nres1dm-chapter i and ii

8/11/2019 Nres1dm-Chapter i and II

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THE GREATEST FACTORS

AFFECTING THE LENGTH OF CONFINEMENT

AMONGST DIABETIC PATIENTS IN THE PHILIPPINES

A thesis presented to the faculty of the College of Nursing at Dr. Carlos S. Lanting College

In partial fulfillment requirements for Bachelor of Science in Nursing

Nursing Research Class

By:

Level III Nursing Students

Cabie, Marielle

Culala, John Christopher

Dychinco, Franklin Gerard

Gaspar, Ryan James

Javier, Raquel

Pulido, Blite Khirsteen

Saleumpatchay, Mona Lee

Saygo, Maria Vienna Rose

Valenzuela, Jennifer


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The concept of a system as applied to an individual. Roy conceptualizes the person in a holistic

perspective. Individual aspects of parts act together to form a unified being. Additionally, as

living systems, persons are in constant interaction with their environments. Between the system

and the environment occurs an exchange of information, matter, and energy. Characteristics of a

system include inputs, outputs, controls, and feedback.

Major concepts

Environment- Conditions, circumstances and influences that affect the development and

behavior of humans as adaptive systems.

Health- A state and process of being and becoming integrated and whole.

Person- The human adaptive system and defined as a whole with parts that function as a unity

for somepurpose. Human systems include people groups organizations, communities, and


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society as a whole. (Roy & Andrews, 1999)

Goal of nursing

The promotion of adaptation in each of the four modes..

Adaptation- The process and outcome whereby thinking and feeling persons as individuals or

in groups use conscious awareness and choice to create human and environmental integration.

Four Adaptive Modes

1. Physiologic-physical mode:physical and chemical processes involved in the function and

activities of living organisms; the underlying need is physiologic integrity as seen in the degree

of wholeness achieved through adaptation to changes in needs. In groups, this is the manner in

which human systems manifest adaptation relative to basic operating resources. The basic

needof this mode is composed of the needs associated with oxygenation, nutrition, elimination,

activity and rest, and protection. The complex processesof this mode are associated with the

senses, fluid and electrolytes, neurologic function, and endocrine function.

2. Self-concept-group identity mode:focuses on psychological and spiritual integrity and a

sense of unity, meaning, purposefulness in the universe.

3. Role function mode:refers to the roles that individuals occupy in society fulfilling the need

for social integrity; it is knowing who one is, in relation to others.

4. Interdependence mode:the close relationships of people and their purpose, structure and

development individually and in groups and the adaptation potential of these relationships.


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Adaptiveresponsesare those that promote the integrity of the person. The persons integrity, or

wholeness, is behaviorally demonstrated when the person is able to meet the goals in terms of

survival, growth, reproduction and mastery. Ineffective responsesdo not support these goals.

(Roy & Andrews, 1991)

Coping mechanismsdescribe the control processes of the person as an adaptive system. Some

coping mechanisms are inherited or genetic, such as white blood cell defense mechanism against

bacteria that seek to invade the body. Other mechanisms are learned, such as the use of

antiseptics to cleanse a wound.

Two Coping Subsytems

A. Cognator subsystem - A major coping process involving four cognitive-emotive

channels: perceptual and information processing, learning, judgment, and emotion.

B. Regulator subsystem - A basic type of adaptive process that responds automatically

through neural, chemical, and endocrine coping channels.

Focal stimuli - Those stimuli that are the proximate causes of the situation.


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Contextual stimuli - All other stimuli in the internal or external environment, which may or

may not affect the situation.

Residual stimuli - Those immeasurable and unknowable stimuli that also exist and may

affect the situation.

When using Roys model as a theoretical framework, the following can serve as a guide for the

assessment of Diabetic patients.

I. Adaptation Modes

A. Physiologic Mode

1. To what extent is the patient able to meet his/her basic survival needs?

2. Is there any difficulty in meeting such basic survival needs?

B. Self-Concept Mode

1. How does the clients view themselves in terms of their ability to meet goals? To

what extent do they see themselves as self-directed? Other directed?

