Test your Knowledge

Abstract

Note: Adapted from Review Guide for the Certified Diabetes Educators Exam. 5th ed. 2019. Chicago: Association of Diabetes Care & Education Specialists. Reprinted with permission.

Answers appear on page 48.

Read the following vignette to answer Questions 1 and 2:

JL is a 28-year-old female with type 1 diabetes and diabetic gastroparesis. Recently she has not been able to run for exercise due to nausea, vomiting, bloating, and intestinal pain. Her A1C is 6.7%, and she reports experiencing hypoglycemia about 3 times a week.

What hypoglycemia treatment should JL use?

Juice

Regular soda

Glucose tablets

Peanut butter crackers

What nutrition modifications can JL benefit from?

Consuming 3 meals per day, at the same time each day

Consuming foods with soft consistency and increasing fiber intake

Small, frequent meals; reduced fat and fiber intake; consuming foods with soft consistency

Reduced carbohydrate intake and increased fluids

Which of the following describes normal hormonal response and the acute effects of physical activity?

Insulin levels increase to reduce free fatty acids (FFA) production

Glucagon rises and hepatic glucose production is increased

Both epinephrine and norepinephrine are reduced and free fatty acid (FFA) production is inhibited

Growth hormone and cortisol are decreased and insulin-stimulated glucose uptake is inhibited

How does a diabetes care and education specialist determine which portions of a diabetes self-management program written curriculum content areas are covered with a program participant?

All content areas must be covered

Assess the needs of the individual receiving the care and education

Focus on the areas where the care and education specialist has the most knowledge and skills to impart

Base on desired program outcomes

Test Your Knowledge Answers

Questions appear on page 45.

C: Since JL is experiencing nausea and vomiting, glucose tablets, gels, or hard candies are the most easily digested. Juice (A) and regular soda (B) can be used to treat hypoglycemia but would be more likely to accentuate the nausea. Peanut butter crackers are not a good choice to treat hypoglycemia as food high in fat content slows gastric emptying and absorption (D).

C: Small, frequent meals may lead to lessened bloating, lessened early satiety, and lessened possibility of impaired nutritional status. Reduced fat intake may produce less delay in gastric emptying. Reduced fiber intake may decrease the possibility of bezoar formation. Soft foods are easily digested.

B: Physical activity increases hepatic glucose production and increases the glucose supply available in the blood. Insulin decreases (A), epinephrine and norepinephrine both increase (C), and growth hormone and cortisol increase (D).

B: Standard 6 of the National Standards for Diabetes Education states that the assessed needs of the individual with prediabetes and diabetes will determine which of the 9 content areas described in Standard 6 should be addressed.

Footnotes

Note: Adapted from Review Guide for the Certified Diabetes Educators Exam. 5th ed. 2019. Chicago: Association of Diabetes Care & Education Specialists. Reprinted with permission.