Nutrition and Diabetes Quiz

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Questions and Answers

What is the recommended percentage of carbohydrates in a day's diet?

45%

50%

60% (correct)

75%

Which of the following dietary components is advised to be limited to less than 5 g per day?

Salt (correct)

Carbohydrates

Protein

Sugar

Which exercise advice is appropriate for a diabetic patient?

Regular exercise is beneficial and should be maintained. (correct)

Exercise should be avoided until blood glucose levels return to normal.

Any form of exercise is sufficient, regardless of glucose levels.

Exercise should only be done on an empty stomach for better results.

What should be offered to a patient before they engage in exercise?

Extra food or calories. Signup and view all the answers

To ensure optimal growth in children, their diet should be established by whom?

A dietician with input from a paediatrician. Signup and view all the answers

What is diabetes insipidus primarily characterized by?

Non-sweet urine Signup and view all the answers

Which of the following is the most common type of diabetes mellitus?

Type II Diabetes Signup and view all the answers

What is a significant risk factor for developing Type II diabetes?

Obesity, especially abdominal fat Signup and view all the answers

What typically occurs during Type I diabetes mellitus?

Destruction of pancreatic beta cells occurs Signup and view all the answers

Which of the following statements about Type II diabetes mellitus is false?

Insulin production is typically stopped. Signup and view all the answers

What is a characteristic of gestational diabetes?

It is related to pregnancy and usually appears in the last trimester. Signup and view all the answers

Which of the following describes the cause of Type I diabetes?

Genetic, immunologic factors, and possibly environmental influences Signup and view all the answers

What is a potential trigger of drug- or chemical-induced diabetes?

Corticosteroids Signup and view all the answers

What is the primary function of insulin in regulating blood glucose levels?

To facilitate the uptake of glucose into cells Signup and view all the answers

How does insulin affect glycogen in the liver?

Insulin stimulates the conversion of excess glucose into glycogen Signup and view all the answers

Which of the following statements is true regarding insulin's role in fat metabolism?

Insulin stimulates fat cells to store fatty acids as triglycerides Signup and view all the answers

How does insulin influence protein metabolism?

Insulin enhances protein synthesis by promoting amino acid uptake Signup and view all the answers

What is the normal glucose range that insulin helps maintain?

70 to 120 mg/dL Signup and view all the answers

What condition can arise from the dysregulation of insulin?

Diabetes mellitus Signup and view all the answers

What effect does insulin have on potassium levels in the blood?

Insulin helps regulate potassium levels by stimulating its uptake into cells Signup and view all the answers

What is the average amount of insulin secreted daily by an adult?

40 to 50 U Signup and view all the answers

What is the primary cause of weight gain during pregnancy that contributes to gestational diabetes?

Increased estrogen and placental hormones Signup and view all the answers

What percentage of individuals with diabetes has Type I diabetes?

5%-10% Signup and view all the answers

Which of the following is a risk factor for developing Type 2 diabetes mellitus?

Age of more than 45 Signup and view all the answers

What characterizes the pathophysiology of Type 1 diabetes mellitus?

Decreased insulin production Signup and view all the answers

Which symptom is commonly associated with hyperglycemia in diabetes?

Polyuria Signup and view all the answers

What is a potential environmental factor contributing to Type 2 diabetes?

Sedentary lifestyle Signup and view all the answers

What is the classic triad of symptoms associated with diabetes mellitus?

Polydipsia, polyphagia, hyperglycemia Signup and view all the answers

What effect does gestational diabetes have on newborns?

Newborns may be large and overweight Signup and view all the answers

What should be carried to address potential hypoglycemia during or after exercise?

Fast-acting carbohydrates Signup and view all the answers

Why are people with diabetes particularly prone to foot problems?

Damage to blood vessels and nerves Signup and view all the answers

What is a recommended practice for foot care in individuals with diabetes?

Wear shoes and socks at all times Signup and view all the answers

How should toenails be trimmed for individuals with diabetes?

Straight across and filed at the edges Signup and view all the answers

Which method is NOT advisable for checking water temperature before washing feet?

Testing with the feet Signup and view all the answers

What is a step that individuals with diabetes should take to help protect their feet?

