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PT: Nutrition Exam 1 > Diabetes & CVD > Flashcards

Diabetes & CVD Flashcards

1
Q

Nutrition interventions plays a key role in prevention and treatment of what?

A
  • coronary heart disease
  • HTN
  • metabolic syndrome
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2
Q

T/F nutrition intervention can be cost saving and have improved clinical outcomes

A

True

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3
Q

T/F there is a generalized MNT recommended for everyone with T1D & T2D

A

False!

Individualized best!!
No one size fits all

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4
Q

Variables to consider in diabetic MNT

A
  • individual nutrition needs
  • personal and cultural preferences
  • health literacy and numeracy
  • access to healthy food choices
  • willingness to change
  • barriers to change
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5
Q

Nutrition goals for adult diabetes

A
  • promote and support healthy eating patterns
  • attain individualized glycemic, BP and lipid goals
  • achieve and maintain BW goals
  • delay and prevent diabetes complications
  • address individual nutrition needs
  • maintain pleasure of eating
  • provide practical tools for day to day meal planning
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6
Q

What labs should you attain for adults in diabetes in nutrition goals

A

glycemic
BP
Lipid goals

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7
Q

T/F modest weight loss may provide clinical benefits in some individuals with diabetes, especially those early in disease process

A

True

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8
Q

T/F for overweight and obese individuals increasing energy intake while maintaining a healthy eating pattern is recommended for weight loss

A

False!!

Reducing energy intake

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9
Q

What are some lifestyle intervention programs for adult diabetes?

A

Nutrition
Physical activity
Behavior change

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10
Q

T/f in MNT for diabetes there is no ideal % of calories from carbs, protein and fat

A

True

  • should be individualized
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11
Q

What are general individualized metabolic goals for adult diabetes? (PCF)

A

Protein: 10-35%
Carbs: 35-65%
Fat: 20-35%

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12
Q

_______ intake has direct effect on post meal glucose levels

A

Carbohydrates

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13
Q

T/F evidence is inconclusive for an ideal amount of CHO intake for those with diabetes

A

True

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14
Q

Knowledge and skills needed for those with diabetes

A
  • effect of CHO foods on blood glucose
  • sources of CHO
  • recognizing CHO servings or grams
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15
Q

1 CHO serving = _____ gm CHO

A

15

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16
Q

Ways to recognizing CHO servings or grams

A
  • nutrition facts label
  • measuring portions
  • CHO counting resources
  • insulin to CHO ratio
  • heart healthy food choices if applicable
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17
Q

What are the most important factors influencing glycemic response after eating?

A
  • amount of CHO from foods

- available insulin

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18
Q

What else can affect blood sugar, especially fasting blood sugar?

A

Liver production of glucose

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19
Q

Monitoring _____ intake is crucial for achieving glycemic control

A

CHO

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20
Q

What are some healthier CHO food choices?

A
  • veggies
  • fruit
  • whole grains
  • legumes
  • dairy
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21
Q

Carbohydrates goals for diabetes

A
  • healthier CHO choices
  • limit less healthy CHO
  • substitute low glycemic load foods for higher glycemic foods may modestly improve glycemic control
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22
Q

_____% of grains should come from whole grains?

A

50%

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23
Q

T/F people with diabetes and those at risk do not need to avoid intake of sugar sweetened beverages

A

False!

Should avoid

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24
Q

Why should those with diabetes or those at risk avoid sugar sweetened beverages?

A
  • reduce risk for weight gain

- reduce risk of worsening cardio metabolic risk profile

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25
Q

T/F use of non-nutritive sweeteners is not acceptable in those with diabetes

A

False!

Is acceptable within defined acceptable daily intake levels

26
Q

What is there a potential for when using non-nutritive sweeteners?

A

Potential to reduce overall calorie and CHO intake if substituted for caloric sweetener

Without compensation of additional calories from other foods

27
Q

2 ways to treat diabetes with carbohydrates

A
  • insulin to carb ratio

- fixed daily insulin doses (with meals)

28
Q

Insulin to carb ratio

A
  • Education program using CHO counting can result in improved glycemic control
    Improves ability to match insulin to CHO intake
  • allows for more flexibility based on lifestyle, meal schedule, food choices and activity
  • utilized with rapid acting insulin
  • based on amounts of CHo eating and units of insulin used to meet target BG goals
29
Q

Fixed daily insulin doses (with meals)

A

Consistent CHO intake with respect to time and amount can result in improve glycemic control

30
Q

T/F individuals with T2D identified to have health and numeracy literacy concerns may better suited for simple diabetes meal planning approach

A

True

31
Q

T/F fat quantity is more important than quality

A

False!

