Question of the Week | Annual Quiz 2017
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Weight loss has been shown to have a positive impact on glucose control and reduction of visceral adiposity. At which weight loss threshold do these positive benefits start to become meaningfully apparent?
A. Weight reduction of 0-4%
B. Weight reduction of 5-7%
C. Weight reduction of 7-10%
D. Weight reduction of more than 10%
For someone with newly diagnosed type 2 diabetes, which would be an appropriate nutrition goal?
a. Avoid all desserts and processed foods.
b. Try to lose 5- 10% of current body weight
c. Eat less than 7% saturated fat
d. Increase intake of low fiber foods
Which of the following servings equals 15 gms of carbohydrate?
a. small bagel
b. 1 1/4 cup of strawberries
c. cup of milk
d. 1/2 cup of rice
Which of the following is true about alcohol and diabetes?
White wine increases blood sugars
Alcohol increases the risk of hypoglycemia
"If you are going to drink, eat a protein food"
A shot of margarita is better than a shot of tequila
If someone with type 1 is underweight, which of the following is the most likely cause?
Eating too much junk food
A sit-down job
According to the AACE and ADA Glycemic Control Algorithm, what is the first step to control hyperglycemia in type 2?
Start 2 meds if their A1c is 7.4%
Which of the following is an accurate exercise recommendation for people with diabetes?
a. Exercise must be done daily for 30 mins to be effective
b. Must get stress test before starting an exercise program
c. Try not to miss more than 2 consecutive days of exercise
d. Incorporate resistance training 7 days a week
What is an exercise precaution for people with diabetes?
a. Carry some form of identification on you at all times
b. Always have a snack if BG less than 100
c. Look for signs of hypo for up to 2 hrs after exercise
d. If your calves cramp, keep walking to improve circulation
Which of the following is a SMART Goal?
a. I will lose 5% of my body weight
b. I will eat less sugary foods throughout the week
c. I will monitor my blood sugar on a regular basis
d. I will eat one less bag of chips every day for 1 week.
In the fasting state, hyperglycemia is directly related to:
a. Increased hepatic glucose production
b. Defective insulin stimulation of target tissue glucose disposal
c. Decreased adipocyte lipolysis
d. Loss of pancreatic alpha-cell function
More relaxed hyperglycemia management ( target A1C 7-7.5%) in type 2 diabetes might be supported by which on the following factors:
A. Shorter life expectancy
B. New diagnosis
C. Low risk for hypoglycemia
D. Absent-few comorbidities
Which of the following is the correct diagnostic cut-point for diabetes?
A. A1C ≥ 7%
B. Fasting plasma glucose (FPG) ≥ 130 mg/dL
C. 2-hour post meal plasma glucose of ≥ 140 mg/dL
D. Random plasma glucose ≥ 200mg
MT takes 4 units of bolus insulin before each meal. At her sister’s 4th of July BBQ, she took her 4 units then ate a burger (with half a bun), 2 cubes of watermelon, green salad and a lite beer. Afterwards, she played a few games of horseshoe with her nephews. One of her nephews noticed she was acting kind of funny. What would be the best action?
A. Encourage her to drink water right away.
B. Have her lay down and rest for a few minutes.
C. Encourage her to walk around the block to get her blood sugars down
D. Encourage her to eat some watermelon
When treating patients with type 2 diabetes, educators include lifestyle interventions when developing diabetes management plans. Which of the following is an appropriate intervention?
A. Achieve A1c to 6% or less through lifestyle changes.
B. Get up and move every ½ hour.
C. Minimizing carb consumption.
D. Consume a high-fat, low-fiber diet
The development of type 2 diabetes is multi-factorial. Who is at most risk of getting diabetes?
A. 24-year-old with history of Gestational Diabetes
B. 83-year-old who has a “sweet tooth”
C. 47 year-old with a BMI of 27
D. 58-year-old who only exercises on the weekend
Which medication class(es) place asymptomatic patients at increased risk of developing hyperglycemia?
A. Atypical antipsychotics
D. Both A and B
The Diabetes Prevention Program Research Group found that implementing intensive lifestyle modifications resulted in an equivalent risk reduction of developing diabetes by:
A 78-year old patient with a 10-year history of type 2 diabetes on glipizide 20 mg a day. GFR is 45 they live alone. What would be a realistic A1C treatment target for this individual?
A. A1C 6.0-6.5%
B. A1C < 7.0%
C. A1C 7.5-8.0%
D. A1C 8.0 or greater
A patient newly diagnosed with type 2 diabetes is started on metformin. Metformin should be titrated to minimize which side effect?
