Exam #1: DM & Nutrition

Question 1

What is the definition of DM?

Answer 1

Group of metabolic disorders characterized by hyperglycemia

Question 2

What are the short-term complications of DM?

Answer 2

• Ketoacidosis
• Hyperosmolarity
• Lactic acidosis

Question 3

What are the long-term complications of DM?

Answer 3

• Retinopathy
• Renal damage
• Neuropathy
• Damage to heart and blood vessels

Question 4

What are the diagnostic criteria for DM?

Answer 4

1) Fasting glucose greater than 126 mg/dl
2) Random glucose greater than 200 mg/dl w/ classic sx of DM
3) Glucose greater than 200 mg/dl after glucose challenge
4) HbA1c greater than 6.5%

Question 5

What are the classic symptoms of DM?

Answer 5

• Polydipsia
• Polyuria
• Weight loss

Question 6

What is DM-I?

Answer 6

• Idiopathic or immune mediated destruction of the B-cells of the pancreas
• Causes an absolute lack of insulin

Question 7

What is DM-II?

Answer 7

• Insulin resistance
• Relative insulin deficiency

*****Insulin resistance is when normal levels of insulin no longer cause the intended physiologic effect–pancreas compensates by making more

Question 8

What are the major actions of insulin?

Answer 8

Remember, insulin is the major anabolic hormone in the body

1) Glucose uptake into muscle and adipose tissue
2) Amino acid uptake and protein synthesis
3) FA synthesis and esterification
4) Glycogen synthesis
5) Glycolysis
6) Decreases blood glucose levels
7) Decreases gluconeogenesis
8) Decreases lipolysis
9) Decreases proteolysis

Question 9

What stimulates the secretion of insulin?

Answer 9

• Increased blood glucose
• Increased amino acids
• Increased FA
• INCRETIN hormones
• ACh

Question 10

What decreases the secretion of insulin?

Answer 10

Leptin

SNS

Question 11

What are the major actions of glucagon?

Answer 11

Remember, glucagon is the major catabolic hormone in the body

1) Glycogenolysis
2) Lipolysis
3) Gluconeogenesis
4) Ketogenesis
5) Decreased synthesis of glycolytic enzymes
6) Decreased rate of glycolysis
7) Decreased glycogen synthesis

Question 12

What stimulates the secretion of glucagon?

Answer 12

• Low blood sugar
• Increased circulating amino acids
• SNS

Question 13

What decreases the secretion of glucagon?

Answer 13

• Hyperglycemia
• Increased FA circulation
• Somatostatin

Question 14

What are the actions of epinephrine in the control of blood glucose?

Answer 14

• Increased glycogen breakdown
• Increased gluconeogenesis
• Fat mobilization

Question 15

What are the actions of cortisol in the regulation of blood glucose?

Answer 15

• Works with glucagon to increase gluconeogenesis enzymes

- Maintains glucose production from protein and facilitates fat metabolism

Question 16

What is the glycemic index (GI)?

Answer 16

A measure of how quickly a food causes blood sugar to rise

Question 17

What is the standard reference for GI?

Answer 17

glucose or white bread

Question 18

What is the difference between high and low GI foods?

Answer 18

High= quickly digested and absorbed
- spike blood sugar

Low= slowly digested and absorbed
- slow rise in blood sugar

Question 19

What is glycemic load?

Answer 19

GI x carbohydrate content in serving/100

Question 20

What are the five elements of Metabolic Syndrome?

Answer 20

1) Centripetal Obesity
2) Elevated TG
3) Hyperglycemia
4) Low HDL
5) HTN

Question 21

What is a simple way to calculate Basic Metabolic Rate (BMR)? How do you factor calorie needs for activity level?

Answer 21

BMR:

• Male= weight x 11
• Female= weight x 10

X % needed for activity level

Question 22

What dietary and lifestyle changes can prevent, treat, and/ or reduce the complications of DM?

Answer 22

1) Weight loss i.e. diet and exercise
2) Monitor glucose
3) Dose insulin according to intake and exercise
4) Regular healthcare visits

Question 23

What are the macronutrient recommendations for patients with DM?

Answer 23

• Carbohydrate= 45-65%
• Protein= 10-35%
• Fat= 20-35%
• Saturated fat= less than 10%
• Cholesterol=