Subgroup Analysis In Clinical Trials And Nutritional Needs Of Teenage Male With Type 1 Diabetes

Identified Nutritional Needs for a male teenage patient with Type 1 Diabetes

In a clinical trial, a subgroup analysis involves evaluating the effects of the randomly assigned intervention among a portion of the selected subjects.

A subgroup describes the patient based on specific characteristics such as their age and gender.

Subgroup analysis seeks to evaluate the effects of the use of therapy on the chosen population.

This includes the diagnosis of a disorder and the various treatment options available for the population subgroup being analyzed.

Type 1 diabetes is a form of diabetes mellitus that affects children and young adults.

It was previously referred to as insulin-dependent or juvenile diabetes (Levy, 2011).

Viruses and infections destroy the pancreatic cells known as beta cells.

Type 1 diabetes occurs when the immune system attacks the pancreas such that it does not produce enough insulin resulting in an increase in blood sugar levels.

High blood sugars result in complications such as eye damage, nerve kidney, and cardiovascular disease.

Type 1 Diabetes is not a lifestyle disease but is an autoimmune, chronic disorder that is incurable (Holt, Cockram, Flyvbjerg, & Goldstein, 2011).   

We seek to conduct a case study of a 16-year-old male teenager by the name Ben who has type 1 diabetes.

We shall identify the nutritional needs this teenager, the potential nutritional problem, ways of addressing these nutritional issues and finally recommend a meal plan for Ben

Nutritional Needs for a male teenage patient with Type 1 Diabetes

Proper nutrition forms a foundation for the management of diabetes. Below are some of the identified nutritional needs for Ben based on him being a teenage male using both number of serves and Reference Daily Intake (RDI’s) for each food group.

Carbohydrates affect blood sugar and glucose levels. 

Ben should improve glycemic control by monitoring his carbohydrate intake (Frost, 2017)

For better health, it is advised that Ben should seek carbohydrates from sources such as whole grains, vegetables, fruits, dairy products and legumes as opposed to other sources that contain sodium, added sugars or fats.

It is recommended that Ben should consume between 45 to 60 grams of carbohydrates per meal and 15grams while snacking.

Caloric sweeteners should be substituted with the use of sweeteners that are nonnutritive (NNSs).

Ben should limit the intake of nutritive sweeteners such as table sugar and focus on intake of fructose obtained from fruits which should not be more than 12% energy.

Ben should consume high fiber-containing foods and for every 1000 calories consumed, he should consume about 14g of dietary fiber.

Ben should limit the intake of trans fats and saturated fatty acids so as to control the risk of cardiovascular disease (Harris, Hood, & Benchell, 2014).

His intake of saturated fats should be equal to or less than 7% of the total calories consumed.

Proteins do not affect blood sugars but instead promote growth and development.

Therefore, Ben should focus on consuming proteins from sources that contain all the 9 essential amino acids such ass poultry and it is recommended he consumes about 0.8 g protein/ kg his total body weight Ben should reduce his sodium intake to less than 1500 mg per day.

Potential Nutrition Issues/Deficiencies for the Patient

Mineral and vitamin supplements are unnecessary as these should be gotten from natural food sources with the focus on a balanced diet.

We can conclude that half of Ben’s plate should consist of vegetables and fruits while the other half with lean protein sources and whole grains.

Ben need also be involved in the regular moderate exercise.

Potential Nutrition Issues/Deficiencies for the Patient

The main potential nutrition issues/deficiencies for Ben is being obese and overweight.

Many teenagers often consume fast foods such as fries and burgers accompanied with sugary drinks such as fancy coffee beverages, fruit punch, and energy drinks. They also often consume snacks with a high glycemic index, diet beverages and foods low in carbohydrates (Hanas, 2010).

All these foods are rich in saturated fats, have high calories levels leading to being overweight.

Deficiency of vitamin D results in weakening of the immune system resulting in attack of the pancreas.

Teenagers with type 1 diabetes are at a risk of emerging an eating disorder

Reasons, Behaviors And Attitudes That May Have Contributed To The Disorder

Some of the factors that contribute to this include peer pressure among teenagers leave some to conform to a particular weight and body stereotype.

This leads to dieting which results in disordered eating (Hood & Ische, 2010). Disordered eating contributes to unstable and poor blood sugar levels.

Teenagers with type 1 diabetes often alter their insulin doses in a bid to either lose weight or evade weight gain.

Nowadays, the society has changed into one of the screens. This has changed the activities of young adults whereby instead of playing they stare at their screens.

Lack of physical activity and exercise contribute to weight gain. Young adults often cringe and make faces when vegetables are served.

Low vegetable intake contributes to the weakening of the immune system.

Short And Long Term Effects For The Patient If These Nutrition Issues Are Not Addressed

Poor eating habits for patients with type 1 diabetes such as Ben has both short and long-term effects.

Fatty foods have an immediate effect on brain function resulting in poor concentration abilities.

Dieting results in fainting and physical inactivity and coordination.

Eating greasy foods results in bloating, nausea and indigestion which is often accompanied by hurt burns.

An unhealthy diet, overeating or going to sleep hungry often results in poor 

Skimping on carbohydrates or calories results in depressive moods as it affects the production of chemicals in the brain, such as serotonin that promotes positive moods (Fuhrman, 2012).

Consumption of fast foods, sugary beverages, and overeating all lead to weight gain resulting in obesity.

Obesity exposes one to disorders such as heart disease, cancer, high blood pressure, all of which may result in death.

Increase in body fat may increase the risk of contracting type 2 diabetes. Poor eating habits may result in chronic disease whose long-term effect is death.

Ways of Addressing/Rectifying these Nutrition Issues

There exist a number of ways to rectify or address nutritional issues associated with obesity.

Reasons, Behaviors And Attitudes That May Contribute To The Disorder

These include involvement in physical activity such as daily brisk walking, bike rides, weekend hikes among other forms of exercise.

Ben should consume food with a lower glycemic index (Smith, 2009).

Examples of these are brown rice, whole grains, and whole wheat pasta as opposed to sugary desserts and refined grains.

Instead of drinking sugary drinks, people should replace them with water. The benefits of drinking water and keeping the body hydrated are endless. Instead of eating out, which often results in consumption of fast foods, families should focus on preparing healthier meals at home.

People need to increase their intake of fruits and non-starchy vegetables as they help regulate sugar levels (Nestle, 2016)

There need to be a refocus on the things people consider as snacks and start smart snacking.

This may include snaking on healthier options such as nuts and seeds that have numerous nutritional benefits.

People also need to avoid the use of saturated fats and consume foods rich in monounsaturated fats that have amazing health benefits.

Below is an example of a realistic 1-day meal plan designed for Ben that would ensure his nutritional requirements are met.

Breakfast: 1 serving of natural yogurt with honey and blueberries, a tablespoon of ground flaxseeds and I chopped medium plum (27grams carbohydrates, 290calories)

A.M Snack: 1 medium-sized apple (25 grams carbohydrates, 95 calories)

Lunch: 1 serving spaghetti and meatballs, a half sliced medium pear sprinkled with cinnamon (396 calories, 34grams carbohydrates).

.M Snack: 1 medium sized orange (15grams carbohydrates, 62calories)

Dinner: 

A half cup cooked brown rice, I serving of lemon-herbed salmon (39grams carbohydrates, 420 calories)

Daily Total: 140grams carbohydrates, 1263grams calories, 61grams sugar, 35 grams fiber, 63grams protein, 820milligram sodium, 9grams saturated fat, 47grams fat, 61grams sugar)

Below is an interview conducted on Ben to analyze some of the reasons behind some food and eating behaviors and attitudes that may have contributed to the disorder.

Affiliation with interviewee: Ben has been my patient for six months now.

(Start of Interview)

Interviewer: In regard to your condition, what are the main foods that you consume?

Interviewee: I mainly have French fries and a soda for lunch.

Interviewer: Why don’t you carry lunch from home?

Interviewee: My mother is quite busy and does not get time to prepare meals for me to bring to school.

Interviewer: Do your friends carry their own lunch?

Interviewee: No. This is because we had an agreement to grab lunch together here in school.

Interviewer: What are your friend’s view regarding people who are overweight?

Interviewee: They really despise and often make fun of them.

Interviewer: Is this the reason you are dieting?

Interviewee: Yes

Interviewer: Do you know that this negatively impacts your blood sugar levels?

Interviewee: Yes, but I also do not want to lose my friends.

Interviewer: That’s all for today Ben. Thank you for your time

Interviewee: Anytime.

To sum up, we can say that Type 1 diabetes though incurable it is manageable.

Apart from daily injection of insulin, proper diet can control the effects (Kaufman, 2012).

Patients need to consume a balanced diet packed with loads of vegetables and fruits.

Eating of fast foods and junk may result in obesity which is a risk for contracting type 2 diabetes and other disorders.

Therefore, patients should consume a diet low in carbohydrates, get plenty of regular exercises and minimize on sugars.

Not only does a healthy diet aid in controlling blood sugar levels but also it aids in weight control.

 A sample meal plan for Ben from our subgroup is provided above.

References