Diabetes Type II & Nutrition in the Elderly By: Zoe Moore

PRE-TEST

What is the largest risk factor for diabetes Mellitus Type II? Family History, Lack of Exercise, Unhealthy Eating or Overweight

TRUE or FALSE: 1 in 10 older people are suffering from or are at risk for malnutrition.

What percentage does a person diagnosed with DM have of getting heart disease? 20%, 30%, 60%, 80%

Goal: Reduce the disease burden of diabetes mellitus (DM) and improve the quality of life for all persons who have, or are at risk for, DM.
Causes of Diabetes Mellitus Type II
OBJECTIVE d-1: Reduce the annual number of new cases of diagnosed diabetes in the population
What happens.....
Effects of Uncontrolled Diabetes Mellitus II
Objective D-16: Increase prevention behaviors in persons at high risk for diabetes with pre-diabetes
D-16.1: Increase the proportion of persons at high risk for diabetes with pre-diabetes who report increasing their levels of physical activity
D-16.2 : Increase the proportion of persons at high risk for diabetes with pre-diabetes who report trying to lose weighT
D-16.3: Increase the proportion of persons at high risk for diabetes with pre-diabetes who report reducing the amount of fat or calories in their diet

Overcoming Barriers:

Losing Weight: Talking with a friend or family member about losing weight can be hard. If you want to help a loved one reach a healthy weight, these tips can help you get the conversation started.

Get Screened: Screenings are medical tests that check for diseases. Find out which screenings you need this year.

Get Active: Physical activity increases your chances of living a longer, healthier life. It can also help you look and feel your best.

Watch Your Weight: To stay at a healthy weight, balance the calories you eat with the calories you burn (use up). If you need to lose weight, start by setting small goals.

Take Steps to Prevent Type 2 Diabetes: You can lower your risk of type 2 diabetes by eating healthy and staying active.

Get Your Blood Pressure Checked: Check your blood pressure at least every 2 years starting at age 18.

Take Care of Your Teeth and Gums: Take good care of your teeth now to help prevent problems as you grow older.

Get Your Vision Checked: Your vision changes as you get older. Learn the signs and symptoms of eye problems.

Healthy Eating: Sometimes a family member or friend could use a little encouragement to make a healthy change. Use these tips to start a conversation about eating healthy.

Preventing Diabetes: You can lower your risk of type 2 diabetes by eating healthy, staying active, and watching your weight. Use these questions to talk to your doctor about how you can prevent type 2 diabetes.

NUTRITION IN THE ELDERLY

Goal: Improvement in indicators of nutritional status in order to optimize functional status and general well-being and promote positive nutritional status.
Malnutrition in older adults is defined as "faulty or inadequate nutritional status; undernourishment characterized by insufficient dietary intake, poor appetite, muscle wasting, and weight loss" (Chen et al., 2001). In the older adult, malnutrition exists along the continuum of care. Older adults admitted to acute care settings from either the community of long-term care settings may already be malnourished or may be at risk for the development of malnutrition during hospitalization.
Assessing Nutrition in Older Adults: 1) Obtain an accurate weight and height through direct measurement. 2) Weight history: A detailed weight history should be obtained along with current weight. 3) Calculate body mass index (BMI) to determine if weight for height is within the normal range of 22–27. A BMI below 22 is a sign of under-nutrition 4) Visceral Proteins. Evaluate serum albumin, transferrin, and pre-albumin are visceral proteins commonly used to assess and monitor nutritional status

Plan of Care Strategies:

A. Collaboration: Refer to dietitian if patient is at risk for or has under-nutrition.

B. Alleviate Dry Mouth: Avoid caffeine; alcohol; tobacco; and dry, bulky, spicy, salty, or highly acidic foods. If patient does not have dementia or swallowing difficulties, offer sugarless hard candy or chewing gum to stimulate saliva. Encourage frequent sips of water.

C. Maintain adequate nutritional intake: Daily requirements for healthy older adults include 30 kcal per kg of body weight and 0.8 to 1g/kg of protein per day, with no more than 30% of calories from fat. Caloric, carbohydrate, protein, and fat requirements may differ depending on degree of malnutrition and physiological stress.

D. Improve oral intake: Suggest small frequent meals with adequate nutrients to help regain or maintain weight. Provide nutritious snacks. (Ref 19)

E. Provide conducive environment for meals: Create a more relaxed atmosphere. Always eat sitting up in a chair.

F. Take oral supplements

POST-TEST:

Having too much glucose in your blood can cause damage to all but which organ? Kidney, Heart, Brain, Lungs

Which of the following are effective ways to manage diabetes? Select all that apply: Diet, Exercise, Medication, Sleep

Which of the following ways are effective in treating malnutrition? Taking oral supplements, eating only 1-2 meals per day to avoid over-eating, or eating twice as many calories to increase nutrition

SOURCE: Balk, E. M., Earley, A., Raman, G., Avendano, E. A., Pittas, A. G., & Remington, P. L. (2015). Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among Persons at Increased Risk: A Systematic Review for the Community Preventive Services Task Force. Annals Of Internal Medicine, 163(6), 437-451. doi:10.7326/M15-0452

SOURCE:Carlsson, P., Tidermark, J., Ponzer, S., Soderqvist, A., & Cederholm, T. (2005). Food habits and appetite of elderly women at the time of a femoral neck fracture and after nutritional and anabolic support. Journal of Human Nutrition and Dietetics, 18, 117–120. Evidence Level II: Individual Experimental Study.

Created By
Zoe Moore
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