ADCES Curriculum

Question 1

What are the ways to dx type 1 or 2?

Answer 1

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)

Question 2

What is diagnosis for GDM using OGTT?

Answer 2

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

Question 3

How is BMI calculated?

Answer 3

Weight in pound x 703 divided by height in inches

Question 4

Waist circumference should be under __ inches for men and < __ inches for women

Answer 4

40 (men), 35 (women)

Question 5

__ oz of fruit juice = 15 g CHO

Answer 5

4 oz

Question 6

__ cup of (cooked) oatmeal, grits, or cream of wheat = 15 g CHO

Answer 6

1/2 cup

Question 7

___ cup of past, rice, or polenta = 15 g CHO

Answer 7

1/3rd

Question 8

Each serving (choice) of milk contains about __ g of CHO

Answer 8

12 grams ( 1 cup milk, 2/3 cup nonfat or low fat yogurt, plain or w/ artificial sweetner)

Question 9

Each serving of non starchy vegetables contains about ___ g of CHO

Answer 9

5 grams (1/2 cup cooked, 1 cup raw)

Question 10

What is the ADAs stance on using the glycemic index?

Answer 10

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

Question 11

Protein does not cause BG to risk after a meal in pt’s with DM2 but does increase ___ response

Answer 11

insulin response; therefore it is not advised to use protein to treat/prevent hypos

Question 12

What is the safe level set for artificial sweeteners called?

Answer 12

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

Question 13

What is the ADA definition of free foods?

Answer 13

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

Question 14

Women should try and get ___ g of fiber daily whereas men should try and get ___ g

Answer 14

25 g; 38 g

Question 15

True or false: whole grains have not been shown to improve BG, but may reduce inflammation and heart disease risk

Answer 15

True

Question 16

Why does ETOH indirectly causing lowering of BG?

Answer 16

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

Question 17

What is considered an adequate amount of K+ in the diet?

Answer 17

4700 mg/day

Question 18

Meal plans for women usually call for __ to ___ CHO servings in a meal; meal plans for men usually call for __ or __

Answer 18

3 to 4 (women)

4 to 5 (men)

Question 19

What components should be incorporated into a fitness plan?

Answer 19

F(reuency)
I(ntensity) 
T(ime)
T(ype)
V(olume)
P(rogression)

Question 20

When should glucose checks be done when assessing BG before/after physical activity?

Answer 20

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

Question 21

Being active at the same time insulin is _____ can cause hypoglyecmia?

Answer 21

Peaking

Question 22

If a pt has already taken shorter acting insulin and does unplanned physical activity, what should be considered to prevent hypos?

Answer 22

May need a snack

Question 23

If using DM pills that may cause hypo, BG should be > ___

Answer 23

90 mg/dL

Question 24

If using insulin, BG should be > __ mg before exercise by less than ____

Answer 24

110; 250 mg/dL

Question 25

What are the best exercise options for a pt with unstable retionpathy?

Answer 25

Walking, low impact aerobics, and stationary cycling

Question 26

What is the duration of action for fixed combo insulins? (NPH/reg or NPH/rapid)

Answer 26

10-16 hours

Question 27

If a pt plans to eat a snack that contains more than ___ g of CHO, an injection of rapid acting insulin may be needed

Answer 27

15 grams

Question 28

Why should regular insulin be taken 30-45 minutes before eating?

Answer 28

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

Question 29

True or false: If regular insulin is taken after eating, it is impossible for that dose to control the glucose rise from that meal

Answer 29

True

Question 30

What must be done prior to administering NPH insulin?

Answer 30

Solution must be gently and throughly mixed before injection is prepared–roll between palms

Question 31

If NPH is taken before breakfast, which meal is most affected by BG rise?

Answer 31

Lunch

Question 32

What can be done to help prevent hypo for pt taking NPH before dinner?

Answer 32

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

Question 33

How often should infusion sets be changed for pt’s using insulin pumps?

Answer 33

every 3 days

Question 34

What is Alpha Lipoic Acid known as?

Answer 34

Thioctic acid. Can be considered a valid treatment option for pt’s with DM neuropathy

Question 35

What does DCCT stand for?

Answer 35

Diabetes Control and Complications Trial

Question 36

What risk factors is pre DM associated with?

Answer 36

Prediabetes is associated with obesity (especially abdominal or visceral obesity), dyslipidemia with high triglycerides and/or low HDL cholesterol, and hypertension.