FINAL - TAHC
I. Assessment of your target clientele
-Demographic profile of your clientele
-Existing records and studies
-Common complaints of your clientele
Name of Patient: A.B.C.
Age: 54 years old
Educational Attainment: College Graduate
A.B.C. is a 54-year-old manager with a 5-year history of type 2 diabetes. Although he was diagnosed in 2008, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him by his doctor as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with large pasta meals and pastries. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken.
The patient presents with recent weight gain, suboptimal ...view middle of the document...
During the past 6 months, he has also taken chromium picolinate, gymnema sylvestre, and a “pancreas elixir” in an attempt to improve his diabetes control. He stopped these supplements when he did not see any positive results.
He does not test his blood glucose levels at home or at the office and expresses doubt that this procedure would help him improve his diabetes control. “What would knowing the numbers do for me?,” he asks. “The doctor already knows the sugars are high.”
A.B.C. states that he has “never been sick a day in my life.” He lives with his wife of 30 years and has three children. Although both his mother and father had Type 2 Diabetes, A.B.C. has limited knowledge regarding diabetes self-care management and states that he does not understand why he has diabetes since he never eats sugar. In the past, his wife has encouraged him to treat his diabetes with herbal remedies and weight-loss supplements, and she frequently scans the Internet for the latest diabetes remedies.
During the past year, A.B.C. has gained 22 lb. Since diagnosed, he has been more physically active, playing badminton once a week and gardening, but he has been unable to lose more than 2–3 lb. He has never seen a dietitian and has not been instructed in self-monitoring of blood glucose (SMBG).
A.B.C.’s diet history reveals excessive carbohydrate intake in the form of bread and pasta. His normal dinners consist of 2 cups of cooked pasta with homemade sauce and three to four slices of bread. During the day, he often has “a slice or two” of bread with butter or olive oil. He also eats eight to ten pieces of fresh fruit per day at meals and as snacks. He prefers chicken and fish, but it is usually served with a tomato or cream sauce accompanied by pasta. His wife has offered to make him plain grilled meats, but he finds them “tasteless.” He drinks 8 oz. of red wine with dinner each evening. He stopped smoking more than 10 years ago.
The medical documents that A.B.C. brings to this appointment indicate that his hemoglobin A1c (A1C) has never been