MNT Diabetes

Question 1

Type 1 Diabetes: Elevated blood glucose determination

Answer 1

-Fasting overnight plasma glucose 126 mg/dL or higher on at least two separate occasion
-After ingesting 75 g glucose, plasma glucose 200 mg/dL or higher at 2 hours postingestion, and at least one other sample during 2 hour test
-Random blood glucose level 200 mg/dL or more plus presence of symptoms
-Symptoms polyuria (urinary frequency), polydipsia (excessive thirst), polyphagia (extreme hunger)
-presenting symptoms: fatigue, blurred vision, poor wound healing, periodontal disease, frequent infections
-Glycosylated hemoglobin (HbA1c) : proteins with attached glucose molecules are elevated severalfold in DM->6.5 can diagnose DM

Question 2

T1DM

Answer 2

-most often in children and adolescents, juvenile onset <10 % of case T1DM
-autoimmune -caused by destruction of beta cells f pancreas, which synthesize insulin
-Life long exogenous insulin to control blood glucose
-Obesity at onset uncommon,
-high diabetic ketoacidosis and lean in presentation

Question 3

Risk factors for T1DM

Answer 3

-Environmental and dietary- abnormality of gut immune development of antibodies by gut immune systems (attack beta cells)
-risk higher in children with celiac
-enterovirus
-vitamin D deficiency
-Omega 3 fatty acid deficiency
-Nitrates in diet and water

Question 4

T1DM interventions

Answer 4

-Level 1, glucose target met, HgbA1c<7% foundation supplements, alpha-lipoic, grapeseed or pine bark
-level 2, glucose target, HgbA1c>7%, level 1 supplements plus gymnema biotin, bitter melon
-Cardiovascular- Niacin and garlic
-Hypertension- garlic, CoQ10, Anti-ACE peptides from bonito, Hawthorne extracts, olive leaf extract, hibiscus
-Retinopathy-bilberry extract
-Neuropathy- gamma-linlenic acid, benfotiamine, capsaicin
-Nephropathy-modified hypertension protocol Benfotiamine
-poor wound healing- aloe vera gel
-foot ulcers-gingko biloba extract

Question 5

Clinical diagnosis of Diabetes/Prediabetes

Answer 5

-A1c >= 6.5 % or
-FPG >=126 mg/dL
-2 hour PG >=200 mg/dL
-pts with hyperglycemia or hyperglycemic crisis, plasma glucose >=200mg/dL
-Hyperglycemia that doesnt meet diagnostic criteria: impaired fasting glucose (IFG), impaired glucose tolerance (IGT)- prediabetes

Question 6

TIIDM MNT

Answer 6

Same MNT as TIDM

Question 6

Nutrition Therapy T1DM

Answer 6

-structured lifestyle change program, counseling on 5-7% weight loss
-physical activity 150 min/week
-consumption of 14 g fiber per 1000kcal daily
-limit sugar sweetened beverages
-replace saturated fats with MUFAs and PUFAs
-limited alcohol
-Mediteranean- style eating patterns