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MNT Diabetes

MNT Diabetes

Assessment

Presentation

Biology

University

Easy

Created by

Caroline Geist

Used 3+ times

FREE Resource

34 Slides • 38 Questions

1

MNT: Diabetes

By Caroline Geist

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2

2: prediabetes with archie

1: insulin with betty

ok heres the tea

Some text here about the topic of discussion

3: gestational with jughead

4: type 1 with veronica

5: type 2 with cheryl

3

lets gooooooo!

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Insulin Resistance

Part 1: Betty

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Part 1: Betty: Insulin Resistance

who's going to ace this part???!!!

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Fill in the Blank

Insulin is secreted in the __ cells of the ___ (organ). separate answers with a semicolon.

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Open Ended

What are 3 ways insulin lowers blood glucose?

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Insulin:

  1. Helps glucose enter muscle, fat, and liver cells.

  2. Stimulates the liver and muscles to store excess glucose.

  3. Reduces blood glucose production in the liver.

Part 1: Betty: Insulin Resistance

9

Multiple Choice

Having dark, velvety patches on the skin that indicates insulin resistance is called:

1

THE SERIAL KILLER GENE

2

Aconthosis Nigricans

3

Acerosis Nagthicans

4

Atherosclerosis

10

Multiple Select

Insulin resistance increases risk of:

1

Type I diabetes

2

Type II Diabetes

3

prediabetes

11

Multiple Choice

What is the most effective way to increase insulin sensitivity?

1

Lose weight

2

Low-carb diet

3

Increase physical activity

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oh no! Betty, a diabetic, has collapsed!

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Multiple Choice

Betty's blood glucose is 60 mg/dL. She is:

1

A SERIAL KILLER

2

hyperglycemic

3

normal

4

hypoglycemic

14

Hypoglycemia: >70 mg/dL

Part 1: Betty: Insulin Resistance

15

Open Ended

You figure out she is in a mild hypoglycemic state. What will you do to help her?

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-give 15-20 g carbs

-​simple, easily digestible carbs

-retest in 10-20 minutes; retreat if <70​ mg/dL

Some text here about the topic of discussion.

Mild hypoglycemic treatment:

Severe hypoglycemic treatment:

-give 15-20 g carbs

-may have to give ​

-​simple, easily digestible carbs

-retest in 10-20 minutes; retreat if <70​ mg/dL

17

Multiple Choice

As Betty recovers, Jughead falls into a severe hypoglycemic coma. What should you do?

1

Give him a Snickers bar

2

Give him some fruit

3

Put honey in his cheek

4

Shake him to wake him up

18

Now you know all about insulin!

Part 1: Betty: Insulin Resistance

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Prediabetes

Part 2: Archie

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Fill in the Blank

What fasting glucose range defines prediabetes?

21

Fill in the Blank

What glucose tolerance range defines prediabetes?

22

Multiple Select

Most people with prediabetes develop Type 2 within 10 years. What lifestyle changes decrease this risk?

1

Losing 5-7% of body weight

2

Using insulin pumps

3

High carb diet

4

Increasing physical activity

23

Open Ended

List as many prediabetes risk factors as you can think of.

24

-overweight/obese

-45+ years old

​-parent/sibling with T2

-low physical activity

-having Gestational Diabetes

-Giving birth to a 9+ lb baby​

​-Race, ethnicity​

Part 2: Archie: Prediabetes

Risk factors for Prediabetes​:

25

Open Ended

What is the pathophysiology behind prediabetes?

26

The pathophysiology of prediabetes:

Beta cells are no longer produce in​sulin in sufficient amounts, and continue to degrade, leading to type 2 diabetes.

Part 2: Archie: Prediabetes

27

Multiple Choice

What is commonly prescribed with the goal of slowing the development of prediabetes?

1

Statins

2

Insulin

3

Mastins

4

Metformin

28

Open Ended

What are the nutrition intervention goals of prediabetes?

29

MNT goals of prediabetes:

  • Reduce risk of Type 2

  • Reduce energy intake if indicated

  • Weight loss may be needed (5-7%)

  • Increase physical activity

  • Healthy food choices

  • ​Maintain optimal metabolic factors

  • (A1c, FG, PPG, Blood pressure, LDL, HDL, Triglycerides, etc.​)

Part 2: Archie: Prediabetes

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you might think this is hard... but clearly you've never known the epic highs and lows of high school football.

