Spring 2016, Volume 7, Issue 3
Welcome back to EBSCO Health's free evidence-based nursing newsletter. We will periodically send news on the latest evidence in nursing. Please share this with your colleagues, students, practitioners and others who would benefit from this information.
Mr. W is a 50-year-old patient with diverticulitis in the acute care unit. The nurse caring for this patient wants to clarify the prescribed diet for him, so she consults Nursing Reference Center Plus, keying in the words "diverticulitis diet." She retrieves the quick lesson "Diverticulitis: Diet."
The nurse reads about the appropriate diet for a patient with diverticulitis, including indications, potential complications, laboratory tests, treatment goals and interventions. Based on the information in the quick lesson, the nurse carefully monitors the patient's pain levels and requests referral to a dietitian for a diet assessment and patient education about meal planning. She provides Mr. W with emotional support.
Note: The above-referenced quick lesson is freely accessible to all readers of the EBSCO Health Nursing Newsletter.
Glucose transporter type 1 deficiency syndrome (GLUT1-DS) is a rare neurologic condition caused by a deficiency of the transport protein glucose transporter type 1 (GLUT1) that impairs glucose uptake by the central nervous system (CNS). GLUT1-DS manifests as early-onset seizures beginning in infancy when the cerebral demand for glucose increases. GLUT1-DS impairs brain function and eventually causes movement disorders and developmental and cognitive delays.
Glucose is necessary fuel for CNS function and it is transported across the blood-brain barrier solely by GLUT1. When there is a GLUT1 deficiency, the energy needs of brain function cannot be met. Normal glucose utilization for brain metabolism increases after birth and peaks at 3 years of age, after which it remains elevated during the first decade of life for normal brain development; glucose utilization slowly declines during the second decade of life until a constant level is reached in early adulthood. When in a resting state, the brain of infants and children uses up to 80% of the total body glucose supply, compared to the adult brain, which normally consumes up to 25% of the total body glucose supply.
GLUT1-DS is a treatable encephalopathy. Treatment of choice is immediate initiation of a ketogenic diet (KD) to provide the brain with an alternative source of energy. When the glucose supply is depleted, the brain normally utilizes ketone bodies from fat, which are an alternative to glucose that easily cross the blood-brain barrier. The KD provides nutritional ketones as fuel for the brain by mimicking the effects of starvation. This is achieved with a diet that is high in fat, low or moderate in protein and very low in carbohydrates. Treatment with anticonvulsants is usually ineffective and valproic acid should not be prescribed. A KD also beneficially treats non-epileptic manifestations in patients with GLUT1-DS. Prognosis is good after initiation of the KD because it helps resolve seizure activity and movement disorders, although its effect in improving cognition is not as apparent.
Please log in to your Nursing Reference Center™ or Nursing Reference Center Plus subscription to read the quick lesson on "Glucose Transporter 1 Deficiency Syndrome."
Recently, the evidence-based care sheet "Diabetes Mellitus, Type 2: Screening in Asymptomatic Adults" was revised following review under the Systematic Literature Surveillance Program. Among new information of value to nursing practice were guidelines from the American Diabetes Association regarding screening for diabetes mellitus type 2 in asymptomatic adults.
The American Diabetes Association recommends that individuals diagnosed with prediabetes achieve weight loss of 7% of total body weight and participate in moderate physical activity for at least 150 minutes per week and resistance training 3 times per week to reduce their risk for conversion to DM2.
We invite you to log in to Nursing Reference Center or Nursing Reference Center Plus to read updated content as it becomes available.