2. What are the values of the patient?

C. Role Function Mode

1. Describe the roles assumed by the patient.

2. To what extent are the roles supportive, in conflict, reflective of role overload?

3. How are the decisions reached?

D. Interdependence Mode

1. To what extent are family members, health care team and subsystems within the

environment allowed the patient to be independent in goal identification and

achievement?


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2. To what extent are the members supportive of one another?

3. What are the familys support systems? Significant others?

4. To what extent is the patient open to information and assistance from others

5. Describe the interaction patterns the patient engage with his/her support systems

and multidisciplinary team, during the period of confinement.


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patientsphysiologic system, self concept, knowledge, cognition of the problem, beliefs,

perceptions and values. External factors include the rest of the affecting variables that are

beyond patients control. (Ex. Environment, support system,medical management,

nursing care quality, financial aspect etc..). Such factors, be it internal or external, can

either be a barrier against or synergistic with self care continuum.

4. The Multi-Factor Variables are group of multi-dimensional variables pertaining to the

internal and external factors affecting the patients Self-care continuum, coping

mechanisms, adaptation, multi-factor health barrier continuum/ health synergistic

continuum and length of hospital confinement.

5. The Relative state of Health, is the patients health state that is relative to condition (or

pathological condition or disease process). It means that any person can be considered

healthy according to their own conditions, as long as majority of the Multi-factor

Variables in the y-axis will purposively work towards pushing the patients self-care

continuum to the zone of good adaptation.

6. Multi-factor health barrier continuum is the measure of how much the factors become

antagonistic with the self care-continuum, adaptation and coping mechanisms. It pulls the

patient back to the zone of poor adaptation.

7. Multi-factor health synergistic continuum is the measure of how much the factors are

purposively working well towards the patients good adaptation. It pushes the patient

away from the zone of poor adaptation.

8. The nurses, with the multidisciplinary care team, have the unique role in therapeutically

manipulating the external factors, towards thebetterment of clientsadaptation. As for

example, convincing the client to increase his/her will to achieve self-care, via educating

the client and the support system in assisting the latter. The ultimate goal of Nursing is to

move the patients adaptation, self-care and coping mechanism continuum towards the

nearest zone of Good adaptation.


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9. The length of hospital confinement pertains to the period which begins at the patients

admission and ends as soon as the patient was discharged.

10. There are three different goals of the self- care and adaptation continuum, namely; The

5.1. Ideal health, which is the state of not merely the absence of disease or infirmity but

wellness in all aspects (as defined by the WHO), 5.2. Recovery, the state of the resolution

of pathological condition and 5.3. is the Relative state of health. The 3rd

goal is the more

realistic version of the ideal health, and therefore, the practicable goal of this conceptual

model in the context of diabetic patients, because, it is a fact that it is almost impossible

for them to totally eliminate such infirmity from their body.

11. The adaptation continuum is composed of two different levels, 6.1. Zone of Good

adaptation and 6.2. Zone of Poor Adaptation. Good adaptation, is when coping

mechanisms are being used purposively, and thus, adaptive, while poor adaptation, on the

contrary, is maladaptive.

12. The zone of good adaptation starts at the point of equilibrium between the graph of the

length of confinement and self-care continuum graph. It pertains to the point at which the

patient has the ability for self-care, or at least, manifests the will for self-care.

13. The efficiency of the methods that will be implemented in achieving the self-care

continuum goals can attain its optimum levels by focusing on the greatest factors that

affect the patients length of hospital confinement.

14. Self-care is equal to the manifestation of adaptive behaviors..


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THE PARADIGM: Self care and Adaptation Continuum

The figure below represents the paradigm that depicts the conceptual framework.


