Chapter 20: Diabetes Mellitus Flashcards Preview

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Flashcards in Chapter 20: Diabetes Mellitus Deck (30):
1

The primary organ involved in the disease process of type 1 diabetes mellitus is the
a. adrenal gland.
b. pancreas.
c. kidney.
d. liver.

b. pancreas.

For glucose to be used by the cells in the body, it first must be taken out of the blood and put into the cell. The hormone insulin must be present. Insulin is produced by the cells of the pancreas. Thus the pancreas is the organ involved in the disease process of type 1 diabetes mellitus.

2

The factors that seem to play a role in the development of type 2 diabetes mellitus are
a. weight and heredity.
b. liver disease.
c. enzyme deficiencies.
d. childhood illnesses.

a. weight and heredity.

Weight and heredity seem to play a role in the development of type 2 diabetes mellitus. Unlike type 1 diabetes, type 2 is not caused by an autoimmune response. Weight and heredity seem to play a role in the development of type 2 diabetes.

3

Type 2 diabetes is most common in
a. infants.
b. children.
c. adolescents.
d. older adults.

d. older adults.

4

Acidosis, underweight, and rapid onset are characteristics of _____ diabetes.
a. type 1
b. type 2
c. gestational
d. secondary

a. type 1

Type 1 diabetes presents with unintentional weight loss, polydipsia, polyphagia, and polyuria, and acidosis can occur if the disease is left untreated.

5

Which of the following describes characteristics of type 2 diabetes?
a. Requires insulin and is a milder form of the disease
b. Acidosis is present and the onset is rapid
c. Acidosis is present and the form is more severe
d. Improves with weight loss

d. Improves with weight loss

6

Other symptoms that may be present in patients with diabetes include
a. paralysis and loss of hearing.
b. diarrhea and gastrointestinal upset.
c. fainting and amnesia.
d. skin infections and weakness.

d. skin infections and weakness.

In addition to early signs of diabetes, additional signs may include blurred vision, skin irritation or infection, and general weakness or loss of strength.

7

Uncontrolled diabetes is related to the abnormal metabolism of
a. carbohydrates and proteins.
b. proteins and fats.
c. carbohydrates and fats.
d. carbohydrates only.

c. carbohydrates and fats.

Uncontrolled diabetes causes alterations in glucose metabolism as well as abnormal metabolism of proteins and fats. Protein tissues are broken down in the body’s effort to secure energy sources, causing weight loss and urinary nitrogen loss. Fat tissue, in the absence functioning insulin, breaks down. However, normal lipolysis (fat breakdown) requires an adequate supply of glucose, which in turn relies on the help of insulin to accept glucose into the cell. Therefore intermediate products of fat breakdown, called ketones, accumulate in the body.

8

The normal range for blood glucose is _____ mg/dL.
a. 20 to 50
b. 50 to 100
c. 70 to 110
d. 100 to 150

c. 70 to 110

A value above this is considered hyperglycemia. Normal control mechanisms ensure that people always have sufficient circulating blood sugar, glucose, to meet constant energy needs—even the basal metabolic energy needs during sleep—because glucose is the body’s preferred fuel.

9

The largest portion of islet cells are the cells that synthesize
a. glucagon.
b. insulin.
c. somatostatin.
d. growth hormone.

b. insulin.

The largest portion of islet cells are the cells that synthesize insulin, a hormone. Insulin must be present for glucose to be carried into the cell.

10

The hormone that is synthesized by the pancreatic islet cells is
a. glycogen.
b. ketone.
c. somatostatin.
d. insulin.

c. somatostatin

is the pancreatic hormone that acts as a “referee” for several other hormones affecting blood glucose levels. It is produced in the cells of the pancreatic islets, scattered between the á and â cells and making up approximately 10% of each islet’s cells.

11

If the diet prescription for type 1 diabetes allows 2200 kcal, and if the common distribution of kilocalories is followed, then the number of grams of carbohydrates in the diet plan should be _____ g.
a. 50
b. 100
c. 200
d. 275

d. 275

Approximately 50% of total kilocalories should be supplied from carbohydrates. In this case, 2200 kcal (50%) = 1,100 kcal ÷ 4 g/kcal = 275 kcal.

12

A food that is not in the meat group of the Choose Your Foods: Exchange Lists for Diabetes is
a. cottage cheese.
b. shrimp.
c. egg.
d. milk.

d. milk.

it is in a separate group from the meat and meat substitute group.

13

Studies indicate that exercise
a. decreases insulin efficiency.
b. stimulates the release of insulin.
c. increases the number of insulin receptors on muscle cells.
d. raises blood glucose levels.

c. increases the number of insulin receptors on muscle cells.

exercise helps control blood glucose and reduces the risk of cardiovascular disease, hyperlipidemia, hypertension, and obesity.

14

Mr. Jones comes into the clinic and is 20 lb above his desirable weight and has type 2 diabetes. A recommendation to Mr. Jones would be to
a. increase kilocalories.
b. include between-meal snacks.
c. take extra food during exercise.
d. lose weight.

d. lose weight.


Maintaining a proper weight will decrease complications associated with diabetes, including high blood sugar and the risks of cardiovascular disease, hyperlipidemia, hypertension, and obesity.

