Diabetes Mellitus

Question 1

The primary organ involved in the disease process of type 1 diabetes mellitus is the

a. adrenal gland.
b. pancreas.
c. kidney.
d. liver.

Answer 1

b. pancreas.

For glucose to be used by the cells in the body, it first must be taken out of the blood and put into the cell. The hormone insulin must be present. Insulin is produced by the cells of the pancreas. Thus the pancreas is the organ involved in the disease process of type 1 diabetes mellitus.

Question 2

The factors that seem to play a role in the development of type 2 diabetes mellitus are

a. weight and heredity.
b. liver disease.
c. enzyme deficiencies.
d. childhood illnesses.

Answer 2

a. weight and heredity.

Weight and heredity seem to play a role in the development of type 2 diabetes mellitus. Unlike type 1 diabetes, type 2 is not caused by an autoimmune response. Weight and heredity seem to play a role in the development of type 2 diabetes.

Question 3

Type 2 diabetes is most common in

a. infants.
b. children.
c. adolescents.
d. older adults.

Answer 3

d. older adults.

Question 4

Acidosis, underweight, and rapid onset are characteristics of _____ diabetes.

a. type 1
b. type 2
c. gestational
d. secondary

Answer 4

a. type 1

Type 1 diabetes presents with unintentional weight loss, polydipsia, polyphagia, and polyuria, and acidosis can occur if the disease is left untreated.

Question 5

Which of the following describes characteristics of type 2 diabetes?

a. Requires insulin and is a milder form of the disease
b. Acidosis is present and the onset is rapid
c. Acidosis is present and the form is more severe
d. Improves with weight loss

Answer 5

d. Improves with weight loss

Question 6

Other symptoms that may be present in patients with diabetes include

a. paralysis and loss of hearing.
b. diarrhea and gastrointestinal upset.
c. fainting and amnesia.
d. skin infections and weakness.

Answer 6

d. skin infections and weakness.

In addition to early signs of diabetes, additional signs may include blurred vision, skin irritation or infection, and general weakness or loss of strength.

Question 7

Uncontrolled diabetes is related to the abnormal metabolism of

a. carbohydrates and proteins.
b. proteins and fats.
c. carbohydrates and fats.
d. carbohydrates only.

Answer 7

c. carbohydrates and fats.

Uncontrolled diabetes causes alterations in glucose metabolism as well as abnormal metabolism of proteins and fats. Protein tissues are broken down in the body’s effort to secure energy sources, causing weight loss and urinary nitrogen loss. Fat tissue, in the absence functioning insulin, breaks down. However, normal lipolysis (fat breakdown) requires an adequate supply of glucose, which in turn relies on the help of insulin to accept glucose into the cell. Therefore intermediate products of fat breakdown, called ketones, accumulate in the body.

Question 8

The normal range for blood glucose is _____ mg/dL.

a. 20 to 50
b. 50 to 100
c. 70 to 110
d. 100 to 150

Answer 8

c. 70 to 110

A value above this is considered hyperglycemia. Normal control mechanisms ensure that people always have sufficient circulating blood sugar, glucose, to meet constant energy needs—even the basal metabolic energy needs during sleep—because glucose is the body’s preferred fuel.

Question 9

The largest portion of islet cells are the cells that synthesize

a. glucagon.
b. insulin.
c. somatostatin.
d. growth hormone.

Answer 9

b. insulin.

The largest portion of islet cells are the cells that synthesize insulin, a hormone. Insulin must be present for glucose to be carried into the cell.

Question 10

The hormone that is synthesized by the pancreatic islet cells is

a. glycogen.
b. ketone.
c. somatostatin.
d. insulin.

Answer 10

c. somatostatin

is the pancreatic hormone that acts as a “referee” for several other hormones affecting blood glucose levels. It is produced in the cells of the pancreatic islets, scattered between the á and â cells and making up approximately 10% of each islet’s cells.

Question 11

If the diet prescription for type 1 diabetes allows 2200 kcal, and if the common distribution of kilocalories is followed, then the number of grams of carbohydrates in the diet plan should be _____ g.

a. 50
b. 100
c. 200
d. 275

Answer 11

d. 275

Approximately 50% of total kilocalories should be supplied from carbohydrates. In this case, 2200 kcal (50%) = 1,100 kcal ÷ 4 g/kcal = 275 kcal.

Question 12

A food that is not in the meat group of the Choose Your Foods: Exchange Lists for Diabetes is

a. cottage cheese.
b. shrimp.
c. egg.
d. milk.

Answer 12

d. milk.

it is in a separate group from the meat and meat substitute group.

Question 13

Studies indicate that exercise

a. decreases insulin efficiency.
b. stimulates the release of insulin.
c. increases the number of insulin receptors on muscle cells.
d. raises blood glucose levels.

Answer 13

c. increases the number of insulin receptors on muscle cells.

exercise helps control blood glucose and reduces the risk of cardiovascular disease, hyperlipidemia, hypertension, and obesity.

Question 14

Mr. Jones comes into the clinic and is 20 lb above his desirable weight and has type 2 diabetes. A recommendation to Mr. Jones would be to

a. increase kilocalories.
b. include between-meal snacks.
c. take extra food during exercise.
d. lose weight.

Answer 14

d. lose weight.

Maintaining a proper weight will decrease complications associated with diabetes, including high blood sugar and the risks of cardiovascular disease, hyperlipidemia, hypertension, and obesity.

Question 15

The form of insulin designed to last between 18 and 24 hours is the

a. rapid-acting form.
b. intermediate-acting form.
c. long-acting form.
d. oral hypoglycemic agent.

