Nutrition in Diabetes Flashcards
A 20-year-old mother expecting her first baby makes a follow-up visit to her doctor for prenatal care. Palpation of her uterus revealed a gravid uterus at about 26 weeks gestation. Her blood pressure was normal, but she presented with an elevated blood glucose level. She was admitted to the hospital for monitoring and treatment. Subsequently, she delivered a bouncing baby boy, ten pounds in weight. Which of the following outcomes is anticipated in a newborn, if the mother presented with such an obstetric history?
A. Kidney failure at birth
B. Low birth weight baby
C. Hyperglycemia at birth
D. Hypoglycemia at birth
D. Hypoglycemia at birth
Mothers with elevated blood glucose typically deliver high birth weight babies. Those babies are adapted to the high glucose in the mother and have compensated by secreting insulin, moving more GLUT 4 to the membranes of all cells to handle the excess glucose and storing more body fat. Thus, when the child is born the blood glucose becomes very low due to the high circulating insulin in the fetal blood supply and high GLUT 4 levels on cell membranes that are clearing glucose out of the blood quickly.
A 52-year-old man with a 10-year history of diabetes visited his Primary Care Physician, because his blood glucose had been rising steadily over the past two months, in spite of the fact that he had been using metformin as prescribed by the doctor. On examination, he was found to have a random blood glucose of 300 mg/dL, body mass index 30; blood pressure 160/90. The doctor recommended daily exercise and referred him to the dietitian. Which of these statements truly reflect the positive effect of exercise on blood glucose levels?
A. Exercise blocks gluconeogenesis.
B. Exercise activates incretin hormones in the gut.
C. Exercise increases glucagon secretion.
D. Exercise promotes an increase in peripheral glucose uptake.
E. Exercise causes decreased insulin sensitivity in type 2 diabetes
D. Exercise promotes an increase in peripheral glucose uptake.
Exercise improves the mobilization of GLUT 4 on the the cell surface in peripheral tissues. This effect has been shown to increase insulin sensitivity in T2D.
A 21-year-old Type1 diabetic man goes out to celebrate his 21st The next day police find him passed out and smelling strongly of alcohol. The man is assumed to be in an alcoholic stupor. No identification or jewelry is found with the man during a search. However, when his insulin pump is located glued to his waist, it is realized a more serious problem in occurring. What is the most likely cause of his unconsciousness?
A. Hypoglycemic event
B. Alcohol poisoning
C. Increased HbA1c
D. Hyperglycemic event
E. Dehydration
A. Hypoglycemic event
Alcohol consumption can cause hypoglycemia up to 24 hours after the consumption of alcohol in diabetics. Many insulin pumps must be programmed with “usual” cycles and needs for insulin. Unique events like parties must be monitored by the patient and the patient must remember to compensate the insulin for their extra consumption of food or alcohol as well as changes in exercise routines.
Glycemic index is determined by monitoring the glucose levels in blood 2 hours after eating a food. The level of blood glucose is compared to that same person eating the same mass of either glucose or bread. Why is the comparison to glucose more consistent worldwide?
A. Bread has more air in it in some countries making it less dense.
B. There are many types of bread and recipes with different CHO content.
C. All bread is the same and it is just as consistent as glucose.
D. Some recipes of bread use butter fat and others use none.
E. The protein content of the bread varies by the process used to make the flour.
B. There are many types of bread and recipes with different CHO content.
The glycemic index is a measure of rise in blood glucose levels. Carbohydrates have the greatest impact on the glycemic index. Changes in flour (whole grain content versus only bleached) and individual recipes is the major cause of differences between white bread in various countries and can lead to a difference in glycemic index measurements when the comparison is to bread rather than pure glucose.
Blood glucose levels change in response to food consumption. Patients need to control their medications and their diet to maintain a blood glucose level that is as constant as possible. What is a good indicator that the patient his having difficulty keeping the blood glucose levels as constant as possible.
A. Fasting blood glucose level
B. Blood pressure
C. Elevated HbA1c
D. Food diary and insulin injections log comparison
E. Amount of insulin used by the patient per day
C. Elevated HbA1c
Hemoglobin is glycosylated when blood glucose is high. It is therefore a marker for events of high glucose. An elevated HbA1c (>6.5%) indicates poor glucose control in a patient. All other answers are signs and measures that aid in monitoring the health of a patient but are not related to the spikes in blood glucose as directly as HbA1c.
