Exam 2 Flashcards
How many gm CHO of fruit is one serving?
15 gm CHO
How many gm CHO of grains is one serving?
15 gm CHO
How many gm CHO of dairy is one serving?
12 gm CHO
How many gm CHO of starch veggies is one serving?
15 gm CHO
How many gm CHO of non-starchy veggies is one serving?
5 gm CHO
What are examples of 1 serving size of fruit?
-1 small fresh fruit (apple or orange)
-1/2 cup fruit juice, canned fruit, fresh fruit (ex: pineapples cut up)
-1/4 cup dried fruit
What are examples of 1 serving size of grains?
-1/2 small bagel or english muffin
-1 slice of bread or 1/2 a hamburger bun
-1 tortilla
-1/2 cup cereal
-1/3 cup of rice or pasta
What are examples of 1 serving size of dairy?
-1 cup milk
-1 cup yogurt
What are examples of 1 serving size of starchy veggies?
-1/2 cooked beans, peas, or corn
-1 small potato
-1/4 cup sweet potato, squash (winter, acorn, butternut)
What are examples of 1 serving size of non-starchy veggies?
-1 cup raw veggies
-1/2 cup cooked veggies
-1/2 cup tomato juice
How much is one serving size of protein?
2-3 oz
What are examples of 1 serving size of protein?
-Lean meat, poultry, fish
-1 egg
-1 oz cheese
-1/4 cup cottage cheese
-2 tbsp peanut butter
What are examples of 1 serving size of fat?
-1/8 avocado
-1 tsp oil, butter, margarine
-1 slice bacon
-1 tbsp cream cheese
-2 tbsp sour cream
-1 tbsp French/Italian dressing
What are examples of healthy fats that should be consumed more?
Olives, nuts, avocados
True or False:
Saturated fats and cholesterol should be limited
False – trans fats and cholesterol should be limited
What is the onset of rapid insulin?
10-30 min
What is the peak of rapid insulin?
30 min- 3hr
What is the duration of rapid insulin?
3-5 hr
What is the onset of short/regular insulin?
30 min - 1hr
What is the peak of short/regular insulin?
2-5 hr
What is the duration of short/regular insulin?
5-8 hrs
What is the onset of intermediate/NPH insulin?
1.5 - 4 hr
What is the peak of intermediate/NPH insulin?
4-12 hrs
What is the duration of intermediate/NPH insulin?
12-18 hr
What is the onset of long acting insulin?
0.8 - 4 hr
What is the peak of long-acting insulin?
less defined/not pronounced
What is the duration of long-acting insulin?
16-24 hrs
What are examples of rapid acting insulins?
1) Lispro (HumaLog)
2) Aspart (NovoLog)
3) Glulisine (Apidra)
What are examples of long acting insulin?
1) Glargine (Lantus)
2) Detemir (Levemir)
3) Degludec (Tresiba)
What type of insulin is the most likely to cause hypoglycemia?
Short-acting because duration of action is longer
What types of insulin are used to control blood glucose between meals/overnight?
Intermediate & long-acting
What insulins should be given at mealtime?
Short-acting & rapid
What are the 2 combinations of mixed insulins?
1) Intermediate & short
2) Intermediate & long
If drawing up 2 types of insulin, how do you draw them up?
Clear before cloudy (NPH)
What are the T2DM meds?
1) Metformin
2) DPP-4 inhibitors
3) GLP-1 & dual GLP-1/GIP receptor agonsits
4) SGLT2 inhibitors
5) Sulfonylureas
6) Type 2 diabetics
What is the first medication choice for a T2D?
Metformin
How does metformin decrease BG?
1) Suppress glucose output by liver
2) Improve insulin sensitivity in peripheral tissues
3) Decrease intestinal absorption of glucose
What T2D med is well-tolerated, and does not cause weight gain or risk of hypoglycemia?
DPP-4 Inhibitors
What is insulin produced by?
Beta cells
What are the functions of insulin?
1) Stims active transport of glucose into muscle & fat cells
2) Promotes conversion of glucose to glycogen for storage
3) Stims protein synthesis
4) Promotes conversion of fatty acids into fat
What is glucagon synthesized by?
Alpha cells
What kind of agent is insulin?
Hypoglycemic agent
What kind of agent is glucagon?
Hyperglycemic agent
True or False:
Glucagon works in opposition of insulin
True
What are the counterregulatory hormones?
Cortisol
Epinephrine
Growth hormone
Why does T1DM occur (patho)?
D/t destruction of beta cells, so not enough insulin can be produced
What autoimmune diseases usually trigger T1DM?
Celiac, Crohns, and Lupus
Why does T2DM occur (patho)?
Defects at the cell membrane prevent insulin action – causing insulin resistance
What are modifiable RFs for T2DM?
-Obesity
-Physical inactivity
-Lipid levels (high tris and low HDL)
What are non-modifiable RFs of T2DM?
-1st degree relative
-Ethnicity
-Birthing big baby
-HTN
-PCOS
What are the main sx of T1DM?
Polyuria, Polydipsia, Polyphagia
*More sudden/rapid onset
What are the sx of T2DM
-Recurrent infections
-Poor wound healing
-Blurred vision
-Less often 3 Ps
-Wt loss
-Fatigue
What are the diagnostic testings for DM?
1) Sx with random plasma glucose
2) HA1C
3) Fasting plasma glucose
4) OGTT
What is the only test that does not have to be repeated and is considered diagnostic?
Sx with random plasma glucose >/= 200 mg/dL
What would be considered diabetic results for an OGTT?
> /= 200 mg/dL
What would be considered a diabetic result for a fasting plasma glucose?
> /= 126 mg/dL
What would be considered a diabetic result for someone with sx and a random plasma glucose test?
> /= 200 mg/dL
What would be considered diabetic results for an HA1C test?
6.5% or above
What is HA1C?
1) measures amount of glucose bound to RBCs
2) Shows avg blood glucose values overtime (6-8 weeks)
What is a normal HA1C value?
4-6%
What is the goal HA1C for a diabetic patient?
</= 7%
What is a normal fasting plasma glucose?
70-100/110
What are examples of carbs that should be eaten more?
Whole, unprocessed, non-starchy veggies
- Green beans
- Cucumbers
- Broccoli
- Tomatoes
What are the 3 main types of carbs?
Starches, Sugars, Fiber
What are examples of carbs that should be eaten in moderation?
-Fruits
-Brown rice
-Whole wheat bread
-Starchy veggies (potatoes, corn)
-Beans
What are examples of carbs that should be eaten less?
Refined, highly processed foods
-Soda, white bread, sugary cereal
When does lipodystrophy occur?
When injection site is not changed frequently
What is lipodystrophy?
Atrophy (indentation) or hypertrophy (thickening/scar tissue) of subQ tissue
What is Dawn’s Phenomenon?
Increased BG in the early AM caused by hormone release
-Most common in T1DM
What is the Somogyi Effect?
Excess insulin dosage at night (common in T1DM) resulting in decreased BG
True or false:
Insulin can worsen hyperkalemia
False – insulin can worsen hypokalemia
What causes macrovascular comps?
Diseases of large & medium-sized blood vessels
What causes microvascular comps?
Thickening of vessel membranes in the capillaries and arterioles in response of chronic hyperglycemia
What are the common microvascular complications of DM?
-Retinopathy (eyes)
-Nephropathy (kidneys)
-Neuropathy (nerves)
What are RFs of macrovascular comps?
-Obesity
-HTN
-Smoking
-High fat intake
-Sedentary
What are the classifications of diabetic retinopathy?
1) Non-proliferative
2) Proliferative
