Patients suffering from diabetes have varying and comprehensive learning challenges and needs. The learning need in this instructional plan will be focused at educating and empowering the patients (Dunning, 2003). It will educate patients on different methods that can enhance management of glucose levels. Educating the patients will help prevent any complications associated with diabetes. Every year thousands of patients are diagnosed with diabetes and many of them are not aware of the lifestyle changes that they must adapt to in order to live long and healthy. Adapting to the new changes is very challenging to the patients (Dunning, 2003). Patients need a lot of training on their nutritional and physical activities. Therefore, it is worth noting that learning needs for diabetic patients are complex and include:

Accurate monitoring of glucose levels;

Food and menu planning;

Medication management of the co-existing diseases processes;

Knowledge of the disease process;

Medications;

Management of hypo/hyperglycemic episodes.

Broad Goal

Having noted these challenges and complexities of managing diabetes, the main goal of this instruction plan will be to provide the patients with adequate knowledge that can help them make self-directed changes (Wozniak, 2008). These self-directed changes will help improve the participants or learners health through effective management of their conditions.

Specific Learner Objectives

Specific learner objectives in this instruction plan will aim at changing the behavior of patients suffering from diabetes. Learners objectives will be the following:

Patient will learn about different diabetic medications and how to take the medicines effectively;

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Patient will be able to describe different food groups that can be used to manage diabetes mellitus;

The patient will be able to know the benefits of regular exercise in improvement of his/her glucose level;

Patients will be able to plan their meals to meet all nutritional requirements.

Teaching Plan

This diabetic instruction or teaching plan is intended to help diabetic patients make informed lifestyle choices. It will also help patients make changes that will enhance health and promote a stable level of sugar in blood (Dunning, 2003). Each diabetic patient needs a comprehensive treatment approach. This includes individualized meal plans that are appropriate for their lifestyle. Patients will also need to be educated on any matter concerning diabetes and nutrition therapy (Dick & Reiser, 2009). Finally, this instructional plan is aimed at coming up with a mutually agreed long-term and short-term objectives of lifestyle changes. In this teaching plan the emphasis should be made on the importance of abiding by the diabetes management plan. In addition, this instruction plan should be devised to meet individual needs, developmental stage, and abilities.

Learning Activities

Power Point Presentations

PowerPoint will provide a general overview of diabetes and enable patients to understand the different types of medications available for diabetes (Dick & Reiser, 2009). In this PowerPoint presentation, various treatments that are available to diabetic people will be discussed. Patients will be aware of the difference between diabetes type 1 and diabetes type 2. In the PowerPoint, medication to be presented will include insulin secretagogues, meglitinides, insulin sensitizers, and Glucose Absorption Inhibitors (Dunning, 2003). Patients with diabetes need to understand what being diabetic entails. It will be assumed that patients with some knowledge of diabetes and those who understand complications involved will likely adapt to the prescribed regimen. Diabetes is a syndrome with distorted metabolism and inappropriate hyperglycemia as a result of deficiency of insulin secretion or as a result of insulin resistance and inadequate insulin in the body. The patients with diabetes should be explained that the medicine is prescribed to them not because they are failing at their diet management. Patients become depressed or despondent when they have to begin taking oral hyperglycemic insulin or medication. The patients should be taught how to manage their diabetes when they have a minor illness, such as flu or cold. The patients should also be educated on symptoms or indicators they can watch out. Identifying these indicators will help them understand how diabetes affects the cardiovascular system. This will help minimize cases or stroke incidents and coronary artery disease. Assessment of the signs of diabetic neuropathy will also be a component taught in the PowerPoint presentation. In addition, patients should receive education on the importance of smoking cessation, lipid management, blood pressure monitoring, and management of other diseases.

Educational Game

The aim of this educational game will be to help patients understand different types of food groups.

Diabetes Bingo

This game will help patients describe the different food groups that can be used to manage diabetes mellitus. Material needed for this game includes pictures of different food items and most preferably two samples of each sort of food. Index cards and a basket or bag to hold the cards is also needed. Finally, one should get Bingo cards measuring 7 by 9 inches with 5 by 6 grids drawn. Once all of these materials are ready, individual Bingo cards will be created (Wozniak, 2008). In the place of the letter BINGO in the upper column or row, write the various food groups of fruits, protein, fats, and dairy. Randomly glue the pictures of each food item in the appropriate column on each card. Each food item used on the cards will also be put on a single index card bearing the name of the food group. An explanation will be given to the patient that different foods belong to different food groups. It will be essential to make sure that the students know which group certain food belongs to. This is especially important for patients with type 1 diabetes. To play this game students will be handed a handful of Bingo chips. Each student will then be asked to draw index cards from the basket and call out the name of the food item. They will also call out which food group the food belongs to and the winner of the game will be the one who gets five chips in a row first, diagonally or in column. The discussion that will follow the game will help students learn various food types that can help a person live with diabetes.

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Video Watching

In this activity patient will be introduced to the different exercises that diabetic patients can participate in.

Aims of Exercising

Diabetic people are encouraged to exercise regularly because it enhances sugar control. This reduces the risk of cardiovascular diseases. Engaging in physical exercise enhances muscle movement and leads to improved sugar uptake by the muscle cells (Pichert, Nowacek & American Association of Diabetes Educators, 2004). This aids in reducing blood sugar levels. Other benefits of exercising are that it promotes better weight control, healthier heart, and stress management. A moderate weight loss of ten to twenty pounds has been established to improve hyperglycemia, hypertension, and dyslipidemia. The target goal for body weight for patients with diabetes is based on a reasonable or health body weight. A waist circumference exceeding 40 inches in males is not healthy. For women, anyone with a waist circumference of more than 35 inches indicates a danger for metabolic diseases. Patients should be made aware that reducing abdominal fat will improve insulin sensitivity and lipids profiles (Pichert, Nowacek & American Association of Diabetes Educators, 2004). A careful medical examination will be essential to determine the presence of macro- and micro-vascular complications.

Recommended Exercises for Diabetic Patients

Light jogging;

Fast-paced walking rowing;

Bike riding;

Water aerobics;

Cutting glass and doing other daily chore such as cleaning the house.

Meal Planning and Diabetes

The American Diabetes Association has established nutritional guidelines for patients with diabetes. The focus of a meal planning for diabetic patients is to achieve optimal metabolic outcomes related to blood pressure levels, glycemia, and lipid profiles. For patients with diabetes mellitus it is essential to retain a fit or healthy diet consisting of a variety of fruits, wholegrain, low fat food items, and vegetables. A meal plan is based on the individuals appetite, usual schedule of food intake, cultural preference, and preferred food.

Identifying or analyzing calories requirement among different patients will be based on their current energy levels and their current weight. For an adult who has normal daily activities, a calorie requirement of 40 kcal/kg or 20 kcal/lb. per day is recommended. Emphasis should be put on maintaining a consistent day-to-day carbohydrate intake at snacks and meals. Carbohydrates have the greatest impact on glycemia. Maintaining a food diary can help identify areas of weakness and how to prepare better meals or menu plans. It is strongly recommended that diabetic patients take the same amount of fiber in their diet as the people who are not diabetic. It is suggested that patients increase their amounts of fiber to approximately 50 grams per day in their diet. Soluble and insoluble globular fiber delay glucose uptake in the body and weaken the post-prandial serum glucose peak (Kemp, 2011). They also help to lower the elevated triglyceride levels, which mostly leads to uncontrolled diabetes.

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The discussion of diet management should also include discussion of alcohol consumption. Provisions concerning drinking of alcohol that apply to people who are not diabetic also relate to people with diabetes. Refraining from alcohol consumption should be prescribed for patients who previously had problems related to alcohol abuse or misuse (Pichert, Nowacek & American Association of Diabetes Educators, 2004). This is especially important during pregnancy and for patients with other medical conditions, such pancreatitis and elevated triglycerides. The effects of alcohol on blood glucose levels depend on the total volume of alcohol consumed and the food intake.

Visual Aids and Equipment

Visual aids that will be used in this instruction plan will include a video demonstrating how to conduct the various exercises (Ansari, 2003). A projector and a laptop will also be essential to help present the PowerPoint.

Evaluation Plan

The evaluation plan will focus on monitoring behavioral changes among the patients. The main elements of evaluation will be focused on outcome measures, observational system, and process measures (Dunbar, McKeough, Somers & Mulroney, 2006). Patients will be evaluated on the basis of their behavioral and lifestyle changes. Knowledge on diabetes will also be evaluated. This instructional plan will be successful if the patients will show increased knowledge on matters related to diabetes medication (Kemp, 2011). Patients will be expected to demonstrate an understanding of the various types of food. Behavioral surveys will be conducted with an aim to identify risk behaviors among the patients. Interviews with patients will help identify if they are able to describe different food groups that can be used to manage diabetes mellitus. Instructional activities will be evaluated regarding their effectiveness (Dunbar, McKeough, Somers & Mulroney, 2006). This instruction plan for patients with diabetes can be designed and held in two sessions. However, it depends on the needs of the patients and whether they are able to make use of the material being taught (Ansari, 2003).

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