DM Nutrition Flashcards
What are the elements of metabolic syndrome?
- High TGs
- HTN
- Central obesity
- Low HDL
- Hyperglycemia
What is the range of fasting plasma glucose to diagnose DM?
> 126 mg/dl
What is the range of random plasma glucose to diagnose DM?
> 200 mg/dl + symptoms
What is the HbA1c level to diagnose DM?
> 6.5%
What are the cells that are attacked in DM I?
Beta cells in the pancreas
Why is the C peptide level important when assessing hypoglycemia?
Exogenous insulin does not have C peptide (think munchausen’s syndrome)
What happens with amino acids uptake and synthesis with insulin?
Increase
What happens with FA synthesis with insulin action?
Increases
What happens with glycogen synthesis with insulin action?
Increases
What happens to glycolysis with insulin action?
Increases
What happen to gluconeogenesis with insulin action?
Decreases
What happen to lipolysis with insulin action?
Decreases
What happen to proteolysis with insulin action?
Decreases
Increase or decrease insulin secretion: increased blood glucose
Increase
Increase or decrease insulin secretion: leptin secretion
Decreases
Increase or decrease insulin secretion: increased amino acids
Increases
Increase or decrease insulin secretion: Increased FAs
Increases
Increase or decrease insulin secretion: incretin hormone
Increases
Increase or decrease insulin secretion: sympathetic nervous system stimulation
Decreases
Increase or decrease insulin secretion: Acetylcholine
Increases
Increase or decrease glucagon secretion: sympathetic nervous system stimulation
Increased
Increase or decrease glucagon secretion: increased circulating AAs
Increased
Increase or decrease glucagon secretion: increased circulation of FAs
decreased
Can the brain use ketones?
Yes, but only at the very end
Epinephrine acts on which pancreatic cells?
alpha and beta cells
What is the role of Epinephrine on blood glucose/FA levels?
Increases energy available to the blood
What is the role of cortisol on protein/fat metabolism?
Maintains glucose/fat metabolism
True or false: DM II pts do not have an insulin deficiency, only insulin resistance
False- there is some insulin deficiency
What is the scale that the glycemic index uses?
0-100
What is the standard reference for the glycemic index?
Glucose or white bread
How many grams of carbs are eaten when testing the glycemic index?
50 grams
What is the glycemic load?
Glycemic index multiplied by the carb serving
What is the best way to achieve glycemic control?
Total carb intake regulation
What is the BMI that above which is concerning for DM?
> 25
Giving birth to a baby that is greater than what weight is considered a risk factor for DM?
9 lbs
What is the HDL level below which is concerning for DM?
What is the Triglyceride level above which is concerning for DM?
> 250 mg/dl
What is the disease specific to women that leads to insulin resistance
Polycystic ovarian syndrome
Why is visceral fat concerning?
More metabolically active
What is the equation to determine metabolic rate for males and females?
Males = (lbs x 11) Females = (lbs x 10)
Losing what percent of weight has been shown to improve glycemic control?
10%
Postprandial levels of BG are reflective of what?
How many carbs taken in
What is viscous fiber?
Aids in blood sugar control
What is gum/pectin fiber?
gel-like substance from fruits/vegetables
What is the function of incompletely fermented fiber?
Enhance digestion
What is the function of cellulose?
Substrate for microbial fermentation
Adds stool bulk
What is the function of hemicellulose?
Substrate for microbial fermentation
What is the function of lignin?
Binds to bile acids to prevent reabsorption in the intestines
Broccoli stems, seeds and nuts have what type of fiber?
Lignin
Skin of corn kernels have what type of fiber?
Hemicellulose
Wheat bran, fruit, and veggies have what type of fiber?
Cellulose
What percent of total calories for DM pts should come from: carbs?
45-65%
What percent of total calories for DM pts should come from: fat?
10-35%
What percent of total calories for DM pts should come from: sat fats?
What is the recommendation for cholesterol intake for DM pts?
What is the recommendation for fiber intake for DM pts?
38 g/day male
25 g /day female
With nephropathy, DM pts should limit protein intake to what percent of total calorie intake?
10%
Carb counting is better for which type of DM?
Type I
Foods with near zero CHOs are what?
Meats
What is the fasting glucose target for DM pts?
90-130 mg/dl
What is the HDL target for DM pts?
> 50 mg/dl
What is the random glucose target for DM pts?
90-130 mg/dl
What is the triglyceride level target for DM pts?
What is the LDL target for DM pts?
