Nutrition for Special Populations
Unit 5 Assignment
Devin Lee Aikens
patient, Mr. D, suffers from type 2 diabetes and is undergoing dialysis. He
rarely follows his diet and/or lifestyle changes that were prescribed by his
physician which has caused him to have many complications. We will try to find
out what has caused his declining health and what can be done to try and
reverse the effects.
If you have
diabetes, your blood glucose, or blood sugar, levels are too high. Over time,
this can damage your kidneys. Your kidneys clean your blood. If they are
damaged, waste and fluids build up in your blood instead of leaving your body (“Diabetic
Nephropathy | Diabetic Kidney Disease | MedlinePlus,” n.d.). In Mr. D’s
case his diabetic nephropathy was caused because of the mismanagement of his
diabetes, with him not getting his checkups and screenings for kidney disease
has along with poor diet and heavy alcohol consumption has brought him to this
point (“Diabetic Nephropathy | Diabetic Kidney Disease |
MedlinePlus,” n.d.). End Stage Renal Disease or diabetic nephropathy is
the last stage of chronic kidney disease. When your kidneys fail, it means they
have stopped working well enough for you to survive without dialysis or a
kidney transplant (“Kidney failure/ESRD,” n.d.). Mr. E in this case
is more at risk than many other diabetics because of his lack of maintenance to
his condition. Obesity, as well as type 2 diabetes, hypertension and
cardiovascular disease are all risk factors for end-stage renal disease (ESRD),
in as much as the presence of one or more of these risk factors multiplies the
overall risk for disease development and progression of end stage renal disease
(“Obesity and Diabetic Kidney Disease,” n.d.). Mr. D, according to
his chart, was once 270lbs at 5′ 10″ which means that he was overweight and
with having diabetes creates an environment for more instances to develop (“Obesity
and Diabetic Kidney Disease,” n.d.).
with diabetes, insufficient insulin prevents the body from getting glucose from
the blood into the body’s cells to use as energy.
Mr. D’s rapid weight loss could be caused because the body
starts burning fat and muscle for energy, causing a reduction in overall body
weight. Unexpected weight loss is often noticed in people prior to a diagnosis
of type 1 diabetes but it may also affect people with type 2 diabetes (“Obesity
and Diabetic Kidney Disease,” n.d.). Weight loss may simply be caused by the loss
of fluid that dialysis pulls off. Fluid may have built up over time because
your kidneys could no longer do this job sufficiently. He also may have lost a
little weight when he started his dialysis, because of the buildup of toxins in
his blood from the kidneys not working well before starting his dialysis could reduce
Mr. D’s appetite (“Obesity and Diabetic Kidney Disease,” n.d.). When he
first started dialysis, Mr. D may notice that you are not eating as well as
usual. It can take a few weeks of dialysis to remove all the “built
up” or excess toxins from his blood.
D’s time before his episode his appetite was greatly discouraged, causing him
to suffer from inadequate energy intake, thus not providing himself adequate
food intake to sustain his changed need of consumption.
??Inadequate protein intake NI-52.1
??Excessive protein intake NI-52.2
??Inappropriate intake of amino acids (specify) __________ NI-52.3
Fiber Intake (53)
??Inadequate carbohydrate intake NI-53.1
??Excessive carbohydrate intake NI-53.2
??Inappropriate intake of types of carbohydrate (specify)
??Inconsistent carbohydrate intake NI-53.4
??Inadequate fiber intake NI-53.5
??Excessive fiber intake NI-53.6
are the foundation in many diets. They consist of vitamins and minerals that
are vital in the sustainment of human life. But carbs do have an effect of the
body’s blood sugar levels very quickly (“10 Diabetes Diet Myths,”
n.d.). Mr. D needs to be sure to monitor how many k/cal’s of carbohydrates he
consumes each day.
Protein is another vital building
block in controlling a diabetics blood glucose levels. For people on dialysis, it
is recommended that they consume 0.55 grams of dietary protein per pound of
body weight daily (“Getting More Protein While on Dialysis,” 2017).
This is higher than the 0.36 grams recommended for the average healthy
individual. The reasoning behind this is because while on dialysis the waste
and toxins, that your kidneys can no longer do effectively, are being filtered
from your blood it can inadvertently filter the proteins from your body.
When dealing with kidney disease and
dialysis there are many ways that dialysis center helps their patients; many of
them offer transportation and support groups to ease the pain of needing
treatment. For aiding with his diet, it is important that sodium intake is regulated,
and his meals are prepared as closely to what he loves. Instead of using salt herbs,
spices, and low-salt flavor enhancers could be used in place of salt and it is important
to avoid salt substitutes made with potassium (“Dietary Guidelines for
Adults Starting on Hemodialysis,” 2017).
It is important
to monitor a dialysis patients progress, especially in Mr. D’s case since he has
a history of not managing his health. I would utilize weight monitoring since he
has had a history of excessive weight loss, this will show me that he is managing
a proper diet. Another method I would use is the aide of a support group because
he lives alone and is often sedentary and missed multiple dialysis appointments,
in hope that it would allow him to socialize and ease his need for dialysis treatment.
10 Diabetes Diet Myths. (n.d.).
Retrieved from https://www.webmd.com/diabetes/10-diabetes-diet-myths#1
Diabetic Nephropathy | Diabetic
Kidney Disease | MedlinePlus. (n.d.). Retrieved from
Dietary Guidelines for Adults
Starting on Hemodialysis. (2017, February 3). Retrieved from
Getting More Protein While on
Dialysis. (2017, October 30). Retrieved from
Kidney failure/ESRD. (n.d.).
Obesity and Diabetic Kidney Disease.
(n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539140/
Support Groups for People Living with
Kidney Disease – DaVita. (n.d.). Retrieved from