EXAM #2: DIABETES AND NUTRITION

Question 1

What is nutritional medicine?

Answer 1

• Understanding the nutrients are essential for proper functioning
• Nutritional plan should come before drug treatment

Question 2

What are the goals of Medical Nutritional Therapy (MNT) in treating Diabetes?

Answer 2

1) Healthful eating pattern
2) Individualized glycemic, blood pressure, and lipid goals
3) Achieve/ maintain body weight goals
4) Delay/ prevent DM complications

Question 3

What is one of the main dietary macro-nutrient to consider in MNT for DM?

Answer 3

Carbohydrates

Question 4

What are the three levels of carb counting?

Answer 4

1) Basic
2) Intermediate
3) Advanced

Question 5

What are the key concepts of basic carb counting?

Answer 5

• Awareness of which foods contain carbohydrates
• Portion sizes
• Avoidance of sweetners
• Maintaining carbohydrate consistency

Question 6

What are the key concepts of intermediate carb counting?

Answer 6

• Understanding how glucose levels are affected by medications and physical activity
• Focus on carb control to reduce weight

Question 7

What is advanced carb counting?

Answer 7

DM-I needing to calculate carbohydrate:insulin levels ratios

Question 8

What are the initial carbohydrate goals?

Answer 8

45-60 grams per meal

15-20 grams per snack

Question 9

What does the glycemic index (GI) measure?

Answer 9

Quality of carbohydrate on scale of 0-100

Question 10

What are the “low” GI foods?

Answer 10

55 or lower

*Note that these are absorbed slowly

Question 11

How does ripening alter the GI of a food?

Answer 11

Increased

Question 12

How does eating a carbohydrate with other macronutrients alter the GI?

Answer 12

Decreased

Question 13

What is Glycemic Load (GL)?

Answer 13

Measurement that takes into account the quality (GI) and quantity of carbohydrates

Question 14

How is the GL calculated?

Answer 14

GI/100g serving

Question 15

What is the definition of a low GL food?

Answer 15

Foods less than 10

Question 16

What are the recommendations for DM patients WITHOUT renal impairment, regarding protein intake?

Answer 16

Same as gen. pop. i.e. 18-20% of diet

Question 17

What are the recommendations for DM patients WITH renal impairment, regarding protein intake?

Answer 17

Avoid high protein diet

Question 18

What are the recommendations for DM patients in regards to fats?

Answer 18

Same as gen. pop. i.e. 20-25% of diet

Question 19

What types of fat have shown to be beneficial for DM patients?

Answer 19

• Monounsaturated

- Long-chain omega-3 fatty acid

Question 20

What were the conclusions of the DPP study?

Answer 20

1) Diet/exercise can prevent progression to DM-II
2) Seen in all minority, age, and gender groups
3) Incidence decreased by 58% with diet/exercise–more than metformin alone (31%)