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Diabetes Knowledge Essentials
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Diabetes Knowledge Essentials
Diabetes Knowledge Essentials
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1
Question
What was the number of people with diabetes in 1980 compared to 2014?
Answer
The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014.
2
Question
What are some major complications caused by diabetes?
Answer
Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputation.
3
Question
What was the increase in diabetes mortality rates by age between 2000 and 2019?
Answer
There was a 3% increase in diabetes mortality rates by age between 2000 and 2019.
4
Question
How many deaths did diabetes and kidney disease due to diabetes cause in 2019?
Answer
Diabetes and kidney disease due to diabetes caused an estimated 2 million deaths in 2019.
5
Question
What is the normal blood glucose level after an overnight fast?
Answer
The normal blood glucose level after an overnight fast is 80 mg/dL.
6
Question
What is the blood glucose level considered postprandial?
Answer
The blood glucose level considered postprandial is 120 mg/dL after a meal.
7
Question
What role does insulin play in metabolism?
Answer
Insulin facilitates glucose transport into cells, suppresses endogenous glucose production, stimulates glycogen synthesis, stimulates secretion of lipoprotein lipase and lipogenesis, and stimulates amino acid uptake and protein synthesis.
8
Question
What are the stimulants and inhibitors of insulin?
Answer
Insulin is stimulated by elevated serum glucose load, arginine, lysine, leucine, alanine, gastrin, CCK, and secretin. It is inhibited by somatostatin, phenytoin, calcium channel blockers, and hypokalemia.
9
Question
What is glucagon and what stimulates its release?
Answer
Glucagon is produced by the alpha cells of the pancreas and is stimulated by low serum glucose levels, arginine, stress, acetylcholine, and vagal nerve stimulation.
10
Question
What are the actions of glucagon?
Answer
Glucagon increases glycogenolysis, gluconeogenesis, and ketogenesis while decreasing fatty acid synthesis.
11
Question
What are catecholamines and their actions in metabolism?
Answer
Catecholamines, such as epinephrine and norepinephrine, are stimulated by stress or fever and increase glucose levels through glycogenolysis and gluconeogenesis in muscle.
12
Question
What is the effect of cortisol on metabolism?
Answer
Cortisol causes relative insulin resistance and increases proteolysis while potentiating glucagon action.
13
Question
What are the characteristics of Type I Diabetes Mellitus (IDDM)?
Answer
Type I Diabetes Mellitus has an acute onset, is symptomatic with damaged pancreas, has a tendency towards ketosis, and requires daily insulin injections.
14
Question
What are the characteristics of Type II Diabetes Mellitus (NIDDM)?
Answer
Type II Diabetes Mellitus has a slow, often asymptomatic onset, involves insulin resistance, and hyperglycemia due to increased hepatic overproduction of glucose.
15
Question
What are some risk factors for Type 2 Diabetes?
Answer
Risk factors include age 40 years, first-degree relative with diabetes, history of impaired glucose tolerance, vascular disease, gestational diabetes, hypertension, dyslipidemia, abdominal obesity, overweight or obese status, and polycystic ovary disease.
16
Question
What are the diagnostic criteria for diabetes according to the American Diabetes Association?
Answer
1. A1C ≥ 6.5% OR 2. FPG ≥ 126 mg/dL (7.0 mmol/L) OR 3. 2-h plasma glucose ≥ 200 mg/dL (11.1 mmol/L) during an OGTT OR 4. Random plasma glucose ≥ 200 mg/dL (11.1 mmol/L) in a patient with classic symptoms of hyperglycemia or hyperglycemic crisis.
17
Question
What are the macrovascular complications of diabetes?
Answer
Macrovascular complications include disorders affecting large blood vessels, such as cardiovascular disease (CVD), atherosclerosis, coronary heart disease (CHD), hypertension (HTN), and claudication.
18
Question
What are the microvascular complications of diabetes?
Answer
Microvascular complications include retinopathy (damage to small blood vessels in the eyes), nephropathy (damage to small blood vessels in the kidneys), and neuropathy (damage to nerves leading to pain or numbness).
19
Question
What is the role of sulfonylureas in diabetes treatment?
Answer
Sulfonylureas are drugs that stimulate the beta cells to increase insulin production.
20
Question
How do biguanides like Metformin work?
Answer
Biguanides like Metformin increase glucose uptake in muscle, decrease gluconeogenesis in the liver, and prevent the breakdown of fat.
21
Question
What are the specific nutrition recommendations for carbohydrates in diabetes management?
Answer
Complex carbohydrates should comprise 45-65% of total energy requirements, with limited sources of simple sugars to 10%, and a consistent carbohydrate diet is recommended.
22
Question
What is the recommended daily intake of sodium for individuals with diabetes?
Answer
The recommended intake of sodium for individuals with diabetes is 2,300 mg/day.
23
Question
What is the glycemic index (GI)?
Answer
The glycemic index is a measure that ranks foods according to their effect on blood glucose levels.
24
Question
How is glycemic load (GL) calculated?
Answer
Glycemic load (GL) is calculated as GI x Carbohydrate g. It provides a more complete picture of the expected elevation in blood glucose levels based on the carbohydrate content of the food.
25
Question
What dietary adjustments are recommended for diabetes management?
Answer
Dietary recommendations should be tailored to individual needs, taking into account age, lifestyle, baseline anthropometric measures, cardiovascular risks, and co-existing medical conditions.
26
Question
When should insulin be used in diabetes management?
Answer
Insulin should be used in cases of symptomatic severe hyperglycemia, contraindications or allergy to oral antidiabetic drugs, significant co-morbid conditions, seriously ill patients, major surgery, pregnancy, or by choice.
27
Question
What is the recommended protein intake for individuals with diabetes?
Answer
The recommended protein intake for individuals with diabetes is 15-20% of total energy requirements or 1 g/kg body weight for those with normal renal function.
28
Question
What is the significance of monitoring blood glucose levels before and after exercise?
Answer
Monitoring blood glucose levels is important to prevent hypoglycemia and ensure that adequate dietary adjustments are made before exercising.
29
Question
What is the role of exercise in diabetes management?
Answer
Exercise improves glycemic control, blood lipids, blood pressure, and can reduce the risk of cardiovascular disease.
30
Question
What is the formula for calculating total daily insulin (TDI) requirement?
Answer
Total daily insulin (TDI) requirement can be calculated as weight in pounds divided by 4, or for weight in kilograms, the formula is 0.55 x total weight in kg.