NUTR-4240 Lecture Notes - Lecture 6: Gestational Diabetes, Prediabetes, Blood Sugar

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15 Dec 2018

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Diabetes: diabetes is an independent risk factor for cvd. Many of the treatments are aimed at lipid levels because it is independent risk factors: diabetes: having fasting blood glucose of equal to or greater than 126 mg/dl. Individual is given 75 grams of anhydrous glucose (load of glucose) and then testing response of the individual to the glucose. Test it at 1 hour, 2 hours, and maybe 3 hours. Statistics: every 5 minutes, 2 people die from diabetes, every 5 minutes, 14 people are newly diagnosed. In 2050, 1 in 3 american adults will have diabetes: diabetes kills more americans every year than hiv and aids and breast cancer combined. Prevalence of diabetes: 9. 3% of the population has diabetes, and 21 million people are diagnosed, and to be diagnosed, you have to have a fbg level of 126 or greater. To fast, it takes about 8 hours: undiagnosed = 8. 1 million people, pre-diabetes = 86 million people have pre-diabetes.

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CASE STUDY SCENARIO

SJ is a 64-year-old, South East Asian male from the Greater Toronto Area (GTA) in Ontario, who comes to the Emergency Department with his wife of 22 years. SJ and his wife are South East Asians and live in GTA, Ontario. SJ has been complaining of nausea and vomiting over the last 2â3 days, and his wife states he seems confused at times. His blood sugar on arrival to the department read 19.6 mmol/L. The client has already been started on regular insulin (Humulin R) via SQ route, and he will be admitted for further investigation and diagnostic purpose.

This is a new diagnosis of diabetes for SJ, and he is very anxious. SJ is 5 feet 7 inches tall and weighs 171 pounds. He reports no form of regular exercise or special diet. SJâs diet entails carbohydrate dense foods and high glycemic index beverages. For the past 4 months or more, his wife has noticed that her husband has been very thirsty, and goes to the bathroom every 30 minutes.

PART 1: Questions

1. Describe the following serum glucose tests used to help diagnose diabetes mellitus: fasting, postprandial, and oral glucose tolerance test.

2. Explain what a hemoglobin A1c lab test tells the health care team.

3. Taking SJâs cultural background into consideration, explain what could have possibly contributed to SJâs diagnosis? Which type of diabetes does SJ have? List all the criteria from the case study that would support his diagnosis.

4. please include references in APA styles.

amaranthbear314

Question 2

The DSM-IV describes an "Eating Disorder Not OtherwiseSpecified" as:

self-starvation that leads to severe nutrient deficiencies

compulsive eating disorder

a variety of atypical eating behaviors used to maintain or lowerbody weight

recurrent episodes of extreme overeating followed byself-induced vomiting

Question 3

The nutrition paradox refers to:

coexistance of underweight and obesity in the same region

too mucn vitamin A in foods rich in vitamin C

poor countries that have excessive rates of obesity

obese children from nonobese parents

Question 4

Which of the following represents a nutrition transition?

decreased reliance on carbohydrates

increased consumption of sugar

increased availibility of maize over corn

lower-fat subsistence crops

Question 5

Which of the following is NOT part of the GOBI initiative?

breast-feeding

obesity control

immunization

growth monitoring

Question 6

Which of the following is a response to the drawbacks of theGreen Revolution?

WIC

high yield varities of grains

sustainable agriculture

biotechnology

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Question 70.5 pts

Worldwide, the major cause of undernutrition is:

unequal distribution of food

diseases (like AIDS)

poor farming practices

overpopulation

Question 8

Which agency monitors all confirmed causes of food-borneillness?

EPA

FDA

CDC

USDA

Question 9

In which of the following environments does Clostridiumbotulinum flourish?

acidic

alkaline

<40 degrees F

> 140 degrees F

Question 10

Which of the following is an example of food intoxication?

Norwalk virus

Salmonella

hepatitis A

Clostridium botulinum

Question 11

All of the following describe characteristics of the femaleathlete triad EXCEPT

menstrual dysfunction

disordered eating

hypertension

osteoporosis

Question 12

Impulsive, low self-esteem, seeks attention, extroverted, anderratic describe personality traits of:

bulemia nervosa

binge-eating disorder

obesity

anorexia nervosa

Question 13

Obsessive-compulsive, perfectionism, socially inhibited,compliant, and emotionally restrained describe personality traiatsof

binge-eating disorder

anorexia nervosa

bulimia nervosa

obesity

Question 14

The Institute of Medicine recommends a minimum of ________minutes of physical activity each day for adults.