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STATEMENT OF THE PROBLEM:

Zone of Poor Adaptation

Adaptation Boundary

Length of Hospital Confinement

Multi-factor Health Barrier

ContinuumSelf Care Continuum

Multi-factor Health Synergistic

continuum

Multi-FactorVaribles(Internal/External)

Equilibrium


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The study will explore the possible factors among diabetic patients at QMMC regarding

the length of confinement/stay at the hospital. Specifically, it sought to answer the following

questions:

1. What is the personal profile of the diabetic patients as to:

1. Age

2. Gender

3. Occupation

4. Civil Status

5. Monthly Income of the Family (below 3000above 50000)

6. Date of Confinement/ Admission

7. Length of Confinement (upon survey)

8. Educational attainment

2. What are the common complications causing confinement for diabetic patients?

3. What are some factors that affect the length of their stay at the hospital?

4. Does the length of their confinement affect their family members? How does diabetic patients

affect the family members? (Financial, social, emotional, physical)

5. What are their coping mechanisms during the period of their stay? Is it effective?


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ASSUMPTIONS:

1. A diabetic patient may have blurry visions. Or worse, diabetic retinopathy.

2. A patient with diabetes might have difficulties in wound healing process. And might

have complaints of foul smelling odor from the wound.

3. A diabetic patient who is being confined in a long period of time might have some

financial issues and might not be able to meet his daily hospital bills and medications.

4. The negligence and carelessness of a health care team member, may lead to

complications that should not suppose to happen to the patients. For example: Bed

sores, pulmonary embolism, infections, etc.

5. Environmental status of the hospital delays the healing process of the patients wound

and brings more infections to the patient.

6. Multi-organ dysfunction is one of the leading causes of being confined in the hospital in

diabetic patients.

7. The patients family and primary care giver/s, shoulders the burden of care.

8. The goal of the health care team, especially the nurses, is to assist the patient for better

adaptation.


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HYPOTHESES:

1. There is a significant correlation between the diabetic patients length of

hospital confinement and compliance with medical regimen.

2. There is a significant difference between the length of diabetic patients length

of hospital confinement and presence of co-morbid conditions.

3. There is no difference between the diabetic patients educational attainment

and degree of compliance with medical regimen.

4. There is no significant correlation between the diabetic patients socioeconomic

status and degree of compliance with medical regimen.

5. There is a significant relationship between a diabetic patients adaptation and

quality of health care.


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SIGNIFICANCE OF THE STUDY

OBJECTIVES:

1. To identify the factors that greatly affects the length of hospital confinement among patients

with diabetes.

2. To explain how such factors contributes to the length of hospital confinement.

3. To identify the most effective nursing management in terms of discharge plan and health

teaching towards minimizing the length of confinement and alleviating unwanted effects of the

disease process.

This study will help, in providing careful planning and knowledge on how to teach patients about

diabetes, helping them create a diet plan that caters to there personal needs and the demands of

there particular disease, instruct them to maintain a healthy weight, exercise regularly, go

through each aspect of her medical needs and how to take care of them: this includes insulin

shots, measuring glucose levels and monitoring her intake of sodium and sugar.

The aim of patient education especially for people with diabetes is to improve their knowledge,

skills and confidence, enabling them to take increasing control of their own condition and

integrate effective self-management into their daily lives. High-quality structured education can

have a profound effect on health outcomes and can significantly improve quality of life by

follow a consistent meal plan and schedule, eat the right amount of carbohydrate foods for good

blood sugar control, choose lower fat options and limit saturated fats, drink plenty of water.


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At the end of the study this will benefit the nursing students, clinical nurses, people, diabetic

patients and researchers.

A. The nursing students and clinical nurses will benefit through acquiring new knowledge

about more therapeutic nursing management and care of patients with diabetes.

B. This study serves as an aid in providing a significant amount of information to the people

who are not aware of Diabetes and the factors affecting the length of confinement and its

damaging effects to a person as a whole, thereby possessing the necessary knowledge to

handle and make decisions on this situation.

