Diabetes Management Program

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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?

It does not take into account individual variations in carbohydrate intake and exercise Signup and view all the answers

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

Splitting the insulin injection Signup and view all the answers

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

To achieve euglycemia Signup and view all the answers

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

Increased risk of weight gain and related complications Signup and view all the answers

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

To adjust for changes in blood glucose levels above 10 mmol/l or below Signup and view all the answers

What is the primary factor affecting the Carbohydrate Ratio?

Post-meal hyperglycemia 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?

Accurate carbohydrate counting Signup and view all the answers

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

10-15g CHO per 1 unit insulin Signup and view all the answers

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

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

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

40-60% Signup and view all the answers

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

Patients may be more likely to experience weight gain and related complications Signup and view all the answers

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

Due to increased physical activity 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?

They allow for more accurate insulin dosing calculations 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?

Caloric drift 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?

Drifty hypothesis Signup and view all the answers

What is the alternative hypothesis to the drifty hypothesis?

Settling point hypothesis 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?

Caloric flux 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?

Due to caloric drift 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?

Insulin-to-carbohydrate ratio Signup and view all the answers