Question 15

Regular exercise reduces the risk of type 2 diabetes by all butwhich of the following?

decreases the cellular uptake of blood glucose

delays the onset of complications of type 2 diabetes

increases control of blood glucose

enhances the action of insulin

Question 16

What is meant by the overload principle?

stretching a muscle group beyond the joint's healthy range ofmotion

improving fitness by placing extra physical demand on thebody

complete depletion of the body's glycogen

subjecting the body to inappropriately high stress

Question 17

The acronym FIT stands for:

fatigue, intensity, and training.

flexibility, increase, and training.

fitness, increase, and time.

frequency, intensity, and time.

Question 18

To achieve cardiorespiratory fitness it is recommended thattraining should occur ________.

3-5 days a week

daily

more than 5 days a week

2-3 days a week

Question 19

To achieve and maintain physical fitness, exercise intensityshould be ________ of the maximal heart rate.

35-50%

15-25%

25-30%

50-80%

Question 20

In which of the following types of exercise would CP (creatinephosphate) be an important source of energy?

biking up a mountain

sprinting in the 100-meter race

running a 10-kilometer road race

playing in a football game

Question 21

Which is NOT an advantage of aerobic metabolism over anaerobicmetabolism?

Much more energy is produced for every fuel molecule.

Aerobic metabolism acts more quickly.

Harmful metabolites do not accumulate as quickly.

A greater fuel supply is available.

Question 22

An unwanted effect of an overly vigorous warm-up is:

increased muscle temperature.

glycogen depletion.

increased body temperature.

reduced stress levels.

Question 23

Each day Bill power-walks for 45 minutes. Which fuel source(s)provide(s) energy during this activity?

amino acids

glucose

fatty acids

fatty acids and glucose

Question 24

The main disadvantage of using fat as a fuel is:

the body's limited storage capability.

its low energy density.

its slow metabolic breakdown.

the limitation of anaerobic metabolism.

Question 25

Joseph plays basketball for his high school team and he isconcerned that he is not consuming enough kilocalories to supporthis activity. Which of the following would be the best indicatorthat he is not consuming adequate kilocalories?

His hemoglobin is low.

His blood glucose levels are low.

His performance has been impaired.

He is losing weight.

Question 26

Rachel is a gymnast who trains 2 hours/day on average. Shesupports her daily activity by consuming 2,500 kilocalories perday. How many kilocalories should she be consuming fromcarbohydrate sources?

1,500-1,625 kilocalories

1,125-1,300 kilocalories

1,300-1,500 kilocalories

1,625-1,750 kilocalories

Question 27

The best time to replenish glycogen stores is:

the day after exercising.

a few hours before exercising.

the day before exercising.

right after exercising.

Question 28

In which of the following events would carbohydrate loading bethe most beneficial?

cross country skiing

baseball game

weight lifting

100-yard dash

Question 29

Osteoporosis, eating disorders, dehydration, and heat illnessare all possible consequences of:

the Zone diet.

carbohydrate loading.

inadequate dietary intake.

overtraining.

Question 30

Which of the following is the most potentially harmful?

heat syncope

heatstroke

heat cramps

heat exhaustion

Question 31

Which of the following athletes would be LEAST likely to developiron deficiency anemia?

a female marathon runner

a male basketball player who is a vegan

a female gymnast

a male distance swimmer

Question 32

Amenorrhea, sometimes seen in female athletes, is:

the onset of menstruation.

osteoporosis.

the loss of the menstrual cycle.

frequent diarrhea.

Question 33

Some athletes believe that caffeine can enhance athleticperformance because it has been shown to:

increase the transport of amino acids to exercising muscle.

increase muscle flexibility and strength.

increase the use of fatty acids as a fuel source.

regenerate ATP for energy.

Question 34

Which of the following ergogenic aids has been shown to enhanceshort-term exercise and resistance training?

chromium picolinate

creatine

carnatine

ephedrine

Question 35

Consuming processed foods as opposed to whole foods decreasesthe risk of contracting a food-borne illness.

True

False

Question 36

Regular physical activity can increase HDL-cholesterol.

