Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Nutrition 1 Final McGill Uni > Diabetes Dietary Effect > Flashcards

Diabetes Dietary Effect Flashcards

1
Q

Why applying Diet Therapy (3)

A

1. encourage the attainment or maintenance of a healthy body weight
2. achieve the best possible metabolic control (w/o seriously compromising quality of life (glycemic control, lipid profile, BP))
3*.to delay or prevent complication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Goals of Diet therapy (3)

A
  1. provide specific guidelines for a different stage in the life cycle (as DM is a long term disease)
    2*. to promote self-care ( by providing the necessary knowledge, skills, resources and support)
  2. to encourage overall health (by practical instructions in optimal nutrition)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

On the nutrition Checklist: refer? follow? individualize? choose? know? encourage (2)?

A

refer to RD for NUTR counselling; follow CFG; individualise the dietary advice by preference and Tx goals; choose low GI food; know the alternative dietary patterns for DM2; Encourage matching insulin to CHO in DM1; encourage the balanced calorie-reduced diet in pt with O/W and obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

the procedure of nutritional management of hyperglycemia in DM2

A
  1. clinical assessment by RD (+ healthy behaviour intervention)
  2. to achieve/ maintain a healthy body weight by initiating an intensive healthy behaviour interventions or energy restriction + PA
  3. provide counselling in a diet tailored to individuals
  4. if not at target, continue healthy behaviour interventions and add pharmaco-therapy
  5. timely adjustment to interventions:
    Healthy behaviour inter. : 2 to 3 months to attain A1C; if combining with Pharmaco-therapy: 3 to 6 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diabetes Canada: Macro-nutrient component in a diet

A

CHO :45-60%
Protein: 15-20%
Fat:20-35%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Diabetes Canada:
why should more than 45%
the limitations (3)

A
  • to prevent high intake of Sat fat to incr. risk of CVD
    1. minimum intake: 130g/d
    2. <10% added sugar (sucrose)
    3. at high range ~ 60%: should inclue low GI food and high fibre intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

def. Glycemic Index (GI)

A
  • area under the curve, AUC, in blood glucose response of a given food, compared to standard for the same content in g of CHO
  • with the scale 0-100
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what’s glucose standard?

A
  • CHO or white bread
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

def. glycemic load

A

the accounts for available CHO in portion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How to calculate glucose load?

A

glucose load=#g CHO content in the given food * GI/100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How to calculate GI?

A

AUC given food/AUC glucose(the same content CHO) *100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

standard range GI:
low
Medium
high

A

L: no more than 55
M: 56-69
H: no less than 70
no unit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

standard range GL:
low
Medium
high

A

L: no more than 10
M: 11-19
H: no less than 20
no unit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T/F High GI must be with a high GL

A

F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T/F high GL must cause a high GI

A

F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T/F a high GL food may be high GI

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

T/F a high GI food may be with low GL

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give 5 dietary factors affecting glycemic response and give one example for each

A
  1. Dietary fibre: oats
  2. cooking method: the harder texture of pasta
  3. other nutrient presence: yogurt
  4. low eater
  5. digestibility
19
Q

why DM pts should intake more dietary fibres, especially soluble fibre?

A

it will be the bulky agent in the gut to slow down the gastric emptying and glucose absorption

20
Q

what’s the guideline of fibre: (2)

A
  1. total 30-50g/d
    1/3 from viscous soluble fibre
  2. food: pulses, whole grains, F/V
21
Q

Sugar: the guideline and why

A

<10%, if beyond, it incre. Blood Glucose and TG

22
Q

why sugar is substituted by fructose

A

frudctose does not affect the blood glucose after eating, so can help lower A1C level

23
Q

what is the concern to fructose (3)

A
  • HFCS: high-fructose corn syrup is no different from sugar
  • > 10%, it still affects TG in DM2 although it lowers the A1C level
  • fructose from F/V is no harm, but the high GI fruits should be concern (pineapple, mango, papaya)
  • sugar-sweetened beverage
24
Q

How is low-carb diet in terms of effect on DM pts ?

A
  1. in the short term, there is some improvement in weight loss but not consistent after 12 months
  2. an improvement of A1C if pts are adherent, but the adherence is modest overall (limited studies in CM1)
25
Q

What is low-Carb diet?

