Diabetes & food

[Nursing.capps, RN]

I have a question I would like input on, please and thank you.

I have a client whose random blood sugar is 204. When it comes time for lunch do I remove the whole wheat roll from the clients lunch that is already pre-measured, low fat, low sodium and diabetic approved USDA food program lunch that our adult daycare uses?

The client has no orders to do so. I'm being told that this is nursing judgement that we should remove the roll. I personally say that the diet is already approved for a diabetic and also the whole wheat food item helps to regulate the clients blood sugar later in the day.

Any suggestions are sooo appreciated.

[brownbook]

What is his blood sugar in the morning or before bedtime? Is the patient on insulin or oral diabetic medications? When does he take his diabetic medications.

You need to take into account what insulin or oral hypoglycemics the patient takes, and when. The patients physical activities. The patients blood sugars over at least 24 to 72 hours. Low in the morning? high at bedtime? Or visa versa, etc. Does he usually eat his entire meal?

Are you able to talk to whomever approved the diet for this diabetic patient? Is there a nutritionist or dietitian?

Eating one whole wheat roll at lunch is very insignificant in the overall picture, the overall health of a diabetic

[nursej22, MSN, RN]

I would let him have the roll. It provides fiber, as you stated, and some B vitamins. Even Type 1s who count carbs eat bread.