C. Diabetic patient will benefit by increasing their awareness about diabetes and promoting

healthy coping techniques, as manifested for example, by fully understanding the

importance of healthy eating strategies, and reducing risk for complications.

D. The Researcher will benefit through awareness why the confinement of diabetic patient

prolonged, and they will improve better the quality of care.


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DEFINITION OF TERMS

Adaptation - The process and outcome whereby thinking and feeling persons as individuals or in

groups use conscious awareness and choice to create human and environmental integration.

Amputation - is the removal of a body extremity bytrauma,prolonged constriction, orsurgery.

Bed sores - are localized injuries to the skin and/or underlying tissue that usually occur over a

bony prominence as a result of pressure, or pressure in combination with shear and/or friction.

Blood Sugar - is the amount of glucose (sugar) present in the blood of a human or animal.
http://en.wikipedia.org/wiki/Physical_traumahttp://en.wikipedia.org/wiki/Physical_traumahttp://en.wikipedia.org/wiki/Physical_traumahttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Physical_trauma


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Blindness is the condition of lacking visual perception due to physiological or neurological

factors.

Blood Pressure - is the pressure exerted by circulating blood upon the walls of blood vessels, and

is one of the principal vital signs.

Contextual stimuli - All other stimuli in the internal or external environment, which may or may

not affect the situation.

Cognator subsystem - A major coping process involving four cognitive-emotive channels:

perceptual and information processing, learning, judgment, and emotion.

Carbohydrates - means any food that is particularly rich in the complex carbohydrate starch

(such as cereals, bread, and pasta) or simple carbohydrates, such as sugar (found in candy, jams,

and desserts).

Cholesterol - A fat-like substance that is made by the human body and eaten in animal products.

Cholesterol is used to form cell membranes and process hormones and vitamin D.

Community-acquired Infection - an infection contracted outside of a health care setting or an

infection present on admission.


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Cardiovascular Disease - is a class of diseases that involve the heart, the blood vessels (arteries,

capillaries, and veins) or both.

Calories - A unit of heat measurement used in nutrition to measure the energy value of foods. A

calorie is the amount of heat energy needed to raise the temperature of 1 kilogram of water 1C.

Coping Mechanism - any effort directed to stress management, including task-oriented and ego

defense mechanisms, the factors that enable an individual to regain emotional equilibrium after a

stressful experience. It may be an unconscious process.

Diabetes mellitus - Diabetes mellitus is a condition in which the pancreas no longer produces

enough insulin or cells stop responding to the insulin that is produced, so that glucose in the

blood cannot be absorbed into the cells of the body.

End-stage Renal Diseaseis a chronic irreversible renal failure.

Environment - The totality of circumstances surrounding an organism or group of organisms,

especially the combination of external physical conditions that affect and influence the growth,

development, and survival of organisms.


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Equilibrium - A condition in which all influences acting upon it are canceled by others, resulting

in a stable, balanced, or unchanging system.

Focal stimuli - Those stimuli that are the proximate causes of the situation.

Gestational Diabetes - Gestational diabetes is a condition that occurs during pregnancy. Like

other forms of diabetes, gestational diabetes involves a defect in the way the body processes and

uses sugars (glucose) in the diet.

Health - a condition of physical, mental, and social well-being and the absence of disease or

other abnormal condition.

Hyperglycemia - Condition characterized by excessively high levels of glucose in the blood, and

occurs when the body does not have enough insulin or cannot use the insulin it does have to turn

glucose into energy.

Healthy Diet - provides the body with essential nutrition: fluid, adequate essential amino acids

from protein, essential fatty acids, vitamins, minerals, and adequate calories.

Insulin - A hormone secreted by the pancreas in response to high blood sugar levels that induces

hypoglycemia. Insulin regulates the body's use of glucose and the levels of glucose in the blood

by acting to open the cells so that they can intake glucose.


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Infection - invasion and multiplication of microorganisms in body tissues, especially that causing

local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-

antibody response.