Check feet daily for sores or changes Signup and view all the answers

Which fluid is recommended for hydration before, during, and after exercise for people with diabetes?

Unsweetened fluids Signup and view all the answers

What action should individuals with diabetes take if they have foot problems?

See a podiatrist for treatment Signup and view all the answers

How often should patients on insulin perform self-monitoring of blood glucose (SMBG)?

2-4 times per day Signup and view all the answers

What is the recommended frequency of SMBG for patients not on insulin?

2-3 times per week Signup and view all the answers

What is the primary purpose of self-monitoring of blood glucose (SMBG)?

To adjust treatment regimen for optimal glucose control Signup and view all the answers

Which of the following statements about educational needs for diabetic patients is incorrect?

Understanding complex pathophysiology is essential. Signup and view all the answers

What is the correct administration timing for sulphonylureas?

30 minutes before meals Signup and view all the answers

Which category of diabetes medication includes metformin?

Biguanides Signup and view all the answers

What type of exercise is especially beneficial for individuals with diabetes?

Regular and enjoyable physical activity Signup and view all the answers

Which of the following is NOT a proper storage guideline for insulin?

Store all types of insulin together in a refrigerator Signup and view all the answers

Study Notes

Pancreas Overview

The pancreas is located in the abdomen, behind the stomach.
It plays a crucial role in the digestive system and the regulation of blood sugar.

Insulin Function

Insulin is produced by beta cells in the islets of Langerhans within the pancreas.
It lowers blood glucose levels by facilitating the uptake of glucose into cells (primarily muscle, fat, and liver cells).
This uptake allows cells to use glucose for energy or store it as glycogen.
Insulin also promotes glycogen storage in the liver and inhibits glucose production (gluconeogenesis) when blood sugar is high.
Insulin is needed to help transport glucose across the cell membrane to the cytoplasm of the cell.
Insulin is an anabolic or storage hormone, which stimulates the storage of fat by stimulating fat cells (adipocytes), inhibits the breakdown of fat, and plays a role in protein metabolism by promoting amino acid uptake into cells for protein synthesis and muscle building.
Insulin also helps regulate potassium levels in the blood.
Daily insulin secretion in adults is approximately 40-50 units, or 0.6 units per kilogram of body weight.
Normal blood glucose range is approximately 70-120 mg/dL (3.9-6.66 mmol/L).

Diabetes Mellitus

Diabetes mellitus is a chronic multi-system disease characterized by disordered metabolism and inappropriately high blood glucose (hyperglycemia). This is caused by either low levels of insulin or impaired insulin utilization.
A diagnosis of diabetes is suggested when fasting whole blood glucose level is 5.7 mmol/L or more, or when random blood glucose, taken 2 hours after a meal or 75g glucose load (1.75g/kg body weight in children), is 7.8 mmol/L or more.
There are different types of diabetes: type 1 (insulin-dependent/juvenile onset), type 2 (non-insulin-dependent/maturity onset), gestational diabetes, diabetes secondary to other medical conditions or syndromes, and other specific types like monogenic diabetes syndromes and diseases of the exocrine pancreas (e.g., cystic fibrosis).

Type 1 Diabetes Mellitus (IDDM)

Characterized by the destruction of pancreatic beta cells.
Genetic, immunologic, and possibly environmental factors are involved in beta cell destruction.
Usually occurs in younger people (before age 30).
Insufficient or absent insulin production.

Type 2 Diabetes Mellitus (NIDDM)

Occurs typically after age 30.
Two main causes are insulin resistance, and impaired insulin production.
Obesity, especially abdominal and visceral adiposity, is a significant risk factor.
The pancreas typically continues to produce some insulin, but it's either insufficient for the body's needs or used poorly by the tissues.
Often treated with diet, exercise, and oral medications.

Gestational Diabetes Mellitus

This type of diabetes occurs during pregnancy, usually in the last trimester.
Pregnancy leads to weight gain and increased levels of estrogen and placental hormones, which are antagonistic to insulin utilization.
Babies born in these pregnancies are often large and overweight, sometimes accompanied by maternal polyhydramnios.
Blood glucose returns to normal after delivery.

