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A case study of a 7-year-old boy named Christopher, who has been diagnosed with Type 1 Diabetes Mellitus (T1DM). the boy's medical history, current symptoms, and diagnostic results. It also outlines the problems that need to be addressed, interventions, and meal planning for managing T1DM in children. The document also explains the concept of the honeymoon phase and provides advice for parents regarding their child's participation in sports.
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EXS 425 Diabetes Project Name: Derrick D. Dennis Christopher is a 7yo male. He was diagnosed w/strep throat 4 weeks ago. He is still very tired. He comes home from school, naps, eats dinner and goes to bed. He seems to be eating all the time, but it does not improve his energy level. A visit to his pediatrician indicates T1DM. He and his parents will be worked-up for introduction to insulin administration and diet modification. A. wt: 48 lbs. (approx. 40th^ %ile). He has lost 5 lbs. in the past month. ht: 48 in. (approx. 50th%ile) B. glucose is 327mg/dl. Electrolytes are mildly elevated. Rapid strep test was negative. C. Appears pale, wrung out. Dark circles under eyes. Oral cavity appears dry. Skin is dry, intact w/no abnormal bruising D. Mom reports appetite is good and eats just about anything. (See 24hr. recall below) E. Lives w/parents and older sibling 24 hr. Diet Recall (Use either the textbook or the Exchange list in Moodle to analyze recall.) g CHO g pro g fat Breakfast 1 glazed donut 15 3 0 1 cup orange juice 15 0 0 Lunch (school) 2 oz. hamburger (medium fat) 0 7 8 Hamburger bun ½ cup green beans 2.5 1 0 ½ cup fruit cocktail 7.5 0 0 1 cup chocolate milk 12 8 8 Snack 1 oz. potato chips 15 3 0 Dinner 1 cup spaghetti 43 3 0 2-1oz. meatballs (medium fat) 0 7 8 1 cup 2% milk___ 12__________________ 8_____________________________________________________ Totals (grams) 122g 40g 32g total Kcal = 194 Distribution of Calories -194kcal x50% CHO = 97 Cal CHO/4 per gram = 24.3g CHO 194kcal x20% PRO = 39 Cal PRO/4 per gram = 9.8g PRO 194kcal x30% FAT = 58 Cal FAT/9 per gram = 6g FAT Percentages CHO= 122g/194kcal = 63% PRO= 40g/194kcal = 21% FAT= 32g/194kcal = 16.5 % 100.5%
Meal plan Contains 122g CHOx4 = 488cal 40g PROx4 = 44cal 32g FATx9 = 288cal 820 Cal Functional analysis I. Identify the problems that need to be addressed w/this patient. Lowering that Elevated glucose below 140mg/dl instead of 327mg/dl and Electrolytes, Eating normal meals and still not energy, Sleeping all the time, Dark rings around eyes, Dry skin (Patient is Dehydrated) Increase fluids which will address His early stages of Ketoacidosis. II. Interventions What are the goals in the management of T1DM? The goals for the management of type 1 diabetes in adolescents are to (i) prevent diabetic ketoacidosis; (ii) prevent severe hypoglycemia; (iii) maintain normal growth and development; and (iv) prevent long-term diabetic complications. To prevent diabetic ketoacidosis, patients must take their insulin appropriately.
IV. Self-monitoring What does this family need to track in order to successfully manage Christopher’s diabetes? Christopher’s diet, Blood glucose, meals, exercise and weight loss or gain should be tracked.