Length of confinementis the duration of stay of a patient in a hospital.

Mental stress - A general term encompassing mental arousal and/or emotional stress.

Multi-factor health barrier continuum - is the measure of how much the factors become

antagonistic with the self care-continuum, adaptation and coping mechanisms. It pulls the patient

back to the zone of poor adaptation.

Multi-factor health synergistic continuum - is the measure of how much the factors are

purposively working well towards the patients good adaptation. It pushes the patient away from

the zone of poor adaptation.

Multi-Factor Variables- are group of multi-dimensional variables pertaining to the internal and

external factors affecting the patients Self-care continuum, coping mechanisms, adaptation,

multi-factor health barrier continuum/ health synergistic continuum and length of hospital

confinement.


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Multiple organ dysfunction - is the presence of altered organ function in acutely ill patients such

that homeostasis cannot be maintained without intervention. It usually involves two or more

organ systems.

Mortality - the ratio of the total number of deaths to the total number of the population during a

specified time period.

Obesity - is an abnormal accumulation of body fat, usually 20% or more over an individual's

ideal body weight.

Overweight - more than normal in body weight after adjustment for height, body build, and age,

or 10% to 20% above the person's "desirable" body weight.

Omega-3 Fatty Acids - Any of various polyunsaturated fatty acids that are found primarily in

fish, fish oils, vegetable oils, and leafy green vegetables, and that seem to reduce the risk of

stroke and heart attack.

Proteins - the principal constituents of the protoplasm of all cells, are of high molecular weight

and consist of -amino acids joined by peptide linkages


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SCOPE AND DELIMITATTION

Research Problem: This research seeks to determine the factors affecting the length of

confinement among diabetic patients.

General Purpose: This study aims to focus on the identified factors as the determinant/s on

the formulation of better care plan, more effective health teaching and implementation of

necessary interventions in the care of diabetic patients in the hospital.

Topic studied: The demographic profile of the selected diabetic patients, their coping

mechanism, the effect of their condition on their primary care giver, and how all such

factors and variables affects their coping and adaptation.

Population: 15 selected Diabetic patients confined on the medical-surgical wards of Quirino

Memorial Medical Center.

Locale of the study: Quirino Memorial Medical Center- Project 4, Cubao, Quezon City.

Period of Study: Second semester of the School Year 2013-2014 to the end of the first

semester of the School year 2014-2015.


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CHAPTER II- REVIEW OF THE RELATED

LITERATURES

The burden of diabetes is increasing globally, particularly in developing countries. The causes

are a complex, but are in large part due to rapid increases in overweight, obesity and physical

inactivity.

Although there is good evidence that a large proportion of cases of diabetes and its complications

can be prevented by a healthy diet, regular physical activity, maintaining a normal body weight

and avoiding tobacco, this evidence is not widely implemented. Coordinated action is needed

from the level of international and national policy to reduce exposure to the known risk factors

for diabetes and to improve access to and quality of care.

However, despite of the knowledge of these prevention efforts, still, there are about 347 million

people worldwide have diabetes and, in the local scenario, Diabetes Mellitus still ranks the 8th

leading cause of mortality from 2004- 2009.

According to the website of DOH, Diabetes is ranked 8 in the leading causes of mortality from Year

