Case study – part one

Mr White is a 67-year-old man diagnosed with IPMN (Intraductal Papillary Mucinous Neoplasm is lumps in the pancreas that are potentially pre-cancerous). 

• Weight: 71kg
• Height: 1.75m
• BMI: 23kg/m²

He previously had a steady weight of 75kg and a BMI of 24kg/m², equating to a 5% weight loss over 6 weeks.

Mr White was diagnosed with type 2 diabetes 5 months ago and referred to a diabetes management programme via his GP which involved group education sessions on diet, weight management and exercise. The diabetes was treated with diet and exercise to aim to reduce his HbA1c.

Mr White has always been active, walking 3 – 5 miles per day, swimming and line dancing 3 times per week. He has no family history of diabetes and has followed a balanced diet. Mr White was confused by his diabetes diagnosis and didn’t feel he had many changes to make. However, he has lost 4kg over the previous 6 weeks (which he thought was beneficial). Mr White has had a recent CT which showed a potentially resectable IPMN. The MDT plan was for him to have a total pancreatectomy.

Mr White’s appetite has been reduced for the last 2 months and his activity levels have been a bit lower.

He is currently managing to eat breakfast, lunch and an evening meal. He has been choosing lower fat options and eating more vegetables and salad based on the diabetes information he received.

His HbA1c is 68 mmol/mol.

Meeting with the oncology dietitian

Note: the above answer won’t be scored.