Nutritional Aspects of Diabetes

Question 1

which is more effective in preventing diabetes, metformin or lifestyle?

Answer 1

lifestyle

Question 2

what advice is given to people at low risk of diabetes?

Answer 2

benefits of healthy lifestyle and modifying risk factors

Question 3

advice for moderate risk of diabetes?

Answer 3

brief intervention on benefits of healthy lifestyle and modifying risk factors

Question 4

advice for high risk of diabetes?

Answer 4

intensive intervention to increase ohysical activity, achieve and maintain weight loss, increase fibre intake, reduce fat and saturated fat intake

Question 5

short term diabetes complications?

Answer 5

hypoglycaemia
DKA
hyperosmolar
hyperglycaemia

Question 6

general type 1 management?

Answer 6

diet + insulin

Question 7

general type 2 management?

Answer 7

lifestyle alone

lifestyle and medication

Question 8

what are the main nutritional considerations in type 1 diabetes?

Answer 8

consistency and timing of meals and carbs
timing of insulin
monitoring blood glucose regularly

Question 9

what are the main nutritional considerations in type 2 diabetes?

Answer 9

weight loss
smaller meals and snacks
physical activity
monitoring blood glucose and medication (if on insulin)

Question 10

how can regular physical activity affect HbA1c?

Answer 10

can reduce it independently of weight loss

Question 11

how does weight loss affect T2DM?

Answer 11

reducing adiposity improves insulin sensitivity and beta cell function

Question 12

how can metabolic syndromes in T2DM be managed via nutrition?

Answer 12

reduce salt intake to reduce BP

reduce fat intake to decrease triglycerides which will increase HDL

Question 13

advice for diabetes diet?

Answer 13

focus on total energy intake rather than source of energy
low GI diet (can reduce HbA1c by 0.5%)
be aware of sugars and sweeteners
fibre is good for health but doesn't affect hyperglycaemia
reduce energy dense and fast foods
reduce alcohol
reduce sedentary behaviour
can prescribe -600kcal deficit

Question 14

challenges to weight loss?

Answer 14

medication can induce weight gain

extra calories consumed to treat hypoglycaemia

Question 15

what is the main nutritional consideration for glycaemic control in type 1?

Answer 15

carbohydrates
people can benefit from adjusting insulin to carbohydrate intake
consistent quantities of carbs on a day-to-day basis are beneficial for people in fixed insulin regimens

Question 16

who is carb counting suitable for?

Answer 16

type 1 using basal bolus insulin (MDI or CSII)

Question 17

what does advanced carb counting require in order to work?

Answer 17

regular blood glucose monitoring

consider pre-meal glucose and activity levels

Question 18

hypoglycaemia is a risk in which type of diabetes?

Answer 18

type 1

or type 2 on insulin

Question 19

how is early stage hypoglycaemia treated?

Answer 19

15-20g of rapidly absorbed carbohydrate (glucose tablets or sugary drink)

Question 20

what are some common causes of a hypo?

Answer 20

missed/delayed meal
not enough carbs at previous meal
increase in exercise
too much insulin
alcohol (esp on empty stomach)
tight control

Question 21

how can the risk of hypo be reduced?

Answer 21

carry emergency supply of carbs and diabetic ID
check BG frequently (esp before bed)
never consume alcohol on empty stomach
beware of how stress, exercise, illness etc affects BG

Question 22

how can exercise cause a hypo?

Answer 22

> 60 mins of moderate intensity
if you exercise during peak insulin activity
afternoon exercise can cause nocturnal hypo

Question 23

when can a hypo occur after exercise?

Answer 23

12-14 hrs afterwards

Question 24

at what level of BG should you avoid exercise?

Answer 24

> 14

or ketones present

Question 25

does alcohol cause hypo or hyper?

Answer 25

hypo

Question 26

how do sweeteners affect BG?

Answer 26

no effect on BG so