Diabetes Management Program

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Questions and Answers

What was the primary focus of the initial attempt to teach patients to adjust their insulin doses?

  • To educate patients on the importance of regular exercise
  • To teach patients to evaluate their treatment by comparing their blood glucose values against a visual target range (correct)
  • To instruct patients on how to count carbohydrates in their meals
  • To provide patients with a fixed insulin dosage for their entire lives

What was a common issue with the initial method of adjusting insulin doses based on blood glucose values?

  • It was too time-consuming for patients
  • It resulted in inconveniently timed hypoglycemia due to exercise and dietary deviations (correct)
  • It was too complex for patients to understand
  • It was only effective for patients with type 1 diabetes

What is an essential aspect of insulin dosing, according to evidence-based advice?

  • Administering a fixed dose of insulin before every meal
  • Varying insulin doses based on carbohydrate intake and other factors (correct)
  • Injecting insulin only once a day
  • Adjusting insulin doses based solely on blood glucose values

Why is the old advice for a fixed dose of insulin deemed unacceptable?

<p>It does not take into account individual variations in carbohydrate intake and exercise (C)</p> Signup and view all the answers

What is a useful suggestion for managing insulin doses during large meals?

<p>Splitting the insulin injection (D)</p> Signup and view all the answers

What is the ultimate goal of the diabetes management program discussed in the chapter?

<p>To achieve euglycemia (D)</p> Signup and view all the answers

What is the primary consequence of not considering caloric drift in patients?

<p>Increased risk of weight gain and related complications (B)</p> Signup and view all the answers

What is the primary purpose of using a 10% correction in insulin dosing?

<p>To adjust for changes in blood glucose levels above 10 mmol/l or below (B)</p> Signup and view all the answers

What is the primary factor affecting the Carbohydrate Ratio?

<p>Post-meal hyperglycemia (A)</p> Signup and view all the answers

What is the key factor in successfully matching insulin dose to the likely blood glucose outcome of a meal?

<p>Accurate carbohydrate counting (B)</p> Signup and view all the answers

What is the recommended Carbohydrate Ratio for patients on intensive therapy?

<p>10-15g CHO per 1 unit insulin (A)</p> Signup and view all the answers

What is the main difference between fixed-dose insulin therapy (FIT) and multiple daily injections of insulin?

<p>FIT involves a set dose of insulin with each meal, whereas multiple daily injections involve adjusting insulin dose based on blood glucose levels (C)</p> Signup and view all the answers

What percentage of daily insulin dose comes from the Carbohydrate Ratio?

<p>40-60% (B)</p> Signup and view all the answers

What is the consequence of not refining patient education on the implications of food choices on disease factors?

<p>Patients may be more likely to experience weight gain and related complications (C)</p> Signup and view all the answers

Why do girls tend to have a higher Carbohydrate Ratio than boys?

<p>Due to increased physical activity (A)</p> Signup and view all the answers

What is the primary advantage of using carbohydrate ratio and fixed-dose insulin therapy (FIT) over rule-of-thumb approaches?

<p>They allow for more accurate insulin dosing calculations (D)</p> Signup and view all the answers

What is the phenomenon seen in patients with type 1 DM and type 2 DM on insulin, involving unintended increases in HbA1c and total daily insulin?

<p>Caloric drift (D)</p> Signup and view all the answers

What is the hypothesis that suggests a small genetically or epigenetically determined increase in fatness due to a minute and chronic excess of energy intake over expenditure?

<p>Drifty hypothesis (C)</p> Signup and view all the answers

What is the alternative hypothesis to the drifty hypothesis?

<p>Settling point hypothesis (D)</p> Signup and view all the answers

What is the term used to describe a mismatch between energy intake and energy expenditure, resulting in a small but significant increase in weight and an increase in the levels of circulating insulin?

<p>Caloric flux (C)</p> Signup and view all the answers

Why do individuals with type 2 DM tend to have a higher caloric requirement (CR) compared to those of the same body weight with type 1 DM?

<p>Due to caloric drift (A)</p> Signup and view all the answers

What is the strategy that allows patients to match a unit of insulin to a certain amount of carbohydrates?

<p>Insulin-to-carbohydrate ratio (C)</p> Signup and view all the answers

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