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Chronic Disease 3221
According to the Centers of Disease Control and Prevention (CDC, 2023), six out of ten adults in the United States have at least one chronic disease, and about four in ten have two or more chronic diseases. Chronic diseases include cardiovascular conditions, cancers, diabetes mellitus, and Alzheimer’s. Diet is a lifestyle factor that affects the development of many chronic conditions and even some neurological diseases.
After studying Module 6: Lecture Materials & Resources, read the case study and answer the following:
Lenora is a 57-year-old Jamaican American female who works as a desk clerk. Her job requires her to sit all day from 9 a.m. to 5 p.m., then she drives for one hour to go home. She lives alone in a studio apartment. By the time she gets home, she is tired and barely has time to pick up some fast food. She was recently diagnosed with hypertension and diabetes type 2. She is 5’ 5” tall and weighs 180 pounds with a BMI of 30.1. Her blood pressure was 150/105 and her HbA1C of 7.5%. The healthcare team starts Lenora on atenolol (Tenormin) for her hypertension and metformin (Glucophage) for her diabetes.
Provide at least two (2) complications of uncontrolled hypertension and diabetes. Provide at least two (2) risk factors that may contribute to Lenora’s development of hypertension (see Appendix J: Body Mass Index (BMI) of your textbook) Describe what is HbA1C and how is it used to monitor diabetes? (see Chapter 20, page 564 of your textbook). Discuss what dietary counseling will Lenora need to control her hypertension and diabetes? Provide at least two (2) examples.
Full Answer Section
Diabetes:
Kidney Disease:High blood sugar levels damage blood vessels in the kidneys, leading to kidney disease and potentially kidney failure.
Nerve Damage: Diabetes can cause nerve damage (neuropathy), leading to numbness, tingling, pain, and loss of sensation, especially in the feet and hands.
Risk Factors for Lenora's Hypertension
Several risk factors may have contributed to Lenora's development of hypertension:
Obesity:Lenora's BMI of 30.1 indicates she is obese.Obesity is a major risk factor for hypertension, as excess weight puts extra strain on the cardiovascular system.
Sedentary Lifestyle: Lenora's job requires her to sit for long periods, and her overall lifestyle seems to lack regular physical activity. A sedentary lifestyle is a significant risk factor for hypertension.
HbA1c and Diabetes Monitoring
HbA1c (glycated hemoglobin) is a blood test that measures the average blood sugar level over the past 2-3 months.It's a key indicator of long-term blood sugar control in people with diabetes.
How it works: Glucose in the blood attaches to hemoglobin, a protein in red blood cells.The higher the blood sugar levels, the more glucose attaches to hemoglobin. HbA1c reflects the average amount of glucose attached to hemoglobin over its lifespan.
Monitoring: An HbA1c of 6.5% or higher is generally diagnostic of diabetes.For people with diabetes, the goal is usually to keep HbA1c below 7%, although individual targets may vary. Lenora's HbA1c of 7.5% indicates that her blood sugar levels have been elevated over recent months.
Dietary Counseling for Lenora
Lenora will need comprehensive dietary counseling to manage both her hypertension and diabetes. Here are two key areas to address:
DASH Diet for Hypertension: The DASH (Dietary Approaches to Stop Hypertension) diet emphasizes fruits, vegetables, whole grains, lean protein, and low-fat dairy. It's low in saturated and trans fats, cholesterol, sodium, and added sugars. This diet can help lower blood pressure and improve overall health.
Carbohydrate Control for Diabetes: Lenora needs to learn how to manage her carbohydrate intake to control her blood sugar levels. This includes understanding the different types of carbohydrates, portion control, and the impact of different foods on blood sugar. A registered dietitian can help her create a meal plan that meets her individual needs and preferences.
Additional Lifestyle Changes
In addition to dietary changes, Lenora would benefit from:
Increased Physical Activity: Even moderate-intensity exercise, such as brisk walking for 30 minutes most days of the week, can help lower blood pressure and improve blood sugar control.
Weight Management: Losing even a small amount of weight can significantly improve Lenora's blood pressure and blood sugar levels.
Stress Management: Stress can exacerbate both hypertension and diabetes. Lenora may benefit from learning stress management techniques such as relaxation exercises, yoga, or meditation.
It's crucial for Lenora to work closely with her healthcare team, including a physician, registered dietitian, and possibly a certified diabetes educator, to develop a comprehensive plan to manage her hypertension and diabetes effectively.
Sample Answer
Complications of Uncontrolled Hypertension and Diabetes
Uncontrolled hypertension (high blood pressure) and diabetes can lead to a range of serious complications. Here are two examples for each condition:
Hypertension:
Stroke: High blood pressure damages blood vessels, increasing the risk of a blood clot blocking an artery in the brain, leading to a stroke.
Heart Attack: Hypertension forces the heart to work harder, increasing the risk of heart attack, heart failure, and other cardiovascular diseases.