Quality > quantity

32
Q

Large intake of ____ can affect insulin response and may slow decline in blood glucose after meal

A

Fat

33
Q

T/F recommendations for saturated fat, cholesterol and trans fat intake in diabetic is the same as general population

A

True

34
Q

What type of eating pattern may benefit glycemic control and CVD risk factors?

A

Mediterranean

Increased intake of monosat FA
Effective alternative to lower fat, higher carb eating pattern

35
Q

What type of fats is recommended to prevent or treat CVD

A

Long chain omega 3 FA

Nuts/seeds

36
Q

T/F ingested protein may increase insulin response without increasing plasma glucose concentrations

A

True

37
Q

T/f avoid use of CHO food source low in protein for treating or preventing hypoglycemia

A

False!

CHO high in protein

38
Q

T/F for people with diabetes and diabetic kidney disease, reducing the amount of dietary protein below usual intake is NOT recommended

A

True!

Not recommended because it does not alter glycemia measures, CVD risk or course of GFR decline

39
Q

T/F there is evidence of benefit from vitamin or mineral supplementation in people with diabetes who do not have underlying deficiencies

A

False!

No clear evidence

40
Q

Alcohol and diabetes

A

Consumed in moderation
1/day for women
2/day for men

41
Q

Alcohol consumption may put people at risk for __________, especially if they are using insulin

A

Delayed hypoglycemia

42
Q

T/f increased blood glucose monitoring after consuming alcohol is recommended

A

True

43
Q

What your patients need to know about nutrition and diabetes

A
  • understand components of healthy eating
  • how to apply current meal/snack plan to their medication plan
  • importance of monitoring CHO intake
44
Q

T1D & T2D focus of interventions

A
  • integrate insulin into nutritional and physical activity patterns
  • adjust meal/snack insulin doses based on CHO content when using rapid acting insulin
  • use consistent CHO with fixed meal doses
  • planned exercise requires adjusting insulin or additional CHO intake
45
Q

Lifestyle modifications for T2D

A
  • reduce intake of energy, saturated and trans fat, sodium
  • total calorie recommendations based on weight loss goals
  • recommend CHO intake based on calorie needs, review pre and post meal blood sugars, lipid and preferences
  • increase physical activity
46
Q

Using a food label in diabetes

A
  • pay attention to serving size and servings/container

- look at total grams of carbs

47
Q

1 serving = _____ gm of carbs

A

15gm

48
Q

Information to obtain when establishing insulin to carb ratios

A
  • meal CHO intake/food log
  • blood glucose log
  • total daily dose of insulin (50% of total dose should be bolus)
  • evaluation of BG2 hours after meals
49
Q

Who can use insulin to carb ratios?

A

T1D or T2D

Patient needs to have ability to accurately count CHO servings

Also used in hospital setting

50
Q

Hypoglycemia

A

<70mg/dL

- use fast acting CHO

51
Q

Hyperglycemia

A
  • increase fluids
  • maintain CHO servings
  • may need additional short/rapid acting insulin
  • frequent BG monitoring
52
Q

Therapeutic lifestyle changes overview for CVD

A
  • promote targeted changes in individuals lifestyle to produce significant reduction in patient’s risk
  • track outcome measurements
  • includes diet, physical activity, weight management
53
Q

TLC diet guidelines for CVD

A
  • <7% total calorie sat fat
  • 25-35% total calorie fat
  • <200mg of dietary cholesterol/day
  • limit sodium 2400mg/day
  • consume enough calories to achieve or maintain healthy weight
54
Q

The ADA recommend ______ mg of sodium for general public with further restrictions for those with diabetes & HTN

A

2300mg

55
Q

Dietary changes to lower cholesterol

A
  • increase fiber
  • add sources of plant stanols/sterols
  • decrease sat fat
  • replace sat fat with MUFA or PUFA
  • limit high cholesterol
56
Q

Dietary changes to raise HDL

A
  • use MUFA in place of PUFA
  • weight loss
  • limit trans fat intake
57
Q

MNT for HTN

A
  • reduce sodium levels
  • generous amounts of K and Ca (fruits/veggies)
  • abstinence or moderation of alcohol
  • weight control
58
Q

Recommended sodium level in HTN

A

1500-2400mg/day

59
Q

____ drinks/day can increase BP

A

3

60
Q

____ weight loss = ____ HG drop in systolic BP

A

20lbs

6.3mm

61
Q

Dietary approaches to stop HTN (DASH)

A
  • grains 7-8
  • veggies/fruits 4-5
  • low fat dairy 2-3
  • meats, poultry, fish <2
  • nuts/seeds 4-5
  • fats/oils 2-3
  • sweets 5/week

PT: Nutrition Exam 1 (12 decks)

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