15

The form of insulin designed to last between 18 and 24 hours is the
a. rapid-acting form.
b. intermediate-acting form.
c. long-acting form.
d. oral hypoglycemic agent.


b. intermediate-acting form.

Intermediate-acting (NPH) insulin can last from 18 to 24 hours. The onset of action is from 1 hour up to 3 hours, with a peak action ranging from 7 to 14 hours.

16

A high intake of saturated fats is associated with
a. hepatitis.
b. diabetes.
c. coronary artery disease.
d. nephropathy.

c. coronary artery disease.

results from a high intake of saturated fat in the diet. The percentage of energy from fat for a person with diabetes should be between 25% and 30%. Saturated fat should comprise less than 10% of fat calories. No more than 300 mg/day should be provided as cholesterol.

17

Women with a history of gestational diabetes mellitus are at risk for developing
a. chronic kidney disease.
b. type 2 diabetes.
c. type 1 diabetes.
d. morbid obesity.

b. type 2 diabetes.

It is important to control blood sugar during pregnancy and to maintain a balanced diet, perform regular exercise, maintain a healthy BMI, and keep regular follow-up visits with their physician.

18

Type 2 diabetes usually appears after the age of _____ years.
a. 30
b. 40
c. 50
d. 60

b. 40

19

The protein component for an adult with diabetes is approximately
a. 15-35% of total energy intake.
b. an increased amount equal to 25% of total calories.
c. a decreased amount equal to 10% of total calories.
d. individual choice of the patient.

a. 15-35% of total energy intake.

High protein intakes are generally not recommended because of their saturated fat content and unnecessary stress on the kidneys to excrete excess nitrogen.

20

The nonnutritive sweetener that is composed of two amino acids is
a. saccharine.
b. aspartame.
c. cyclamate.
d. acesulfame-K.

b. aspartame.

is made from two amino acids: phenylalanine and aspartic acid.

21

The percentage of energy from fat for a person with diabetes should be
a. 5% to 10%.
b. 15% to 20%.
c. 25% to 30%.
d. 30% to 35%.

c. 25% to 30%.

Saturated fat should comprise less than 10% of fat calories. No more than 300 mg/day should be provided as cholesterol.

22

The hormone considered to act in a manner opposite to insulin is
a. glucagon.
b. somatostatin.
c. growth hormone.
d. adrenaline.

a. glucagon.

It can rapidly break down stored glycogen and, to a lesser extent, fat.

23

Commonly used nonnutritive sweeteners include
a. sorbitol.
b. aspartame.
c. honey.
d. fructose.

b. aspartame.

which is made from two amino acids: phenylalanine and aspartic acid.

24

Increasing the fiber content of the diabetic diet tends to
a. raise the blood glucose level.
b. lower the blood glucose level.
c. result in weight loss.
d. decrease formation of ketones.

b. lower the blood glucose level.

As with all people, consumption of dietary fiber is encouraged for a healthy diet. There are no reasons for individuals with diabetes to consume greater amounts than others.

25

It is recommended that no less than 130 grams (520 kcal) in the diabetic diet come from
a. carbohydrates.
b. fiber.
c. protein.
d. fats.

a. carbohydrates.

Low carbohydrate diets restricting carbohydrates to less than 130 grams is not recommended for managing diabetes. Carbohydrates are required in a balanced diet to provide energy.

26

The accumulation of glucose in the blood is called
a. glycosuria.
b. polydipsia.
c. hyperglycemia.
d. hypoglycemia.

c. hyperglycemia.

The accumulation of glucose in the blood is called hyperglycemia and the presence of low glucose in the blood is called hypoglycemia.

27

Which of the following functions is not associated with the hormone insulin?
a. Moves glucose into the cell
b. Inhibits fat breakdown
c. Converts glucose into glycogen
d. Mobilizes liver glycogen to yield glucose

d. Mobilizes liver glycogen to yield glucose

Insulin circulates glucose into cells by way of specialized insulin receptors, helps change glucose to glycogen and store it in muscles and liver, stimulates the change of glucose to fat for storage as body fat, inhibits the breakdown of tissue fat and protein, promotes uptake of amino acids by skeletal muscle, and influences the burning of glucose for constant energy as needed.

28

Ketones are a by-product of the metabolism of
a. carbohydrates.
b. proteins.
c. fats.
d. alcohol.



c. fats.

Fat breakdown is called lipolysis. However, normal lipolysis requires an adequate supply of glucose, which in turn relies on the help of insulin to accept glucose into the cell. Therefore intermediate products of fat breakdown, called ketones, accumulate in the body.

29

If diabetes is suspected, the patient should be given which of the following tests?
a. Fasting blood glucose level
b. Insulin level
c. Hemoglobin level
d. Glucose tolerance test

d. Glucose tolerance test

A glucose load equivalent of 75 g anhydrous glucose dissolved in water is administered. A 2-hour plasma glucose level of 200 mg/dL or greater serves as the criterion for the diagnosis of diabetes mellitus.

30

The three common long-term complications of diabetes affect the cells of the
a. pancreas, liver, and spleen.
b. kidney, eye, and nerve tissue.
c. kidney, liver, and spleen.
d. heart, liver, and brain.

b. kidney, eye, and nerve tissue.

Long-term complications of diabetes affect the kidney (nephropathy), eye (retinopathy), and nerve tissue (neuropathy).