Diabetes Final
You say, "I am concerned about your high blood sugar and I wonder what you believe is causing this problem?" The person answers, "I know I do not eat well, I am just hungry all the time." What is best to ask/state next?
"I understand, it is not easy to follow a meal pattern when you are always hungry"
What is the duration of intermediate acting insulin (NPH)?
12 hrs
What fasting plasma BG is the diagnostic cutoff point for a diabetes diagnosis?
126 mg/dl
How many grams of carbohydrate is considered a single serving?q
15 grams
A PW T2D weighs 200 lbs. About how much weight should they lose to improve BG?
15 lbs
After treating low blood glucose, how many minutes should a person wait before rechecking blood glucose?
15 minutes
According to the 2018 federal guidelines, how much aerobic activity is recommended for all adults?
150-300 minutes/wk of moderate exercise
A PW T1D taking insulin is about to eat and for a moderate walk. What decrease in meal time insulin is recommended?
20%
What is the onset of rapid acting insulin (aspart, lispro)?
5 minutes
What A1c is the diagnostic cutoff point for a diabetes diagnosis?
6.5%
What is the minimum percentage of time in range (TIR) needed to attain an A1c < 7.0%?
70%
A man's carb ratio is 8 grams to 1 units. He eats 65 grams of carbohydrate for lunch. Approximately how many units of insulin should he take if his BG is in the target range before his meal?
8
A woman is newly diagnosed with T1D and weights 150 lbs (80 kg). How many units of basal insulin will she begin taking with a formula of basal insulin = kg (0.1) or kg(0.12)?
8-10
How many minutes of structured physical activity a week improves A1c?
>150
What is 70/30 insulin?
A mixed insulin with 70% long acting insulin and 30% short acting insulin
How is peripheral artery disease assessed?
ABI
Which medication for hypertension is know to be protective of kidney function?
Angiotensin converting enzyme inhibitors (ACE-I)
Which best describes Body Mass Index (BMI).
BMI is a reliable tool for identifying risk of diabetes in the population
A PWD wants to learn how much their BG elevates after a meal. When should they check?
Before and two hours after a meal
Which two self-management behaviors best help a T1D athlete to safely exercise?
Check urine ketones if BG >250 and have access to rapid acting carbohydrate
What supplement is recommended for PWD who are taking a statin?
CoQ-10
Which meal pattern has demonstrated benefit for reduction of BP?
DASH meal pattern
Which of the following is a useful way to identify diabetes distress?
DDS
Which of the following is NOT a critical time for a referral to DSMES?
Diabetes prevention
Which medication is associated with genital yeast infections?
Empagliflozin (SGLT-2i)
The _____ has become the most frequently used theoretical model to predict health behaviors
Expanded health belief model
What acronym is used to assess for and take action on a stroke?
FAST
Which medication has an increased risk of hypoglycemia?
Glipizide (Sulfonylurea)
Which of the following is beneficial coping response for a PWD?
House cleaning
Which insulin is rapid acting insulin?
Humalog
What hormones have a major influence on energy balance?
Leptin and Ghrelin
After a meal where does insulin primarily act?
Muscle and Fat
What is a side effect of statin medications?
Myopathy
What glycemic measure is used to diagnose gestational diabetes (GDM)?
Oral glucose tolerance test (OGTT)
Which is a measure of depression?
PHQ-9
What is DKA a greater risk for PWD who use an insulin pump?
PWD has no long acting insulin
Which of the following express the spirit of MI when used by a health professional in discussing a behavior change?
Permission, affirmation, empathy
What class of diabetes medications has the most benefit for prevention of CVD complications?
SGLT-2
Which medication is associated with improved weight loss?
Semaglutide (GLP-1)
Which medication is injected once a week?
Semaglutide (GLP-1)
which is more genetically determine?
T2D
A PWD has hypertension. After diet and exercise what is the first medication for blood pressure a PWD should start?
Thiazide diuretic (HCTZ)
A PWD is frustrated that they have no yet lost 5 lbs after starting an exercise program one week ago. This is an example of what barrier.
Unrealistic expectations
Should a PW T1D who exercised vigorously eat a snack if their BG is 188 and they are going to bed?
Yes, they will keep having BG lowering from their exercise
A health professional asks, "Could you please tell me about how you eat?" What MI process is this is an example of?
an open-ended question
What is the most common mental health disorder in children?
anxiety
A hallmark of MI is ______, an autonomy-supporting strategy to place the person with diabetes in an equal position of power
asking permission to give information or advice
How do PW T1D benefit form a 4-injection insulin regimen
best duplicates the normal physiology of insulin's action
Which of the following is a modifiable risk factor for CVD?
blood lipids
What is the correct instruction on how to use nicotine replacement gum for smoking cessation?
chew and pocket gum in your cheek
Which stage of change is described as being aware of the problem and intending to change behavior?
contemplation
What is the adjustment of insulin that is injected based on a person's blood glucose called?
correction factor
What activity facilitator describes a person scheduling a walk on their calendar?
cue to action
A health professional asks, "What are the good and not so good things about changing your meal pattern?" What MI process is this an example of?
decision balance
Which meal pattern has the highest level of evidence for its benefit for people with T2D?
energy restricted Mediterranean meal pattern
The health professional asks the patient, "What could you gain by increasing your physical activity?" What MI process does this question represent?
evoking
A PW T1D wants to know if their basal insulin is correctly dosed. When should they check their BG?
fasting in the morning
What is the most important treatments in both mild and severe DKA?
fluid and insulin
Which of the following is the best carbohydrate to treat hypoglycemia?
glucose tablets
What is the best response to a PWD who is doing the least they need to do to take of their diabetes?
identify the emotion behind their behavior
What is the primary benefit of resistance training for a PW T2D?
improved insulin resistance
In the US what is most associated with the increased prevalence of T2D?
increased rates of obesity
In T1D what is the most important treatment for hyperglycemia?
insulin and fluids
What is a hallmark of T2D?
insulin resistances
What is the amount of insulin that is injected based on the amount of carbohydrate called?
insulin to carbohydrate ration (ICR)
What is the primary nutrition goal for people with T1D?
integration of insulin therapy with healthy eating and activity
What does the talk test measure?
intensity
What resources would help a PWD to count carbohydrates?
label reading
What are the symptoms of intermittent claudication?
leg pain with walking that gets better with rest
Walking far from the door in a parking lot as an example of what type of activity?
lifestyle activity
Which of the following is a goal of nutrition management for people with T2D?
limiting calories in their preferred meal pattern
What is the best strategy to use when a PWD is making health decisions based on what feels emotionally comfortable to them?
listen and validate feelings as normal
A person is newly diagnosed with T2D. What is the first medication to consider after recommendations related to weight loss, meal pattern changes and physical activity no loner decrease BG?
metformin (Glucophage)
What medications are discontinued in a person with advanced CHF?
metformin and statins
What is the best response to a PWD who is asking a lot of questions and gathering information about diabetes?
move them towards behavior change with MI
What medication treats Angina?
nitroglycerin
What lab value needs to monitored for people who are taking a thiazide diuretic?
potassium
What are the stages of change?
precontemplation, contemplation, preparation, action, maintenance
Which coping style is particularly useful when there is a "best response" to a diabetes challenge?
problem focused coping
What part of exercise prescription is instructing a person to gradually increase their activity.
progression
The health professional responds to a patient by saying, "So, I hear you saying that you are not yet ready to change because you do not believe that your meal pattern is having a negative effect on your diabetes." What MI process does this response represent?
reflection
What should a PWD due if their insulin is cloudy
roll the vial prior to drawing up or administering insulin
______ is mindfully deciding not to get drawn into an argument and not creating an argument
rolling with resistance
What are the three parts of a continuous glucose monitor (CGM)?
sensor, transmitter, monitor
What is the most important health behavior to decrease risk for CVD for PWD?
smoking cessation
Which of the following evolved from Bandura's Social Learning Theory?
social cognitive theory
After a meal, how does glucagon like peptide-1 act in these organs?
stimulates insulin production in the pancreatic Beta-cells, delays gastric emptying of the stomach, reduces appetite signals from the brain
Which of the following are NOT a coronary heart disease?
stroke
_____ focusing on encouragement by noticing and praising the person for things they are doing or saying
supporting self-efficacy
Which of the following is NOT a lifestyle intervention for prevention for CVD in PWD
taking a statin
What does the blue band (area) on the ambulatory glucose profile tell people about their BG?
the area that includes 50% of their readings
Using the hand to visualize portion size, what is equivalent to 3 oz of cooked meat?
the palm
Why does the health professional respond, "why not a lower number?", after asking how ready someone is to make a lifestyle change?
to evoke the person's statement of reason of change
How often should stress be assessed in a PWD?
twice a year
What is the percentage of all PWD have T2D?
up to 95%
How could a health care provider help someone who is problem solving?
use a decision tree to support shared decision making
A PWD has difficulty getting a large enough blood sample from their finger. What may help?
warming the hand with warm water
What three concepts are important in teaching about a meal pattern?
what, how much, when
Which explanation is best to explain the pathophysiology of T1D to a newly diagnosed PWD?
you will need insulin because your body has destroyed the part of your pancreas that makes insulin
Which explanation is best to explain the pathophysiology of T2D to a newly diagnosed PWD?
you will need to lose weight because your fat cells are preventing your insulin from working