Diagnostic Investigations

Random Plasma Glucose Test, Fasting Plasma Glucose (FPG) Test, Oral Glucose Tolerance Test (OGTT), Glycated Hemoglobin (HbA1c) Test, C-Peptide Test, Insulin Autoantibodies (IAA) Test, Lipid Profile, Urine Tests (ketones, microalbuminuria), Continuous Glucose Monitoring (CGM), Fructosamine Test, and Genetic Testing.

Pathophysiology

In diabetes, if insulin levels are low or insensitive, glucose absorption by the body cells is hampered, leading to elevated blood glucose levels (hyperglycemia).
Classic symptoms are polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased appetite).
Other symptoms include fatigue, weakness, sudden vision changes, tingling or numbness in hands or feet, dry skin, poor skin turgor, recurrent infections, weight loss, nausea/vomiting, abdominal pains, poor vision, pruritus vulvae, paresthesia, aching and cramps in the legs, lowered resistance to infection, ketoacidosis, fruity smell of breath, impotence in men, skin lesions/slow-to-heal wounds, foot gangrene, and pedal edema.

Clinical Manifestations

The symptoms of diabetes include increased urination (polyuria), increased thirst (polydipsia), increased appetite (polyphagia), fatigue and weakness, sudden vision changes, tingling or numbness in hands or feet, dry skin, poor skin turgor, recurrent infections, weight loss, nausea/vomiting, abdominal pain, poor vision, genital itching, tingling in hands/feet, aches/cramps in legs, reduced resistance to infections like skin boils, ketoacidosis, fruity breath, impotence, skin lesions, foot gangrene, and swelling in the feet (pedal edema).

Treatment Objectives

Relieve symptoms
Prevent acute hyperglycemic complications (e.g., ketoacidosis and hyperosmolar state).
Prevent treatment-related hypoglycemia.
Achieve fasting blood glucose between 4-7 mmol/L (less intensive targets in elderly).
Achieve 2-hour post-meal blood glucose between 5-9 mmol/L (less intensive targets in elderly).
Maintain glycated hemoglobin (A1c) below 7% (less intensive targets in elderly).
Ensure weight reduction in overweight and obese individuals.
Prevent chronic complications of diabetes like hypertension.

Management

Nutritional measures (diet, carbohydrate control, reduced refined sugars and alcohol, increased fiber, appropriate portions based on individual needs).
Exercise (daily, consistent, appropriate for fitness level, blood glucose monitoring before exercising, providing extra carbs/calories before or after).
Monitoring (self-monitoring of blood glucose, checking before meals and 2 hours after, consistent frequency depending on diabetes type/insulin use).
Pharmacologic treatment (medications like sulfonylureas, biguanides, thiazolidinediones, insulin depending on specific diabetes type).
Education (regarding diabetes pathophysiology, treatment modalities, acute complications). (Foot care, eye care, general hygiene, risk factor management, insulin administration).

Foot Care

Daily foot inspection.
Avoiding barefoot walking.
Wearing appropriate, properly-fitting shoes.
Checking for injuries and infections.
Keeping feet clean and dry, with mild soap only.
Avoiding soaking the feet.
Treatment of corns/calluses under medical guidance.
Prompt treatment during infections.
Seeking professional advice for foot problems including podiatrist checkups.

Incidence, Aetiology and Risk Factors

Type 1 diabetes is sudden in onset and occurs before age 30 (around 5-10% of cases).
Type 2 diabetes typically develops after 30 years of age (around 90-95% of cases).
Gestational diabetes occurs in 2% of pregnancies.
Aetiology includes autoimmune disorders, idiopathic factors, genetic predisposition, excessive calorie intake, and lack of physical activity.
Risk factors include family history of diabetes, obesity, race/ethnicity, age over 45, previously unidentified impaired fasting glucose/impaired glucose tolerance.

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Description

Test your knowledge on nutrition guidelines and diabetes management in this comprehensive quiz. Covering various dietary recommendations and exercise advice, this quiz will help reinforce your understanding of essential concepts related to diabetes. Perfect for healthcare students and professionals.