“diabetes mellitus mcq questions and answers”

^ Jump up to: a b Cox DJ, Kovatchev BP, Anderson SM, Clarke WL, Gonder-Frederick LA (November 2010). “Type 1 diabetic drivers with and without a history of recurrent hypoglycemia-related driving mishaps: physiological and performance differences during euglycemia and the induction of hypoglycemia”. Diabetes Care. 33 (11): 2430–35. PMC 2963507 . PMID 20699432.

The good news for a type 1 and type 2 patient is that if insulin, medication, weight loss, physical activity and changes in eating result in normal blood glucose, that means their diabetes is well controlled and their risk of developing diabetes complications is much lower. But it doesn’t mean that their diabetes has gone away.

Insulin pumps enable tight blood sugar control and support lifestyle flexibility, while minimizing the effects of low blood sugar (hypoglycemia). At present, the pump is the closest device on the market to an artificial pancreas. The latest pumps do not require tubing. The insulin delivery device is placed directly on the skin and any adjustments needed for insulin delivery are made through a PDA-like device that must be kept within a 6-foot range of the insulin delivery device (and can be worn in a pocket, kept in a purse, or on a tabletop when working).

That tingly feeling you get on a first date is a good thing. That tingly feeling in your hands and feet? Not so much. Elevated blood sugar can cause nerve damage, which is often signaled by a tingly feeling in your hands and your feet. If left untreated, this can lead to tissue death and amputations down the line.

“People need to understand the continuum of diabetes,” she says. “If they’re on an upward trajectory of insulin resistance and a downward trajectory of insulin production weight loss, healthful eating and physical activity will slow down the insulin-loss trajectory and improve insulin sensitivity.” But, she says, “If they gain weight back, the diabetes comes back.”

Diet is an important tool to keep your heart healthy and blood sugar levels within a safe and healthy range. It doesn’t have to be complicated or unpleasant. The diet recommended for people with type 2 diabetes is the same diet just about everyone should follow. It boils down to a few key actions:

Rosiglitazone (Avandia) has been associated with an increased risk of heart attack and stroke, and experts have debated the severity of these concerns. On September 23, 2010, the U.S. FDA announced significant restrictions on rosiglitazone (Avandia) for those with type 2 diabetes. These new restrictions responded to data suggesting elevated risk of cardiovascular events (for example, heart attack and stroke) in patients treated with rosiglitazone. GlaxoSmithKline (the manufacturer of rosiglitazone) was required to establish a Risk Evaluation and Mitigation Strategy (REMS) program, with mandatory participation by patients, their health-care providers and pharmacists in order to receive, prescribe, or sell rosiglitazone.

Every 21 seconds someone in the U.S. is diagnosed with diabetes. As of 2015, 30.3 million people — 9.4% of the population — have diabetes, with about 1.25 million American children and adults having type 1 diabetes. Shockingly, about 7.2 million people with diabetes are currently undiagnosed. Roughly 84 million people have prediabetes, when blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes. Long-term damage to the heart and circulatory system can still occur with prediabetes. Diabetes is the seventh leading cause of death in the United States, as reported by the ADA.

Jump up ^ Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J (Dec 12, 2007). “Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis”. JAMA: the Journal of the American Medical Association. 298 (22): 2654–64. doi:10.1001/jama.298.22.2654. PMID 18073361.

Jump up ^ Manohar V, Talpur NA, Echard BW, Lieberman S, Preuss HG (2002). “Effects of a water-soluble extract of maitake mushroom on circulating glucose/insulin concentrations in KK mice”. Diabetes, Obesity & Metabolism. 4 (1): 43–48. doi:10.1046/j.1463-1326.2002.00180.x. PMID 11874441.

^ Jump up to: a b “National Diabetes Clearinghouse (NDIC): National Diabetes Statistics 2011”. U.S. Department of Health and Human Services. Archived from the original on 17 April 2014. Retrieved 22 April 2014.

Sulfonylureas, which also trigger insulin-releasing beta cells in your pancreas, are usually taken one or two times a day, before meals. Examples include glyburide, glimepiride, chlorpropamide, glipizide, and tolazamide.

Jump up ^ Tuomilehto, J; Lindström, J; Eriksson, JG; Valle, TT; Hämäläinen, H; Ilanne-Parikka, P; Keinänen-Kiukaanniemi, S; Laakso, M; et al. (2001). “Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance”. The New England Journal of Medicine. 344 (18): 1343–50. doi:10.1056/NEJM200105033441801. PMID 11333990.

