NTR 5101: Macronutrients New York Chiropractic College Case Study # 3
Directions: Please answer the questions below which pertain to the case study. When answering the questions, please use peer-‐reviewed references. There is no page limit but please be concise. Quality is more important than quantity.
C.S. is a 45-‐year-‐old Hispanic man with a 10-‐year history of type 2 diabetes. He has a glycated hemoglobin of 7.0% and a blood pressure of 130/80 mmHg, treated with an angiotensin-‐converting enzyme inhibitor for the past 2 years. He has stable background retinopathy and is a nonsmoker. His BMI has been 30 (height 5′10″, weight 210 lb) for the past year. However, lately, he has put himself on the latest high-‐protein diet (i.e., the Atkins diet).
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His weight has dropped by 10 lb, his fasting serum triglyceride level has fallen from 185 to 130 mg/dl, and his blood pressure has decreased to 120/78 mmHg. His LDL cholesterol has remained stable at 102 mg/dl on a statin. His serum creatinine is 0.9 mg/dl, and his 24-‐hour urine shows a significant increase in microalbumuria from 100 mg/24 hours last year to the current 200 mg/24 hours. He has stage 1 chronic kidney disease indicating kidney damage, with a normal glomerular filtration rate (GFR) of 98 ml/min/1.73 m2.
1. Would the weight reduction, blood pressure, and lipid-‐lowering accomplished by this high-‐protein, low-‐carbohydrate diet be an acceptable choice for a patient who is at significant risk of cardiovascular disease?
2. What are the recommendations of the American Heart Association (AHA), the National Kidney Foundation (NKF), the National Academy of Sciences, and the American Diabetes Association (ADA) regarding this type of diet for diabetes and/or weight loss?
3. What has research revealed about appropriate levels of macronutrients for patients such as C.S.?
Type 2 Diabetes Name Institutional Affiliation Type 2 Diabetes Type 2 diabetes is a disorder that arises as a result of an elevation in the body glucose levels beyond the normal concentration. The condition is referred to as hyperglycemia. It is the most common type of diabetes. Type 2 diabetes was initially unheard of in children, hence it used to be referred to as adult-onset diabetes. However, the trend has changed due to the ever increasing number of childhood obesity cases, and the disease is now common among the youths especially among the Native American Youths and Asian Pacific Islanders. Insulin is crucial for the body since it regulates blood sugar levels. However, in the case of Type 2 Diabetes, the body does not use the produced insulin properly, a condition referred to as insulin resistance. Unstable production of insulin is normally because the body is unable to produce enough insulin needed to maintain the normal glucose levels. Diabetes di