A

CHO of 4% to 45% of total energy

ketogenic diet: carb below 25%

26
Q

What is low-Carb diet?

A

CHO of 4% to 45% of total energy

ketogenic diet: varb below 25%

27
Q

Is it harmful in terms of low-carb diet? (3)

A

it is not harmful overall, but we should consider the specific conditions.

  1. for DM pts, it is easier to trigger ketoacidosis to the one following insulin treatment
  2. it also affect the medication with Na-Glucose transport?
  3. blunt response to glucagon injection under a severe hypoglycemic condition (the stimulus cannot induce glycogen, as there is no storage to release.)
28
Q

what to consider in terms of fat?

A

the main risk factor of CVD

29
Q

How to resolve the concern of fat?

A
  • avoid trans fatty acids
  • limit sat fat less than 9% of NRG
  • replace sat fat from meat to other sources of PUFAs, MUFAs OR LOW-GI Carbs
30
Q

How about intaking omega-3 supplements?

A

NOT rec.

  • no benefits on CVD or mortality
  • may decr. TG level and platelet aggregation
31
Q

How about fish?

A

High intake of fish can reduce the risk of CVD, kidney disease in DM2, and less albuminemia in DM1.

2-3 servings /week

32
Q

why highly recommend Mediterranean diet to DM pts?

A
  • reduce A1C
  • reduce CVD risk
  • no disadvantage
    the same as DASH and Portfoil
    But M diet also can reduce the risk of retinopathy
33
Q

what is the disadvantage and concern of vegetarian diet?

A
  • Low B12 absorption

- need adjust medication in order to improve glycemia and lipids

34
Q

Five types of diet

A

Mediterranean, Portfolio, Vegetarian, DASH(HTN + 1 RCT), Nordic (MetS)

35
Q

How do you suggest the pt who is a moderate EtOH

A
  • limit 2 drinks/d for F, or no more than 3 drinks/d for M.
  • no big effect on BG if having with meals
  • actually it helps to inverse A1C status and lower risk of CHD (coronary heart disease) in DM2
36
Q

How do you remind a pt who often drink EtOH

A
  • it may mask symptoms of hypoglycemia and increase ketones
37
Q

How do you remind a pt who is going intermittent fasting?

A
  • the same benefits as continous NRG restriction

- but should careful monitoring of medication on fasting days

38
Q

How do you remind a pt who is following Ramadan?

A
  • close self-monitor
  • prevent the risk of hypoglycemia in insulin treatment
  • discourage who had hx of severe hypoglycemia
39
Q

How do you remind a pt who hv followed insulin Tx when drinking EtOH?

A
  • remind: there is a delayed hypoglycemia after drinking with meals
40
Q

4 special concerns with insulin Tx

A
  1. regularity of meal spacing and CHO content may help glycemic control
  2. if the pt tends to consume diets low in fibre, high in fat and protein, it shows requiring more insulin (less insulin, spontaneously low CHO consumption)
  3. snacking: helps to avoid hypoglycemia and balance potential Wt gain
  4. Bed-time protein snack: prevent nocturnal hypoglycemia
41
Q

what are the 5 stage-targeted strategies for DM2?

A
  1. pre-diabetes
  2. early type 2 diabetes
  3. Not on insulin
  4. on basal insulin only
  5. on basal-bolus insulin
42
Q

what is the most significant difference among the 5 stage-targeted strategies for DM2(3+1)?

A

pre-DM: induce low GI CHO + reduce refined CHO

DM w/o insulin: CHO distribution, low GI + high fibre

W/ insulin Tx: CHO consistancy, low Gi+high fibre
* in basal-bolus therapy: CHO distribution initially then learn CHO counting

43
Q

How to self-care glycemic level during illness?

A
  1. no less than 4 days of SMBG
    b/c it is hard to follow the diet and undesired syndrome or coma may occur if due to dehydration or infection
  2. keep hydrate: 250ml - 370ml/hr
  3. F/V: drink semi-liquid containing CHO ( in case of vomiting lol)
  4. consulting MD if cannot tolerate if BS > 20 mM,…. DM symptoms, liquid intolerance

Clinical Nutrition 1 Final McGill Uni (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions