MNT for DM

9\.4%

about how much of the population in the US have Diabetes Mellitus?

glucose intolerance

what else can diabetes mellitus result in?

long-term

damages correlated with failure of eyes, kidneys, nerves, heart, and blood vessels are determined to be _________

production, action, or both

diabetes mellitus can cause defects in insulin ________

Polyuria, Polydipsia, Polyphagia

what are some typical symptoms of Diabetes Mellitus?

Polyuria

this symptom causes frequent urination

polydipsia

this symptom causes excessive thirst

polyphagia

this symptom causes excessive hunger

Type 1 Diabetes

immune-mediated diabetes; about 5-10% of diagnosed cases

\
cellular-mediated autoimmune destruction of ß cells; usually leading to absolute insulin deficiency

Type 2 Diabetes

90-95% of diagnosed cases; risk factors include age, obesity, ethnicity, family history, physical activity, prediabetes and gestational diabetes

insulin resistance

type 2 diabetes can be simplified to _______

metabolic syndrome

shares characteristics with T2DM and requires multifaceted treatment

prediabetes

impaired fasting glucose or impaired glucose tolerance; early intervention and lifestyle changes are important

gestational diabetes

the oral glucose tolerance test is the standard screening for __________

2-3 months

the glycated hemoglobin assays (A1c) measures average glucose concentration over past _____

glutamic acid decarboxylase (GAD) autoantibodies

these are the most sensitive marker to screen for individuals at high risk of type 1 diabetes

insulin pump

small programmable medical device that delivers insulin through a cannula (plastic or steel)

basal or bolus

what are the two programmed ways to deliver insulin?

basal

automatically delivered continuously; job is to keep glucose stable overnight and between meals

bolus

user needs to enter information for the bolus to be delivered; carb, grams, and glucose; based on settings in pump, it is the amount calculated and delivered

rapid-acting

this type of insulin is usually taken before a meal to cover the BG elevation from eating (used with longer-acting insulin)

short-acting

this type of insulin is about 30 minutes before a meal

intermediate-acting

this covers the BG elevations when rapid-acting insulins stop working (used twice a day combined with rapid or short acting)

long-acting

combined with rapid or short acting, taken once or twice a day

automated insulin pumps

these have a predictive low-glucose suspend systems, hybrid closed loop, and DIY systems

hypoglycemia

low blood glucose

common side effect of insulin therapy

sometimes affects patients taking insulin secretagogues

can be life-threatening

ingestion of glucose

hypoglycemia treatment involves ________ or carbohydrate-containing food (glucose preferred)

false

t/f

\
protein helps with treatment or prevents recurrence of hypoglycemia

hyperglycemia

as the insulin deficiency persists, production of addition hormones (catecholamines, cortisol, glucagon, and growth hormone) increases

ketones

one of the manifestations of hyperglycemia leads to fatty acids transforming into ______

ketosuria

ketone bodies are secreted into the urine

kussmaul respirations

deep labored respirations caused by hyperglycemia

hypovolemia

total body water decreases due to hyperglycemia

diabetic ketoacidosis (DKA)

caused by hyperglycemia, life-threatening but reversible; severe disturbances in carbohydrate, protein, and fat metabolism

caused by inadequate insulin for glucose utilization

body uses fat for energy, forming ketones

DKA treatment

fluid and electrolyte replacement

supplemental insulin

medical monitoring

\
these are ways to help with

macrovascular disease

disease of large blood vessels, including cardiovascular diseases; begins with insulin resistance, which predates diabetes by several years. Produces metabolic changes called metabolic syndrome

20-40%

in the US, diabetic nephropathy occurs in ______ of persons with diabetes

20-74 years

most frequent causes of new cases of blindness among adults are around _______

Neuropathy

nerve damage; affects 60-70% of patients with type 1 and type 2 diabetes

MNT in type 1 diabetes

insulin therapy should be integrated into an individual’s dietary and physical activity pattern

\
for individuals using fixed daily insulin doses, CHO intake on a day-to-day basis should be kept consistent with respect to time and amount

MNT in type 2 diabetes

reduce intakes of energy, saturated and trans fatty acids, cholesterol, and sodium

increase physical activity in order to improve glycemia, dyslipidemia, blood pressure

\
can be used to determine whether adjustments to foods and meals will be sufficient to achieve blood glucose goals

consistent

CHO intake on a day-to-day basis should be kept _______ with respect to time and amount (about 50% of energy)

true

dietary pattern that includes CHO from fruits, vegetables, whole grains, legumes, and low-fat milk is encouraged for good health

3-4 CHO servings per meal

the CHO count for women is ….

4-5 CHO servings per meal

the CHO count for men is …

1-2 CHO servings

what is the recommended CHO count for snacks, if desired?

15-20% of energy

the usual protein intake of _______ is recommended

true

t/f

\
high-protein diets are not recommended for weight loss

what is the recommended dietary fat for saturated fat?

what is the recommended amount of cholesterol for people with diabetes?