Teresa Cordova is a 41-year-old Mexican American woman recently diagnosed with type 2 diabetes.

QUESTION

Woman with Type 2 Diabetes

Teresa Cordova is a 41-year-old Mexican American woman recently diagnosed with type 2 diabetes. Mrs. Cordova developed gestational diabetes while she was pregnant with her second child. Her blood glucose levels returned to normal following pregnancy, and she was advised to get regular checkups, maintain a desirable weight, and engage in regular physical activity. Although she reports that she does not overeat and that she exercises regularly, she has been unable to maintain a healthy weight. At 5 feet 3 inches tall, Mrs. Cordova currently weighs 165 pounds. She has decided to lose weight and join a gym because she is concerned about the long-term effects of diabetes and the possibility that she may need insulin injections. She is also concerned about her husband and children because they are overweight and not very active. The physician refers Mrs. Cordova to a dietitian to help her with her weight-management goals.

  1. What factors in Mrs. Cordova’s medical history increase her risk for diabetes? Are her husband and children also at risk?
  2. Describe the general characteristics of a diet and exercise program that would be appropriate for Mrs. Cordova. How might weight loss and physical activity benefit her diabetes?
  3. If Mrs. Cordova is unable to control her blood glucose with diet and physical activity, what treatment might be suggested? Explain to Mrs. Cordova why she would probably not require insulin at this time.
  4. What dietary and lifestyle changes may help to prevent diabetes in Mrs. Cordova’s husband and children?

ANSWER

Managing Type 2 Diabetes: A Holistic Approach for Teresa Cordova and Her Family

Introduction

Type 2 diabetes is a prevalent and chronic condition characterized by insulin resistance and high blood glucose levels. In the case of Teresa Cordova, a 41-year-old Mexican American woman, her medical history reveals factors that increase her risk for diabetes. Additionally, her husband and children may also be at risk due to their overweight status and sedentary lifestyle. This essay aims to address various aspects of diabetes management for Mrs. Cordova, including risk factors, appropriate diet and exercise programs, potential treatments, and preventive measures for her family.

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Factors Increasing Risk for Diabetes

Mrs. Cordova’s history of gestational diabetes during her second pregnancy raises her risk for developing type 2 diabetes. Gestational diabetes is a temporary condition, but it increases the likelihood of future diabetes diagnoses (Noctor & Dunne, 2015). Other factors that contribute to her risk include her inability to maintain a healthy weight despite regular exercise and concerns about her family’s weight and activity levels.

Risk for Husband and Children

Obesity and a sedentary lifestyle are significant risk factors for type 2 diabetes. As Mrs. Cordova’s husband and children are overweight and not very active, they are indeed at an increased risk of developing diabetes. Family members often share dietary and lifestyle habits, further increasing their susceptibility (Pulgaron & Delamater, 2014). It is crucial to address their health as a family unit and implement preventive measures.

Diet and Exercise Program for Mrs. Cordova

A comprehensive diet and exercise program tailored to Mrs. Cordova’s needs can be beneficial in managing her weight and diabetes. The program should focus on the following key components:

Balanced Diet: Emphasize a well-rounded diet consisting of lean proteins, whole grains, fruits, vegetables, and healthy fats. Limit processed foods, sugary beverages, and refined carbohydrates.

Portion Control: Promote mindful eating and portion control to prevent overeating and maintain a calorie deficit for weight loss.

Regular Physical Activity: Encourage aerobic exercises, such as brisk walking, cycling, or swimming, for at least 150 minutes per week. Incorporate strength training exercises to improve muscle mass and overall fitness.

Behavior Modification: Provide strategies to address emotional eating, stress management, and sustainable lifestyle changes. Support from a dietitian can be instrumental in establishing healthy habits.

Benefits of Weight Loss and Physical Activity

Weight loss can significantly improve insulin sensitivity, leading to better blood glucose control. Regular physical activity helps lower blood glucose levels, reduces cardiovascular risks, improves overall fitness, and contributes to weight management. Combined, these lifestyle changes can mitigate the long-term effects of diabetes and decrease the likelihood of requiring insulin injections.

Treatment Options for Uncontrolled Blood Glucose

If Mrs. Cordova is unable to control her blood glucose levels through diet and physical activity alone, her healthcare provider may suggest oral medications or injectable non-insulin medications, such as GLP-1 receptor agonists or SGLT-2 inhibitors. These medications can improve blood glucose control, promote weight loss, and reduce the need for insulin.

Explanation for Insulin Not Required at This Time

Insulin therapy is typically reserved for cases where blood glucose levels remain uncontrolled despite lifestyle modifications and oral medications. Mrs. Cordova’s commitment to a diet and exercise program, along with other medications if necessary, will likely help manage her blood glucose levels effectively (McFarlane, 2009). Insulin may be considered in the future if her condition worsens or other treatment options prove insufficient.

Prevention for Husband and Children

To prevent diabetes in Mrs. Cordova’s husband and children, the following dietary and lifestyle changes are recommended:

Healthy Eating Habits: Encourage a diet rich in whole grains, lean proteins, fruits, and vegetables while minimizing sugary snacks, processed foods, and sweetened beverages.

Regular Exercise: Promote a physically active lifestyle by engaging in regular exercise or sports activities. Encourage family participation in activities that foster movement and recreation.

Family Support: Create a supportive environment that encourages healthy habits and regular check-ups. Involve the entire family in meal planning, grocery shopping, and cooking nutritious meals together.

Education and Awareness: Educate the family on the importance of maintaining a healthy weight, understanding portion sizes, and making informed food choices. Stay updated on diabetes prevention strategies and guidelines.

Conclusion

Managing type 2 diabetes requires a comprehensive approach that encompasses individualized diet and exercise programs, potential medication interventions, and preventive measures for the whole family. By adopting a healthy lifestyle, Teresa Cordova can control her blood glucose levels, reduce the need for insulin, and mitigate the long-term effects of diabetes. Similarly, implementing dietary and lifestyle changes within her family can help prevent diabetes and foster a healthier future for all.

References

McFarlane, S. I. (2009). Insulin Therapy and Type 2 Diabetes: Management of Weight Gain. Insulin Therapy and Type 2 Diabetes: Management of Weight Gain, 11(10), 601–607. https://doi.org/10.1111/j.1751-7176.2009.00063.x 

Noctor, E., & Dunne, F. (2015). Type 2 diabetes after gestational diabetes: The influence of changing diagnostic criteria. World Journal of Diabetes, 6(2), 234. https://doi.org/10.4239/wjd.v6.i2.234

Pulgaron, E. R., & Delamater, A. M. (2014). Obesity and Type 2 Diabetes in Children: Epidemiology and Treatment. Current Diabetes Reports, 14(8). https://doi.org/10.1007/s11892-014-0508-y 

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