2004-2009

MORTALITY: TEN (10) LEADING CAUSES

NUMBER AND RATE/100,000 POPULATION

Philippines

5-Year Average (2004-2008) & 2009


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CAUSES

5-Year Average

(2004-2008)2009*

Number Rate NumberRate

1. Diseases of the Heart 82,290 94.5 100,908 109.4

2. Diseases of the Vascular System 55,999 64.3 65,489 71.0

3. Malignant Neoplasms 43,185 49.6 47,732 51.8

4. Pneumonia 35,756 41.1 42,642 46.2

5. Accidents** 34,704 39.9 35,990 39.0

6. Tuberculosis, all forms 25,376 29.2 25,470 27.6

7. Chronic lower respiratory diseases 20,830 24.0 22,755 24.7

8. Diabetes Mellitus 19,805 22.7 22,345 24.2

9.Nephritis, nephrotic syndrome and nephrosis 11,612 13.4 13,799 15.0

10. Certain conditions originating in the perinatal

period

12,590 14.5 11,514 12.5

Note: Excludes ill-defined and unknown causes of mortality

* reference year

** External causes of Mortality

REFERENCE: http://www.doh.gov.ph/node/198.html

10 facts about diabetes

(Reviewed October 2013W.H.O.) (from: http://www.who.int/features/factfiles/diabetes/en/)


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1. There is an emerging global epidemic of diabetes that can be traced back to rapid

increases in overweight, obesity and physical inactivity.

2. Diabetes is predicted to become the seventh leading cause of death in the world by the

year 2030.Total deaths from diabetes are projected to rise by more than 50% in the next

10 years.

3. There are two major forms of diabetes: Type 1 diabetes is characterized by a lack of

insulin production and type 2 diabetes results from the body's ineffective use of insulin.

4. A third type of diabetes is gestational diabetes. This type is characterized by

hyperglycaemia, or raised blood sugar, which has first appeared or been recognized

during pregnancy.

5. Type 2 diabetes is much more common than type 1 diabetes. Type 2 accounts for around

90% of all diabetes worldwide. Reports of type 2 diabetes in childrenpreviously rare

have increased worldwide. In some countries, it accounts for almost half of newly

diagnosed cases in children and adolescents.

6. Cardiovascular disease is responsible for between 50% and 80% of deaths in people with

diabetes. Diabetes has become one of the major causes of premature illness and death in

most countries, mainly through the increased risk of cardiovascular disease (CVD).

7. In 2004, an estimated 3.4 million people died from consequences of high fasting blood

sugar.

8. 80% of diabetes deaths occur in low- and middle-income countries. In developed

countries most people with diabetes are above the age of retirement, whereas in

developing countries those most frequently affected are aged between 35 and 64.

9. Diabetes is a leading cause of blindness, amputation and kidney failure.Lack of

awareness about diabetes, combined with insufficient access to health services and

essential medicines, can lead to complications such as blindness, amputation and kidney

failure.


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10. Type 2 diabetes can be prevented. Thirty minutes of moderate-intensity physical activity

on most days and a healthy diet can drastically reduce the risk of developing type 2

diabetes. Type 1 diabetes cannot be prevented.

The above mentioned facts stated by the World Health Organization, suggests that, because co-

morbid conditions are very common, hospitalization will always be at hand.

When a person with diabetes is hospitalized, many factors can contribute to variations in blood

sugar or glucose levels. Stress, a different meal plan, various drugs, treatments and the illness for

which the person is being hospitalized for itself can all come into play for a patient with

diabetes.It's well known that excessive glucose levels can slow healing and boost infection risk.

The average length of stay was 5.4 days (4). Diabetes was the principal diagnosis in only 8% of

these hospitalizations. In addition to having a medical history of diabetes, patients presenting to

hospitals may have unrecognized diabetes or hospital-related hyperglycemia. Based on hospital

chart review, 64% of patients with hyperglycemia had preexisting diabetes or were recognized as

having new-onset diabetes during hospitalization. Thirty-six percent of the hyperglycemic

patients remained unrecognized as having diabetes in the discharge summary, although diabetes

or hyperglycemia was documented in the progress notes for one-third of these patients.

(http://care.diabetesjournals.org/content/27/2/553.long)

Patients with type 1 or type 2 diabetes mellitus are frequently admitted to a hospital, usually for

treatment of conditions other than the diabetes. In one study, 25 percent of patients with type 1

diabetes and 30 percent with type 2 diabetes had a hospital admission during one year; patients

with higher values for hemoglobin A1C (A1C) were at highest risk for admission. The

prevalence of diabetes rises with increasing age, as does the prevalence of other diseases; both

factors increase the likelihood that an older person admitted to a hospital will have diabetes.
http://care.diabetesjournals.org/content/27/2/553.long#ref-4http://care.diabetesjournals.org/content/27/2/553.long#ref-4http://care.diabetesjournals.org/content/27/2/553.long#ref-4http://care.diabetesjournals.org/content/27/2/553.long#ref-4


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from 1987 statistics of only 13.5%, he said.

