Lecture 7

Question 1

What constitutes DM?

Answer 1

Hgb A1c >6.5%
Fasting plasma glucose >126mg/dL
2-hour OGTT >200mg/dL
Random plasma glucose >200mg/dL (if in hyperglycemic crisis)

Question 2

What percentage of DM is type 1? type 2?

Answer 2

10%
90%

Question 3

What differentiates type 1 and type 2 DM?

Answer 3

Type 1 can’t make insulin due to destruction of B-cells
Type 2 is insulin resistant

Question 4

What is type 3 DM?

Answer 4

Not a true DM
Development of insulin resistance and insufficiency from the development of Alzheimer’s

Question 5

What lab values reflect pre diabetes?

Answer 5

Fasting glucose 100-125
OGTT 140-199 (impaired glucose tolerance)
HbA1c 5.7-6.4%

Question 6

What is gestational DM?

Answer 6

Diabetes during pregnancy that resolves after birth, because pregnant women get insulin resistance

Question 7

What are the goals of managing DM or preDM?

Answer 7

Maintain normal glcuose
Prevent/reverse lipid abnormalities
Prevent/delay complications of prolonged hyperglycemia

Question 8

What are the goals of managing DM or preDM?

Answer 8

Maintain normal glcuose
Prevent/reverse lipid abnormalities
Prevent/delay complications of prolonged hyperglycemia

Question 9

What are types of management of glycemic control in DM pts?

Answer 9

Type 1: must receive insulin, but benefits from lifestyle modificaitons
Type 2: lifestyle modifications and can be treated solely off of it

Question 9

What are types of management of glycemic control in DM pts?

Answer 9

Type 1: must receive insulin, but benefits from lifestyle modificaitons
Type 2: lifestyle modifications and can be treated solely off of it

Question 10

What are general interventions for DM management?

Answer 10

Healthy eating
Exercise
Sleep
No tobacco
Weight loss(especially if truncoabdominal)

Question 11

What macro diet composition should a DM pt eat?

Answer 11

Carbs/high fiber: about 30g/day, minimal processed, plant-based
Fats: mono/polyunsaturated fats
Protein: 0.8g/kg/day

Question 11

What macro diet composition should a DM pt eat?

Answer 11

Carbs/high fiber: about 30g/day, minimal processed, plant-based
Fats: mono/polyunsaturated fats
Protein: 0.8g/kg/day

Question 12

Whats the best diet for DM pts?

Answer 12

Keto diet, however the best one is the one the pt can adhere to

Question 13

What should you consider for each pts diet?

Answer 13

Comorbidites and weight status
Dietary preferences
Access to food
Ability to prepare meals at home

Question 14

Generally, should DM pts do diet wise?

Answer 14

Eat healthy foods

Question 15

What resources can pts use to develop a meal plan?

Answer 15

Plate method
Diabetic recipes
Diet exchange lists(helpful for counting carbs)

Question 16

What are the benefits on consuming nuts?

Answer 16

Reduced CVD risk
Preventing DM
Filling, low in carbs
Rich in fiber, MUFAs, PUFAs

Question 17

What are some not-benefits on consuming nuts?

Answer 17

Does NOT improve glycemic control with those already DM
Could increase overall caloric intake

Question 18

Why is ETOH bad for DM?

Answer 18

Interferes with hepatic gluconeogenesis
Risk of hypoglycemia when consumed w/o food
Elevated TG and worse glucose control

Question 19

What has the highest risk of hepatic gluconeogensis?

Answer 19

Drinking ETOH while taking insulin or drugs that stimulate insulin release

Question 20

How does caffeine affect DM?

Answer 20

Higher plasma glucose
Higher insulin lvls
Decreased insulin sensitivity in T2DM

Question 21

What are benefits to caffeine?

Answer 21

Long-term abstinence from caffeine lowers HbA1c
Lowers risk of DM(however also shown in decaf coffee drinkers and tea drinkers)