. (2015). The effect
of macronutrients on glycaemic control: a systematic review of dietary randomised
controlled trials in overweight and obese adults with type 2 diabetes in which there
was no difference in weight loss between treatment groups. British Journal of
Nutrition, 114(10), 1656-1666.
Gómez-Ambrosi, J., Gallego-Escuredo, J. M., Catalán, V., Rodríguez, A., Domingo, P.,
Moncada, R., ... & Frühbeck, G. (2017). FGF19 and FGF21 serum concentrations in
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weight loss. Clinical nutrition, 36(3), 861-868.

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Huhmann, M. B., Smith, K. N., Schwartz, S. L., Haller, S. K., Irvin, S., & Cohen, S. S. (2016).
Plasma glucose and insulin response to two oral nutrition supplements in adults with
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Silva, F. S., Oliveira, P. J., & Duarte, M. F. (2016). Oleanolic, ursolic, and betulinic acids as
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diabetes. BMJ Open Diabetes Research and Care, 5(1), e000354.

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Appendix
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