Test Your Knowledge Answers

B: For individuals with severe peripheral neuropathy, high-impact weight-bearing activities such as aerobics classes are discouraged. Moderate walking has been shown to reduce the progression of peripheral neuropathy in both type 1 and type 2 diabetes (A). Swimming and chair exercises are non-weight-bearing and are therefore also recommended (C, D).

D: Individuals with diabetes are susceptible to pneumococcal infections and are at increased risk for bacteremia from this organism. Additional risk is associated with people age 65 years or older with chronic cardiovascular, pulmonary, or renal disease. For adults with diabetes, 1 dose of PPSV23 is recommended between the ages of 19 and 64 years, with a second dose at age 65 or older if it has been more than 5 years since their last vaccination.

A: Although lack of concentration is consistent with depression, sweating and restlessness are not (B). Elevated blood glucose levels would be expected with the flu (C). There is no evidence to suggest fear of social situations (D).

B: An ophthalmologist should perform a dilated examination annually is correct. People with dia-betes should receive annual dilated eye examinations to ensure healthy vision. Less frequent screening may be appropriate for individuals with good glycemic management following one or more normal eye examinations. Although additional screening by endocrinologists (A and D) or optometrists (C) may be useful, dilation of the eye is necessary to identify presence of blood retinal damage in the lateral portions of the eye. Furthermore, only ophthalmologists can initiate cor-rective therapy if retinal damage is identified.