Exam 20: Nutrition and Diabetes Mellitus

Which insulin has the longest duration of action?

Diabetes mellitus describes a group of metabolic disorders characterized by:

In treated diabetes, hypoglycemia is a possible complication of:

Clinical trials have demonstrated that intensive treatment can keep blood glucose levels tightly controlled and reduce the incidence and severity of the chronic complications of diabetes.

Nursing Exam Review Multiple Choice Which compound(s) formed in the body during diabetes alters protein structures and stimulate damaging metabolic pathways?

Jared Joiner is a 56-year-old African American insurance agent. He is single, eats most meals at restaurants, and leads a sedentary lifestyle. He is 5'9" tall and weighs 204 pounds. Mr. Joiner has been feeling particularly fatigued lately and decided to make an appointment with his physician for a check-up. The results of his laboratory tests include a fasting blood glucose level of 121 mg/dL. The simplest and most flexible approach to teaching Mr. Joiner the principles of the diet for optimal management of his blood glucose level is:

A 60-year-old client, Mr. Hummel, has had type 2 DM for several years. Because of a change in insurance coverage, Mr. Hummel changes doctors and at his first appointment, a comprehensive medical exam and dietary history are performed. At the next few appointments, the certified diabetes educator, a registered dietitian, takes a full dietary history. Mr. Hummel works part-time in a seasonal sporting goods store, having retired last year after 35 years working for a manufacturing plant as a supervisor. He is married to a nurse who works full-time. He does most of the cooking and grocery shopping. He and his wife go for walks on weekends, but he does not exercise otherwise, except for doing chores around the house and occasional yard work or gardening. He is 5'9" tall and weighs 196  lbs., though when his diabetes was initially diagnosed, he weighed more. Mr. Hummel is interested in weight reduction, especially if it will help him manage his blood glucose, and provides the following 24-hour food recall that typifies how he usually eats: Breakfast (eats after taking morning blood glucose):   Pancakes with diet syrup or a bowl of cereal (usually corn flakes, Chex, or instant oatmeal) with Sweet 'N' Low and nonfat milk. Drinks coffee throughout the day starting at breakfast with two nondairy coffee creamer packets per cup. May or may not have 4 oz. of 100% fruit juice depending on hunger. Lunch (eats after taking afternoon blood glucose):   Sandwich (rye or wheat bread), deck of cards-size portion of lunch meat (salami, ham, bologna, turkey, or chicken) with thinly spread mayonnaise; coffee with nondairy creamers. May or may not eat a can of soup (cream of tomato, cream of chicken, or Italian wedding soup) instead of a sandwich, with two slices of buttered rye or wheat bread. Afternoon Snack:   Canned fruit or occasionally a cookie, doughnut, a piece of pizza, or a treat, depending on availability, hunger, blood sugar, and situation. Drinks coffee with nondairy coffee creamer. Usually also has a glass of ice water before dinner. Dinner (eats after taking evening blood glucose):   Roast beef, meat loaf, steak, or another red meat; occasionally eats poultry or fish-approximate amount 8 oz.; plain baked potato, au gratin potatoes, or boiled buttered potatoes; a salad with bottled salad dressing or a vegetable, such as canned green beans; and a slice of rye or wheat bread with butter. May use ketchup, steak sauce, salt, and pepper. Drinks water with dinner. Evening Snack:   Varies-may eat a few handfuls of a bagged snack food, such as Doritos; a bag of buttered microwave popcorn; or cookies. Labs are as follows: Fasting glucose: 140-150 mg/dL Glucose one to two hours after mealtime: 200 mg/dL Average bedtime glucose: 152 mg/dL Glycosylated hemoglobin (hemoglobin A _1C ): 7.5%   The CDE teaches Mr. Hummel how to reduce his kcalories by increasing high-fiber foods in place of foods such as bagged snack chips. A higher intake of fiber could also:

Prediabetes is diagnosed when a person has a fasting blood glucose level that falls between 100 and 125 mg/dL.

Which is a symptom of diabetes mellitus?

The hyperosmolar hyperglycemic syndrome is usually a complication of type 2 diabetes.

Identify the acute complications of diabetes and explain why they occur.

Describe the different methods of insulin delivery.

Obesity alone can cause some degree of insulin resistance.

Good glycemic control requires:

Uncontrolled diabetes during pregnancy is most likely linked to what complication?

Acetone breath is a characteristic symptom of hypoglycemia.

Type 2 diabetes often goes undiagnosed in overweight children and teens because:

By the time symptoms of type 1 diabetes develop, damage to the beta cells has often occurred and the first sign of the disease is:

Claudication is a symptom of diabetes that often develops because of polyuria.