Answer 15

b. intermediate-acting form.

Intermediate-acting (NPH) insulin can last from 18 to 24 hours. The onset of action is from 1 hour up to 3 hours, with a peak action ranging from 7 to 14 hours.

Question 16

A high intake of saturated fats is associated with

a. hepatitis.
b. diabetes.
c. coronary artery disease.
d. nephropathy.

Answer 16

c. coronary artery disease.

results from a high intake of saturated fat in the diet. The percentage of energy from fat for a person with diabetes should be between 25% and 30%. Saturated fat should comprise less than 10% of fat calories. No more than 300 mg/day should be provided as cholesterol.

Question 17

Women with a history of gestational diabetes mellitus are at risk for developing

a. chronic kidney disease.
b. type 2 diabetes.
c. type 1 diabetes.
d. morbid obesity.

Answer 17

b. type 2 diabetes.

It is important to control blood sugar during pregnancy and to maintain a balanced diet, perform regular exercise, maintain a healthy BMI, and keep regular follow-up visits with their physician.

Question 18

Type 2 diabetes usually appears after the age of _____ years.

a. 30
b. 40
c. 50
d. 60

Answer 18

b. 40

Question 19

The protein component for an adult with diabetes is approximately

a. 15-35% of total energy intake.
b. an increased amount equal to 25% of total calories.
c. a decreased amount equal to 10% of total calories.
d. individual choice of the patient.

Answer 19

a. 15-35% of total energy intake.

High protein intakes are generally not recommended because of their saturated fat content and unnecessary stress on the kidneys to excrete excess nitrogen.

Question 20

The nonnutritive sweetener that is composed of two amino acids is

a. saccharine.
b. aspartame.
c. cyclamate.
d. acesulfame-K.

Answer 20

b. aspartame.

is made from two amino acids: phenylalanine and aspartic acid.

Question 21

The percentage of energy from fat for a person with diabetes should be

a. 5% to 10%.
b. 15% to 20%.
c. 25% to 30%.
d. 30% to 35%.

Answer 21

c. 25% to 30%.

Saturated fat should comprise less than 10% of fat calories. No more than 300 mg/day should be provided as cholesterol.

Question 22

The hormone considered to act in a manner opposite to insulin is

a. glucagon.
b. somatostatin.
c. growth hormone.
d. adrenaline.

Answer 22

a. glucagon.

It can rapidly break down stored glycogen and, to a lesser extent, fat.

Question 23

Commonly used nonnutritive sweeteners include

a. sorbitol.
b. aspartame.
c. honey.
d. fructose.

Answer 23

b. aspartame.

which is made from two amino acids: phenylalanine and aspartic acid.

Question 24

Increasing the fiber content of the diabetic diet tends to

a. raise the blood glucose level.
b. lower the blood glucose level.
c. result in weight loss.
d. decrease formation of ketones.

Answer 24

b. lower the blood glucose level.

As with all people, consumption of dietary fiber is encouraged for a healthy diet. There are no reasons for individuals with diabetes to consume greater amounts than others.

Question 25

It is recommended that no less than 130 grams (520 kcal) in the diabetic diet come from

a. carbohydrates.
b. fiber.
c. protein.
d. fats.

Answer 25

a. carbohydrates.

Low carbohydrate diets restricting carbohydrates to less than 130 grams is not recommended for managing diabetes. Carbohydrates are required in a balanced diet to provide energy.

Question 26

The accumulation of glucose in the blood is called

a. glycosuria.
b. polydipsia.
c. hyperglycemia.
d. hypoglycemia.

Answer 26

c. hyperglycemia.

The accumulation of glucose in the blood is called hyperglycemia and the presence of low glucose in the blood is called hypoglycemia.

Question 27

Which of the following functions is not associated with the hormone insulin?

a. Moves glucose into the cell
b. Inhibits fat breakdown
c. Converts glucose into glycogen
d. Mobilizes liver glycogen to yield glucose

Answer 27

d. Mobilizes liver glycogen to yield glucose

Insulin circulates glucose into cells by way of specialized insulin receptors, helps change glucose to glycogen and store it in muscles and liver, stimulates the change of glucose to fat for storage as body fat, inhibits the breakdown of tissue fat and protein, promotes uptake of amino acids by skeletal muscle, and influences the burning of glucose for constant energy as needed.

Question 28

Ketones are a by-product of the metabolism of

a. carbohydrates.
b. proteins.
c. fats.
d. alcohol.

Answer 28

c. fats.

Fat breakdown is called lipolysis. However, normal lipolysis requires an adequate supply of glucose, which in turn relies on the help of insulin to accept glucose into the cell. Therefore intermediate products of fat breakdown, called ketones, accumulate in the body.

Question 29

If diabetes is suspected, the patient should be given which of the following tests?

a. Fasting blood glucose level
b. Insulin level
c. Hemoglobin level
d. Glucose tolerance test

Answer 29

d. Glucose tolerance test

A glucose load equivalent of 75 g anhydrous glucose dissolved in water is administered. A 2-hour plasma glucose level of 200 mg/dL or greater serves as the criterion for the diagnosis of diabetes mellitus.

Question 30

The three common long-term complications of diabetes affect the cells of the

a. pancreas, liver, and spleen.
b. kidney, eye, and nerve tissue.
c. kidney, liver, and spleen.
d. heart, liver, and brain.

Answer 30

b. kidney, eye, and nerve tissue.

Long-term complications of diabetes affect the kidney (nephropathy), eye (retinopathy), and nerve tissue (neuropathy).