PMC6644266_01
The main portion of one meal.
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The family was asked to avoid providing buffet-style meals, but to serve the meals on a single plate taking size into account (Figure 1). The daily food intake was recorded by photographs and daily schedules (Figures 1 and 2), from which the daily energy intake was calculated.
Examples of actual daily schedule ((a) Japanese; (b) English) and time of exercise ((c) Japanese; (d) English) used to evaluate changes in the patient's daily lifestyle and treatment behavior following discharge. The patient submitted these at her monthly examinations, and information such as specific exercise time was used for team evaluation.
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The daily food intake was recorded by photographs and daily schedules (Figures 1 and 2), from which the daily energy intake was calculated. While the patient waited to undergo medical examination, the physical therapist confirmed the patient's lifestyle rhythm (Figures 2(a) and 2(b)) and details of the behavior records (Figures 2(c) and 2(d)) over the preceding month.
Energy intake recorded by the patient during 40 months after the second hospitalization for treatment guidance, plotted with the results of manual muscle testing (MMT). Changes in the home environment (mother illness) at 5 months after discharge were associated with increased daily energy intake and decrease in quadriceps femoris muscle MMT. Canagliflozin was subsequently started at 10 months after discharge in order to deal with these changes and correct blood glucose levels.
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Furthermore, the selected exercise load was applied to improve body composition and enhance the sleep quality (Figure 3). HbA1c level from 8.3% to 7.5% and decrease in body weight from 85 kg to 78 kg within 5 months of hospital discharge (Figure 4). However, at 10 months after discharge, the patient apparently stopped observing the daily energy intake and exercise load (Figure 3). This was confirmed through evaluation of physical strength required for daily lifestyle, such as gait analysis and stability during outdoor walking, stair climbing and descending speed, and a decrease in required nursing care (Figures 3 and 4).
Changes in HbA1c and body weight during the 40 months after the second hospitalization, plotted for treatment guidance. Canagliflozin administration was started at 10 months after discharge in response to changes in energy intake.
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HbA1c level from 8.3% to 7.5% and decrease in body weight from 85 kg to 78 kg within 5 months of hospital discharge (Figure 4). However, at 10 months after discharge, the patient apparently stopped observing the daily energy intake and exercise load (Figure 3). This was confirmed through evaluation of physical strength required for daily lifestyle, such as gait analysis and stability during outdoor walking, stair climbing and descending speed, and a decrease in required nursing care (Figures 3 and 4). HbA1c was at 6.8%, and body weight was 70.8 kg (Figure 4).