Kidney damage from diabetes is called diabetic nephropathy. The onset of kidney disease and its progression is extremely variable. Initially, diseased small blood vessels in the kidneys cause the leakage of protein in the urine. Later on, the kidneys lose their ability to cleanse and filter blood. The accumulation of toxic waste products in the blood leads to the need for dialysis. Dialysis involves using a machine that serves the function of the kidney by filtering and cleaning the blood. In patients who do not want to undergo chronic dialysis, kidney transplantation can be considered.

Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of developing prediabetes and type 2 diabetes later increases. If you gave birth to a baby weighing more than 9 pounds (4 kilograms), you’re also at risk of type 2 diabetes.

Jump up ^ Butalia S, Kaplan GG, Khokhar B, Rabi DM (Aug 18, 2016). “Environmental Risk Factors and Type 1 Diabetes: Past, Present, and Future”. Can J Diabetes (Review). 40 (6): 586–93. doi:10.1016/j.jcjd.2016.05.002. PMID 27545597.

In reality, weighing up each drug is something to do in partnership with a prescriber – guidelines partly drawn up by the American Diabetes Association list a great number of advantages and disadvantages for each of the available drug treatments, including the consideration of cost.2

As for packaging, frozen veggies without sauce are just as nutritious as fresh, and even low-sodium canned veggies can be a good choice if you’re in a pinch. Just be sure to watch your sodium intake to avoid high blood pressure, and consider draining and rinsing salted canned veggies before eating, per the ADA. If possible, opt for low-sodium or sodium-free canned veggies if going that route.

Commit to managing your diabetes. Learn all you can about type 2 diabetes. Make healthy eating and physical activity part of your daily routine. Establish a relationship with a diabetes educator, and ask your diabetes treatment team for help when you need it.

Consider initiating insulin therapy (with or without additional agents) in patients with newly diagnosed type 2 diabetes who are symptomatic and/or have A1C ≥10% (86 mmol/mol) and/or blood glucose levels ≥300 mg/dL (16.7 mmol/L). E

Acarbose (Precose) is a medication that decreases the absorption of carbohydrates from the intestine. Before being absorbed into the bloodstream, enzymes in the small intestine must break down carbohydrates into smaller sugar particles, such as glucose. One of the enzymes involved in breaking down carbohydrates is called alpha-glucosidase. By inhibiting this enzyme, carbohydrates are not broken down as efficiently, and glucose absorption is delayed.

Oftentimes, your symptoms may seem harmless. The most common symptoms of diabetes, such as persistent thirst and fatigue, are often vague. When experienced on their own, symptoms such as these may not be anything to worry about.

Sheila Dean, DSc, RD, LD, CCN, CDE, owner of Palm Harbor Center for Health & Healing in Palm Harbor, Florida, places her patients on a carbohydrate-controlled meal plan with minimally processed carbohydrates, which she refers to as “clean carbs.”

It is important to know the signs and symptoms of diabetes to detect the disease early and get it under control before any irreversible damage is done to the body. Recent studies indicate that early detection and treatment of diabetes can decrease the chance of developing complications from the disease.

While there is a strong genetic component to developing this form of diabetes, there are other risk factors – the most significant of which is obesity. There is a direct relationship between the degree of obesity and the risk of developing type 2 diabetes, and this holds true in children as well as adults. It is estimated that the chance to develop diabetes doubles for every 20% increase over desirable body weight.

Insulin is a hormone that is produced by specialized cells (beta cells) of the pancreas. (The pancreas is a deep-seated organ in the abdomen located behind the stomach.) In addition to helping glucose enter the cells, insulin is also important in tightly regulating the level of glucose in the blood. After a meal, the blood glucose level rises. In response to the increased glucose level, the pancreas normally releases more insulin into the bloodstream to help glucose enter the cells and lower blood glucose levels after a meal. When the blood glucose levels are lowered, the insulin release from the pancreas is turned down. It is important to note that even in the fasting state there is a low steady release of insulin than fluctuates a bit and helps to maintain a steady blood sugar level during fasting. In normal individuals, such a regulatory system helps to keep blood glucose levels in a tightly controlled range. As outlined above, in patients with diabetes, the insulin is either absent, relatively insufficient for the body’s needs, or not used properly by the body. All of these factors cause elevated levels of blood glucose (hyperglycemia).

Evert, A. B., Boucher, J. L., Cypress, M., Dunbar, S. A., Franz, M. J., Mayer-Davis, E. J. … Yancy Jr, W. S. (2013, November). Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care, 36(11), 3821-3842. Retrieved from http://care.diabetesjournals.org/content/36/11/3821

Between 1971 and 2000, the death rate for men with diabetes fell, according to a study in Annals of Internal Medicine. This was a major coup, reflecting the many advances in diabetes treatment. However, according to the study, the death rate for women with diabetes showed no signs of improvement. Additionally, the difference in death rates between women who had diabetes and those who didn’t more than doubled.

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