nutrition: chapter 20

Question 1

glucose

Answer 1

primary source of energy for the body

Question 2

insulin

Answer 2

• produced by beta cells of the pancreas
• needed for glucose transport into cells

Question 3

diabetes

Answer 3

• metabolic diseases characterized by hyperglycemia

people with diabetes either:
- produce very little to no insulin (insulin deficiency)
- ineffectively use insulin (insulin resistance)
- produce inadequate insulin amount (insulin insufficiency)

Question 4

hyperglycemia

Answer 4

elevated blood sugar level

Question 5

classifications

Answer 5

• type 1 diabetes
• type 2 diabetes
• gestational diabetes
• other types
• impaired glucose tolerance

Question 6

symptoms

Answer 6

• polydipsia
• polyuria
• polyphagia
• unintentional weight loss (type 1)
• blurred vision, fatigue, dehydration, skin irritation or infection, general weakness, loss of strength

Question 7

lab tests will show

Answer 7

• hyperglycemia
• abnormal glucose tolerance tests (done in pregnancy)
• elevated glycosylated hemoglobin A1c (3 month avg.)
• glucosuria
• proteinuria
• microalbuminuria

Question 8

diabetic ketoacidosis (DKA)

Question 9

stages of glucose metabolism

Answer 9

1. initial interchange with glycogen (glycogenolysis) and reduction to a smaller central compound (glycolysis pathway)
2. joining with the other two energy-yielding nutrients, fat and protein (pyruvate link)
3. final common energy production (citric acid cycle and electron transport chain)

Question 10

exogenous

Answer 10

originating from outside the body

Question 11

sources of blood glucose

Answer 11

• dietary intake
• glycogen from liver and muscles

Question 12

uses of blood glucose

Answer 12

• for immediate energy needs: glycolysis
• change to glycogen for storage: glycogenesis
• convert to fat for longer-term storage: lipogenesis

Question 13

glucagon

Answer 13

• opposes insulin
• responds to hypoglycemia
• alpha cells

Question 14

somatostatin

Answer 14

• acts as a referee for insulin and glucagon
• delta cells

Question 15

abnormal metabolism in diabetes (glucose)

Answer 15

• cells are starved for glucose
• glucose concentrations increase in the blood
• hyperglycemia results

Question 16

abnormal metabolism in diabetes (fat)

Answer 16

• lipolysis in the adipose tissue increases
• fatty acids are released in the blood
• elevated triglyceride levels result
• ketogenesis ensues in the liver
• ketones accumulate in the body
• diabetic ketoacidosis results

Question 17

abnormal metabolism in diabetes (protein)

Answer 17

• protein tissues are broken down
• weight loss, muscle weakness, and urinary nitrogen loss result

Question 18

long term complications

Answer 18

• retinopathy (eye damage)
• nephropathy (kidney damage)
• neuropathy (nerve damage)
• heart disease
  
  • dyslipidemia
  • hypertension

Question 19

postprandial

Answer 19

after eating; normally 1-2 hours after a meal

Question 20

Cushing’s syndrome

Question 21

glucagonoma

Answer 21

• rare neuroendocrine tumor
• found in alpha cells of pancreas
• leads to overproduction of glucagon
• may cause diabetes, weight loss, high glucagon levels, and hypoaminoacidemia

Question 22

pheochromocytoma

Answer 22

• tumor of the adrenal medulla or the sympathetic nervous system
• affected cells secrete excess epinephrine or norepinephrine
• causes headache, hypertension, and nausea

Question 23

hypoglycemia

Answer 23

low blood glucose level

Question 24

GLUT4

Answer 24

insulin-regulated protein that is responsible for glucose transport into cells

Question 25

ketogenesis

Answer 25

production of ketones in the body (occurs in the liver)

Question 26

ketones

Answer 26

acids that occur as intermediate products of fat metabolism

Question 27

acetone

Answer 27

- major ketone compound - results from fat breakdown for energy in individuals with unmanaged diabetes

Question 28

albuminuria

Answer 28

high levels of albumin in the urine

Question 29

estimated glomerular filtration rate (eGFR)

Answer 29

equation used to measure kidney function

Question 30

cellulitis

Answer 30

- diffuse inflammation of soft or connective tissues from injury, bruises, or pressure sores that leads to infection - poor care may result in ulceration and abscess or gangrene

Question 31

glycemic control

Answer 31

management of blood glucose levels within individualized targets

Question 32

insulin secretagogues

Answer 32

- oral medication - stimulates beta cells to secrete insulin - lowers overall blood glucose levels - increases risk of hypoglycemia and weight gain

Question 33

early detection and monitoring

Answer 33

- community screening programs - annual physical examinations - fasting blood glucose, HbA1c

Question 34

basic goals of care

Answer 34

- exogenous insulin - oral/ non-insulin injectable meds - maintaining healthy eating patterns - 150 minutes of moderate-intensity aerobic physical activity weekly

Question 35

Diabetes Self-Management Education and Support (DSME/S)

Answer 35

- dietary and lifestyle management - monitoring - medications - problem solving - reducing risk - psychosocial assessment and care - resource awareness

Question 36

MNT

Answer 36

prediabetes: - healthy dietary pattern, physical activity, weight loss diabetes: - individualized nutrition therapy

Question 37

nutrient balance

Answer 37

- starch and sugar - glycemic index - sugar substitutes and sweeteners - protein - fat

Question 38

nutrient intake, physical activity, and medication timing

Answer 38

- daily schedule - physical activity and glycemic management - meds and meal timing - carbohydrate counting - healthy eating patterns (t2/prediabetes)

Question 39

additional concerns

Answer 39

- "diabetic" foods - alcohol - hypoglycemia - illness - travel - eating out - stress

Question 40

diabetes distress

Answer 40

psychological reaction to the intense emotional burden and negative impact of daily concerns when managing the serious and complex lifelong disease of diabetes