Diabetes and Hypoglycemia

Question 1

when should you screen for diabetes?

Answer 1

overweight with 1 of the following
sedentary
first degree relative with diabetes
african american, latino, native american, asian american, pacific islander
women who had gestational diabetes or delivered a baby >9lbs
hypertensive
low HDL
women with PCOS
A1C >5.7%
acathosis nigricans
history of CVD

Question 2

normal blood glucose

Answer 2

fasting <100mg/dL
2hPG <140 mg/dL
A1C 4-5.6%

Question 3

prediabetes blood glucose

Answer 3

fasting 100-125 mg/dL
2 hPG in 75g oral glucose tolerance test (140-199mg/dL)
A1C 5.4-6.4%

Question 4

diabetes blood glucose

Answer 4

A1C >6.5%
FPG >126mg/dL
2hPG >200 mg/dL

Question 5

nutritional recommendations for prediabetes

Answer 5

weight loss
medeterranean diet
increase fiber
including whole grains
limit sugar sweetened beverages
replace saturated fat with MUFA and PUFA

Question 6

diabetes goals of nutrition therapy

Answer 6

maintain optimal glucose, blood lipids and blood pressure values
prevent and treat chronic complications (obesity, dyslipidemia, CVD, HTN, nephropathy)
enhance health through food choices and physical activity
address individual nutritonal neds

Question 7

diabetes of macronutrient intake

Answer 7

recommendations are the same as non-diabetic patients
protein= 15-20% cal
lipids= 30% cal (sat= <7% cal, NO trans fat)
carbs= 45-64% cal (minimum 130g/day
fiber 25-38g/d

Question 8

carb counting

Answer 8

best method of maintaining blood glucose
total intake of CHo intake, not cource
count starches, fruits, dairy, sweets
nonstarchy veggies don’t need to be counted as long as <15g CHO are no eaten

Question 9

exercise for type 1 diabetes

Answer 9

check blood sugar before, during and after

consume 15g of carbs per every 30-60 min of exercise (prior to exercise)

Question 10

exercise for type 2 diabetes

Answer 10

exercise can help improve glycemic response

often have a lower VO2 max

Question 11

exercise recommendations

Answer 11

minimum of 150 min/week of moderate intensity aerobic activity
no more than 2 consecutive days without activity
adults with type 2 diabetes are encouraged to perform resistance exercise at least 2x/week

Question 12

short term complications of diabetes

Answer 12

diabetic ketoacidosis (life threatening)
macrovascular (ASCVD)

Question 13

long term complications fo diabetes

Answer 13

macrovascular (ASCVD)

microvascular (nephropathy, retinopathy, neuropathy)

Question 14

60-70% of diabetics have what complication?

Answer 14

neuropathy

Question 15

definition of hypoglycemia of nondiabetic origin

Answer 15

abnormally low blood glucose

Question 16

etiology of hypoglycemia of nondiabetic origin

Answer 16

reactive hypoglycemia= blood glucose drops 2-5 hours after eating (excess insulin or insulin-like compounds)
fasting hypoglycemia (signals underlying disease like eating disorder, liver disase, aspirin therapy)

Question 17

whipple triad

Answer 17

low blood glucose (<50mg/dL)
weakness, fatigue, sweating, palpitations
symptoms disappear with carb ingestion and blood glucose returns to normal
(MUST HAVE ALL 3)

Question 18

hypoglycemia nutrition therapy

Answer 18

small, frequent meals with complex carbs, fiber and protein
carb counting
avoid simple carbs and alcohol
limit caffeine