Sally is a 65 year old female who is coming to see you for management of her Type 2 diabetes.

Sally is a 65 year old female who is coming to see you for management of her Type 2 diabetes. Her blood glucose levels are uncontrolled and her A1C is >10%. She complains of increasing numbness in her feet and frequent urination. From your interview and from her medical record you learn the following: Education: did not complete high school Household members: lives with her husband Pt hx: Weighed more than 10 lbs at birth. Was diagnosed with Type 2 diabetes 15 years ago. Diabetes management as follows: Type of treatment: previous nutrition therapy plus oral diabetes medication (Metformin XR 1000 mg BID] and long acting insulin at bedtime. Family hx: mother had type 2 DM, grandson recently diagnosed w/ pre-diabetes Medical hx: type 2 DM, HTN, hyperlipidemia Physical exam shows the following: Wt: 201 lbs, Ht: 5’2″ SMBG shows: Fasting [6:00am]: 173 mg/dL Prebreakfast [9:00am): 248 mg/dL Pre-lunch (1:00pm): 193 mg/dL Predinner [6:00pm]: 195 mg/dL Bedtime: 260 mg/dL 24 hour recall Breakfast: coffee with milk and sugar, 3-4- slices banana bread Lunch: chicken noodle soup with dinner roll, 12-16 02 cranberry drink Dinner: pot roast with mashed potatoes, 12-16 oz cranberry drink Afternoon snack: 1 can regular Pepsi, 3-4 sugar free chocolate chip cookies Bedtime snack: cornflakes and milk Previous nutrition therapy: several years ago when diagnosed, does not currently follow a diet plan and is reluctant to engage in physical activity.

Select 2 of the of the following nutrition diagnoses often used for patients with Type 2 diabetes and complete PES statements for each one:

Inconsistent carbohydrate intake

Excessive carbohydrate intake

Altered nutrition-related laboratory values

Overweight/obesity

Food and nutrition related knowledge deficit

Not ready for diet/lifestyle change