A. Rebound hyperglycemia
B. Reactive hypoglycemia
C. Weight gain
D. Gastrointestinal-side effects
A patient is currently taking metformin, glyburide and an evening basal dose of insulin. After discussing how best to achieve better glycemic control, he has agreed to add a pre-meal insulin dose. Which modification should be made with the addition of the prandial dose?
A. Discontinue the glyburide
B. Discontinue the metformin
C. No modifications should be made
D. Discontinue the metformin, glyburide and evening insulin
Which of the following is considered an added sugar?
d. Non-nutritive sweeteners
Eating a healthy lunch can improve energy levels and help keep blood glucose on track. Eating fiber-rich meals is one strategy to keep on track.Which of the following lunches has the highest amount of fiber?
Slice of pizza with extra mushrooms
An 8-ounce bowl of bean chili with extra jalapenos
Sandwich with 2 slices of whole wheat bread and peanut butter
Lettuce wrapped hamburger bun with pickle relish and ketchup
Which of the following statement is true regarding diabetes awareness?
a. 50% of people with type 2 diabetes have it and don’t know it
b. 30% of people with type 2 diabetes have it and don’t know it
c. 90% of of people with prediabetes have it and don’t know it
d. Both b and c
e. Both a and c
GLP-1 Receptor Agonists, also known as Incretin Mimetics, help improve A1c levels through which of the following actions?
Increased glucagon secretion and increased insulin sensitivity
Decreased appetite and increased cortisol levels
Upregulation of digestive enzymes coupled with decreased glucagon activation
Stimulates glucose-dependent insulin secretion and decreases appetite
What is the effect of sugary drinks and diet soda on the gut microbiome?
Upregulates production of free fatty acids
Supports the proliferation of Akkermansia Mucinphilia
Enhances gut mucous lining
Contributes to a decrease in microbial diversity
Which of the following strategies most improves gut microbial health?
a. Eating a low fiber diet
b. Consuming plant based diet
c. Only eating organic chicken and beef
d. Avoiding pickled foods
Why is a healthy gut mucous barrier important to maintain health?
a. Slows down the rate of food digestion and absorption
b. Inhibits the passage of bacteria into the circulation
c. Stimulates the villi to absorb nutrients
d. Allows for easier passage of stool
Which of the following foods support healthy intestinal microbial diversity?
a. kefir, miso, nuts, whole grains
b. beans, onions, garlic, dandelion greens
c. red wine, processed meats, energy drinks
d. A and B
How do humans establish the majority of their gut microbiome?
a. Through the foods they eat before the age of 10
b. By a combination of birth method, foods and environment
c. Mostly through genetics and stress levels
d. By exposure to animals and foreign bodies
Which of the following statements is accurate regarding sleep and diabetes?
a. Inadequate sleep is associated with hypoglycemia
b. People with diabetes are at lower risk for sleep apnea
c. Oversleeping increases appetite
d. Lack of sleep increases stress hormone levels
Which of the following is true about prediabetes in the United States?
a. Only 40% of people with prediabetes know they have prediabetes
b. Medicare will provide payment for recognized Diabetes Prevention Programs starting in 2018.
c. Prediabetes can only be diagnosed with an A1c test
d. Prediabetes is not associated with any vascular complications
Please choose the person below with the greatest risk of prediabetes?
A Hispanic female over the age of 45.
An overweight, sedentary male, age 39.
An obese Caucasian, age 53.
A 34-year-old woman with history of gestational diabetes.
What is true regarding older adults and prediabetes?
35% of adults over 65 have prediabetes.
Older adults with prediabetes can reduce their risk of getting diabetes 70% through daily exercise and 5-7% weight loss.
Older adults with prediabetes are more likely to get diabetes than younger adults, even if they engage in daily exercise and achieve lose 5-7% weight loss
Older adults with prediabetes have higher rates of prostate and bladder cancer.
What best describes the elements of the CDC Diabetes Prevention Program?
a. Includes 16 weekly sessions followed by at least 6 monthly meetings.
b. Sessions must be taught by at least one licensed health care professional (RN, RD, PharmD etc.)
c. Pediatrics and adults with prediabetes can participate in the program.
d. A physician’s referral is required to participate in the Prevention Program.
A patient has prediabetes and asks you if he can prevent getting diabetes if he loses weight and gets active. What is the most accurate response?
a. By losing visceral fat and walking, you can prevent diabetes.
b. By taking care of your health today, you won’t get diabetes tomorrow.
c. People who get 30 mins of exercise a day and lose 7% of weight, have a decreased risk of getting diabetes.
d. People who get 30 mins of exercise a day and lose 7% of weight eliminate risk of getting diabetes
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