True

False

Question 37

Nearly 1 in 6 American adults reports getting no physicalactivity at all.

True

False

Question 38

Lactic acid is a by-product of high-intensity exercise.

True

False

Question 39

Training can enhance the ability to store glycogen.

True

False

Question 40

The primary fuel source utilized in both anaerobic and aerobicexercise is protein (amino acids).

True

False

Question 41

Studies suggest that athletes need to consume more than 2grams/kg of protein each day to maintain muscle strength.

True

False

Question 420.5 pts

Refigerating or freezing foods will kill any bacteria present inthe food.

True

False

Question 43

Most athletes do not consume enough protein to support theiradded physical activity.

True

False

Question 44

Thirst is a very reliable indicator of dehydration.

True

False

1. The risk of acquiring disease is measured by the

a. Incidence rate

b. Incidence rate times the average duration of the disease

c. Incidence rate divided by the prevalence rate

d. Prevalence rate

e. Prevalence rate times the average duration of the disease

2. The strength of an association between a factor and a disease is best measure by .

a. Incubation rate

b. Incidence of the disease in the total population

c. Prevalence of the factor

d. Attributable risk

e. Relative risk

3. Case fatality rate for a given disease refers to

a. The crude mortality rate per 100,000 population

b. Cause-specific mortality rate due to the disease

c. A fatal outcome of any disease

d. The percentage of deaths among cases of the disease

e. The proportion of deaths due to the disease among all deaths from all causes

4. An investigator is interested in etiology of neonatal jaundice. To study this condition, he selected 100 children who were diagnosed with this condition and 100 children born in the same period and in the same hospital who did not have a diagnosis of neonatal jaundice. He then reviewed the obstetrical and delivery records of their mothers to determine various prenatal and perinatal exposures. This is an example of a(n):

a. Cross-sectional study

b. Case-control study

c. Cohort study

d. Clinical trial

e. Experiment

5. Which of the following statements describes the major advantages of a randomized clinical trial?

a. It avoids observer bias

b. It lends itself to ethical justification

c. It yields results replicable in other patients

d. It rules out self-selection of participants to the different treatment groups

d. It enrolls representative patients

6. A survey conducted in England revealed that of 224 families in which there had been a known case of poliomyelitis, 56 maintained parakeets as a family pet. In another British survey, 30 out of 99 poliomyelitis patients questioned kept parakeets. The inference that there is some relationship between the presence of a parakeet in a household and the occurrence of poliomyelitis among household members is

a. Correct b.

Incorrect because of failure to distinguish between incidence and prevalence

c. Incorrect because a proportionate ratio is used when a rate is required to support the inference

d. Incorrect because a failure to recognize a possible cohort phenomenon

e. Incorrect because there is no control or comparison group.

7. An investigator determines the correlation coefficient between triglyceride levels and degree of atherosclerosis in sampled blood vessels to be +1.67. On the basis of this you would conclude that:

a. Triglyceride level is a good predictor of atherosclerosis

b. Triglyceride level is not a good predictor of atherosclerosis

c. High triglyceride levels cause atherosclerosis

d. Atherosclerosis cause high triglyceride levels

e. The investigator has incorrectly determined the correlation coefficient

8. A screening test of known sensitivity and specificity is applied to two populations. The prevalence of the disease being screened for is 10% in population A and is 1% in population B. Which of the following is true?

a. The percent of all negative tests that have false-negative results is lower in population A than in population B.

b. Specificity is lower in population A than in population B.

c. Reliability is higher in population A than in population B.

d. The percent of all positive tests that have false-positive results is lower in population A than in population B.

e. Specificity is higher in population A than in population B.

9. Serum cholesterol levels are obtained for four healthy men. The probability that all will fall below the 10th percentile of the distribution of cholesterol for healthy males is:

a. 0.4

b. 1 â (0.1)4

c. (0.1)4

d. (0.9)4

e. Cannot be determined from these data

10. In a diabetes screening program, the screening level for a positive blood sugar level in test 1 is set at 160 mg/dl, and in test 2 at 130 mg/dl. The sensitivity is:

a. Greater in test 1

b. Greater in test 2

c. Equal in test 1 and 2

d. Dependent on the size of the population being evaluated

NUTR-4240 Lecture Notes - Lecture 6: Gestational Diabetes, Prediabetes, Blood Sugar

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