ADCES Curriculum Flashcards
What are the ways to dx type 1 or 2?
FPG (preferred): plasma glucose >126 mg/dl
OGTT: 75 g OGTT: >200 mg/dL
Random BG test: Doesn’t matter if fasting or not. Can be done at any time. if >200 mg/dL AND classic symptoms of DM (excessive thirst, urination, wt loss)
What is diagnosis for GDM using OGTT?
after 100 g glucose consumed. 2 or more of the following or met or exceeded: Fasting: 95 mg/dL 1 hr: 180 mg/dL 2 hr: 155 mg/dL 3 hr: 140 mg/dL
How is BMI calculated?
Weight in pound x 703 divided by height in inches
Waist circumference should be under __ inches for men and < __ inches for women
40 (men), 35 (women)
__ oz of fruit juice = 15 g CHO
4 oz
__ cup of (cooked) oatmeal, grits, or cream of wheat = 15 g CHO
1/2 cup
___ cup of past, rice, or polenta = 15 g CHO
1/3rd
Each serving (choice) of milk contains about __ g of CHO
12 grams ( 1 cup milk, 2/3 cup nonfat or low fat yogurt, plain or w/ artificial sweetner)
Each serving of non starchy vegetables contains about ___ g of CHO
5 grams (1/2 cup cooked, 1 cup raw)
What is the ADAs stance on using the glycemic index?
Research does not support the GI as a meal planning tool as for a pt with DM
By monitoring your glucose level before a meal and 2 hours later, you can learn how you respond to the CHO in a given meal. This can help you learn how different food affect your BG level
Protein does not cause BG to risk after a meal in pt’s with DM2 but does increase ___ response
insulin response; therefore it is not advised to use protein to treat/prevent hypos
What is the safe level set for artificial sweeteners called?
The acceptable daily intake (ADI) ; there is a 100 fold safety factor built into ADI
All sweeteners approved by the FDA are also safe for pregnant woman and children
What is the ADA definition of free foods?
Foods that contain < 5 g of CHO or less and <20 kcals per serving
ADA recommends limiting free foods to 3 or less per day
Women should try and get ___ g of fiber daily whereas men should try and get ___ g
25 g; 38 g
True or false: whole grains have not been shown to improve BG, but may reduce inflammation and heart disease risk
True
Why does ETOH indirectly causing lowering of BG?
The body will process ETOH first at the expense of digesting food
ETOH should always be taken w/ food and in moderation, esp for those on insulin or SU
What is considered an adequate amount of K+ in the diet?
4700 mg/day
Meal plans for women usually call for __ to ___ CHO servings in a meal; meal plans for men usually call for __ or __
3 to 4 (women)
4 to 5 (men)
What components should be incorporated into a fitness plan?
F(reuency) I(ntensity) T(ime) T(ype) V(olume) P(rogression)
When should glucose checks be done when assessing BG before/after physical activity?
Minutes before starting and minutes after ending; when undertaking new activity may be helpful to check every 30 minutes or so during activity
May also need to check an hour after end of activity
Being active at the same time insulin is _____ can cause hypoglyecmia?
Peaking
If a pt has already taken shorter acting insulin and does unplanned physical activity, what should be considered to prevent hypos?
May need a snack
If using DM pills that may cause hypo, BG should be > ___
90 mg/dL
If using insulin, BG should be > __ mg before exercise by less than ____
110; 250 mg/dL
What are the best exercise options for a pt with unstable retionpathy?
Walking, low impact aerobics, and stationary cycling
What is the duration of action for fixed combo insulins? (NPH/reg or NPH/rapid)
10-16 hours
If a pt plans to eat a snack that contains more than ___ g of CHO, an injection of rapid acting insulin may be needed
15 grams
Why should regular insulin be taken 30-45 minutes before eating?
To give the insulin a “head start”, as it takes 30-60 mins for regular insulin to enter the bloodstream. After eating, food is actively raising BG for the next 1-2 hours
True or false: If regular insulin is taken after eating, it is impossible for that dose to control the glucose rise from that meal
True
What must be done prior to administering NPH insulin?
Solution must be gently and throughly mixed before injection is prepared–roll between palms
If NPH is taken before breakfast, which meal is most affected by BG rise?
Lunch
What can be done to help prevent hypo for pt taking NPH before dinner?
Eating enough a dinner, and having a snack before going to bed
If NPH is taken at bedtime it will peak during early morning hours which may control glucose rise during this time
How often should infusion sets be changed for pt’s using insulin pumps?
every 3 days
What is Alpha Lipoic Acid known as?
Thioctic acid. Can be considered a valid treatment option for pt’s with DM neuropathy
What does DCCT stand for?
Diabetes Control and Complications Trial
What risk factors is pre DM associated with?
Prediabetes is associated with obesity (especially abdominal or visceral obesity), dyslipidemia with high triglycerides and/or low HDL cholesterol, and hypertension.
