Skip to main navigation menu Skip to main content Skip to site footer

Case Study

Vol. 3 No. 3 (2024): September 2024

Dietary non-adherence and circadian rhythm in diabetic patients: A case report

DOI
https://doi.org/10.55048/jpns130
Published
2024-09-07

Abstract

Background: Non-compliance with both medical and non-medical therapy regimens, such as dietary management, can lead to elevated blood glucose levels in patients with diabetes mellitus. Additionally, disturbances in circadian rhythms can impact glucose metabolism. The combination of these factors requires further investigation to understand their role in increasing glucose levels. Understanding how dietary non-adherence and circadian rhythm disturbances affect glucose metabolism may help improve glycemic control.

Objective: This study aims to assess dietary non-adherence and circadian rhythm disturbances in a patient with type 2 diabetes mellitus and uncontrolled blood sugar.

Case: A 65-year-old male patient was admitted to the inpatient unit from the emergency department. He had been diagnosed with type 2 diabetes mellitus since 2002. Blood sugar monitoring was performed every 12 hours using a sliding scale. Despite receiving a hospital-prescribed diet, the patient consumed additional foods such as bread, donuts, biscuits, and milk from outside sources. The patient also exhibited an irregular sleep pattern, sleeping only about 5 hours per night, going to bed after 9 p.m., waking up frequently during the night, and eating snacks (e.g., small bread) before sleep. On the first day, the morning glucose level (GDS) was 313 mg/dL and 140 mg/dL in the evening. On the second day, the morning GDS was 228 mg/dL, and 138 mg/dL in the evening. On the third day, the morning GDS was 145 mg/dL. The patient was discharged in the afternoon with an increased insulin dose from 6 to 8 units.

Conclusion: Dietary non-adherence and circadian rhythm disturbances are potential risk factors for elevated blood glucose levels in patients with type 2 diabetes mellitus. Providing health education, continuous monitoring, and support to both the patient and family can encourage adherence to medical regimens and improve health outcomes.

References

  1. Alkhulaifi, F., & Darkoh, C. (2022). Meal timing, meal frequency and metabolic syndrome. Nutrients, 14(9), 1719. https://doi.org/10.3390/nu14091719 DOI: https://doi.org/10.3390/nu14091719
  2. American Diabetes Association. (2020). Diabetes care in the hospital: Standards of medical care in diabetes—2020. Diabetes Care, 43(Supplement_1), S193–S202. https://doi.org/10.2337/dc20-S015 DOI: https://doi.org/10.2337/dc20-S015
  3. Cole, J. B., & Florez, J. C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature Reviews Nephrology, 16(7), 377–390. https://doi.org/10.1038/s41581-020-0278-5 DOI: https://doi.org/10.1038/s41581-020-0278-5
  4. Forst, T., Choudhary, P., Schneider, D., Linetzky, B., & Pozzilli, P. (2021). A practical approach to the clinical challenges in initiation of basal insulin therapy in people with type 2 diabetes. Diabetes/Metabolism Research and Reviews, 37(6). https://doi.org/10.1002/dmrr.3418 DOI: https://doi.org/10.1002/dmrr.3418
  5. García-Molina, L., Lewis-Mikhael, A.-M., Riquelme-Gallego, B., Cano-Ibáñez, N., Oliveras-López, M.-J., & Bueno-Cavanillas, A. (2020). Improving type 2 diabetes mellitus glycaemic control through lifestyle modification implementing diet intervention: A systematic review and meta-analysis. European Journal of Nutrition, 59(4), 1313–1328. https://doi.org/10.1007/s00394-019-02147-6 DOI: https://doi.org/10.1007/s00394-019-02147-6
  6. Hariri, A., Mirian, M., Zarrabi, A., Kohandel, M., Amini-Pozveh, M., Aref, A. R., Tabatabaee, A., Prabhakar, P. K., & Sivakumar, P. M. (2023). The circadian rhythm: an influential soundtrack in the diabetes story. Frontiers in Endocrinology, 14(1156757), 01–17. https://doi.org/10.3389/fendo.2023.1156757 DOI: https://doi.org/10.3389/fendo.2023.1156757
  7. Joshua, S. R., Shin, S., Lee, J.-H., & Kim, S. K. (2023). Health to eat: A smart plate with food recognition, classification, and weight measurement for type-2 diabetic mellitus patients’ nutrition control. Sensors, 23(3), 1656. https://doi.org/10.3390/s23031656 DOI: https://doi.org/10.3390/s23031656
  8. Maay, J. K., Blestina, M., Nasrah, Kismiyati, Utami, T. F., Jarona, M., & Suweni, K. (2022). Description of dietary compliance of type 2 diabetes mellitus patients at the sorendiweri health center, supiori regency. Fitness, Performance and Health Journal, 1(1), 52–58. https://doi.org/https://doi.org/10.53797/fphj.v1i1.8.2022 DOI: https://doi.org/10.53797/fphj.v1i1.8.2022
  9. Magkos, F., Hjorth, M. F., & Astrup, A. (2020). Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nature Reviews Endocrinology, 16(10), 545–555. https://doi.org/10.1038/s41574-020-0381-5 DOI: https://doi.org/10.1038/s41574-020-0381-5
  10. Mehriva, D. (2023). Analisis asupan makronutrient dan kadar leptin. Jurnal Pendidikan Dan Konseling (JPDK), 5(1), 755–762. https://doi.org/https://doi.org/10.31004/jpdk.v5i1.11034
  11. Nursihhah, M. (2021). Hubungan kepatuhan diet terhadap pengendalian kadar gula darah pada pasien diabetes melitus tipe 2. Jurnal Medika Hutama, 2(3), 1002–1010.
  12. Parameswaran, G., & Ray, D. W. (2022). Sleep, circadian rhythms, and type 2 diabetes mellitus. Clinical Endocrinology, 96(1), 12–20. https://doi.org/10.1111/cen.14607 DOI: https://doi.org/10.1111/cen.14607
  13. Sumbarwoto, A., Isbandiyah, I., Nelasari, H., & Rarung, G. (2022). Pengaruh gangguan ritme sirkadian dengan kejadian diabetes melitus tipe 2. CoMPHI Journal: Community Medicine and Public Health of Indonesia Journal, 3(2), 58–63. https://doi.org/10.37148/comphijournal.v3i2.103 DOI: https://doi.org/10.37148/comphijournal.v3i2.103
  14. Uloko, A. E., Musa, B. M., Ramalan, M. A., Gezawa, I. D., Puepet, F. H., Uloko, A. T., Borodo, M. M., & Sada, K. B. (2018). Prevalence and risk factors for diabetes mellitus in nigeria: A systematic review and meta-analysis. Diabetes Therapy, 9(3), 1307–1316. https://doi.org/10.1007/s13300-018-0441-1 DOI: https://doi.org/10.1007/s13300-018-0441-1

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...