Mr. Baldemor said the reason Filipinos are becoming heavier could be linked to changing dietary

habits as revealed in the 2008 Food Consumption Survey done by the Food & Nutrition Research

Institute.

The survey showed that 40% of Filipino households are taking their meals and snacks outside of

home, and approximately 30% of the caloric intake in a day was derived from animal sources in

2008 as compared to 20% in 1978.

Rice, sugar and cooking oil are the top three food items commonly consumed by Filipinos. And

there was a significant increase in the intake of rice, he said.

Recognizing the importance of nutrition in the total diabetes management, PADE conducted a

study among Filipinos with diabetes about their typical breakfast.

The study revealed that compared to the expert macronutrient guidelines of the American

Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD), the

typical Filipino breakfast is 30% protein, more than the 20% limit in the ADA and EASD

guidelines.

Mr. Baldemor said the excess protein makes Filipinos more prone to diabetes. And for those who

already have diabetes, the excess protein may lead to complications like end-stage renal disease

and other kidney problems. He explained that kidney damage makes it more difficult for

individuals to process sugar, thus complicating the case of most diabetics.

NUTRITION FOR HEALTH


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Mr. Baldemor said there is a need for complete diabetes management that integrates medication,

a healthy diet, physical activity and exercise, and medical nutrition therapy.

In the Philippines, diabetes experts composed of health care professionals from seven medical

societies and institutions developed the Philippine Diabetes Nutrition Algorithm (PhilDNA).

PhilDNA provides recommendations on diabetes-specific nutrition to support the goals of weight

loss, lowering blood sugar, blood pressure and cholesterol for prevention of complications and

longevity.

Included in the PhilDNA recommendation is the use of diabetes-specific formula like Glucerna

Triple Care, which is a specialized drink manufactured by global health care company Abbott.

Abbott Nutrition International (Philippines) medical director Jose Rodolfo V. Dimaano, Jr. said

Glucerna Triple Care has been clinically shown to help manage weight and reduce

cardiovascular risk factors in conjunction with an overall diabetes management plan, including

diet and exercise.

He said the product provides an advanced, slowly digested carbohydrate system to manage blood

sugar response. It also has a unique heart-friendly lipid blend rich in Omega-3 fatty acids to

support heart health, and a combination of key ingredients to help reduce weight and the

patients waistline.

He added that Glucerna Triple Care has 32 vitamins and minerals and is 225 calories per serving.

It is available in vanilla and chocolate flavors..

(source: Business World

)http://www.bworldonline.com/weekender/content.php?id=68524
http://www.bworldonline.com/weekender/content.php?id=68524http://www.bworldonline.com/weekender/content.php?id=68524http://www.bworldonline.com/weekender/content.php?id=68524


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Having the article written by Valisno (2013), the principles of food management for people with

diabetes can then, be summarized as follows:

- Eat regular meals with carbohydrate making up approximately 50% of meals

- Limit intake of foods high in fat, salt and sugar

- Try to increase fruit and vegetable intake

-Nothing is banned, but some foods may need to be eaten less regularly than others.

A dietitian can help to explain these principles to both ward staff and people with diabetes -

particularly those who are newly diagnosed during their hospital stay.

Summary:

Every nurse in every hospital department will have some contact with people with diabetes.

Illness and stress can interact with the condition and cause blood glucose control to deteriorate.

This in turn can delay recovery and may produce complications such as infection. Attention to

maintaining good diabetes control is thus essential. Nurses can play a significant role in

promoting this by providing up-to-date and evidence-based care and support.

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