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Break time!

31

Gestational diabetes

jughead

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Multiple Choice

Surprise! Jughead is pregnant. When should he be screened for gestational diabetes?

1

11-15 weeks

2

24-28 weeks

3

Immediately

4

At any point

33

Open Ended

Why should Jughead be screened at this time?

34

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This is when insulin-antagonist hormone levels and insulin resistance are highest.​

Some text here about the topic of discussion.

GD screening

35

Open Ended

Describe one of the ways Jughead may be tested.

36

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-one-time OGTT

(3-hour, 75 g)​

(best with high risk groups)

-GCT followed by OGTT if indicated​

-GCT: 1-hour, 50 g

-if >140, OGTT indicated​

Some text here about the topic of discussion.

GM Testing

37

Multiple Choice

Jughead takes the one-time, 2-hour OGTT test. He has a glucose level of 170 mg/dL. Does he have GD?

1

Yes

2

No

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​Fasting >92 mg/dL

One-step: 75 g load​

1h >180 mg/dL

2h >153 mg/dL​

​2-Step:

  1. 50 g load

>140 indicates 2nd test

  1. 100 g load

2h >140 mg/dL

Some text here about the topic of discussion.

GM Diagnosis

39

Open Ended

As Jughead's dietitian, what would your MNT goals be?

40

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  • Adequate energy intake

    -modest energy restriction if wt loss is

    indicated

  • Recommend PA

  • ​Check blood sugar regularly

Some text here about the topic of discussion.

GM MNT

41

Multiple Choice

True/False: Once Jughead delivers his baby, Bughead, he has a 80% chance of having Type 2 Diabetes immediately afterward.

1

True.

2

False.

42

hi, i'm jughead, and i have gestational diabetes. i know, i'm weird. i'm a weirdo.

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Type 1 diabetes

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veronica

44

Multiple Choice

Type 1 Diabetes accounts for what % of overall diabetes diagnoses?

1

1-2%

2

2-5%

3

5-10%

4

10-20%

45

Multiple Choice

What is the peak incidence of Type 1 Diabetes diagnoses?

1

infancy

2

childhood

3

puberty

4

young adulthood

46

Fill in the Blank

The two kinds of Type 1 Diabetes are immune-mediated and __.

47

Open Ended

Describe the difference between immune-mediated and idiopathic diabetes.

48

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Immune-mediated​

idiopathic diabetes:​

-autoimmune

​-destruction of beta-cells

-associated with celiac, thyroid disease​

-no known etiology

-minority of T1​

49

Open Ended

What is the "honeymoon stage" in type 1 diabetes?

50

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Type 1 Diabetes: The Honeymoon Stage

  • ​Occurs over (roughly) one year around diagnosis

  • Exogenous insulin ​needs are decreased and blood glucose is easily managed

  • Exogenous insulin is inevitable

51

Open Ended

List as many symptoms of type 1 diabetes as you can think of:

52

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Some text here about the topic of discussion.

Type 1 Diabetes: The Symptoms

  • ​Drastic weight loss

  • Hyperglycemia

  • ​Polyuria

  • Polydipsia

  • Polyphagia

  • Dehydration

  • Acetone/fruity scented breath

-due to ketoacidosis​

53

Multiple Select

Type 1 is managed through (select all that apply)

1

Daily blood glucose monitoring

2

Syncing insulin with food intake

3

Weight loss

4

Insulin pumps

54

Multiple Choice

True/False: Veronica should focus equally on micronutrients and macronutrients.

1

True.

2

False.

55

Multiple Choice

After tracking her macros, Veronica finds that carbs are 40% of her kcal, protein is 25%, and fat is 35%. Is she within a healthy parameter for Type 1?

1

Yes

2

No

56

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​Some text here about the topic of discussion.

Type 1 Diabetes: Macros

  • ​Carbs: 40%

  • Protein: 20-30%

  • Fat: 30-35%

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Type 2 diabetes

Cheryl

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Saving the best for last...

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Open Ended

List and define the 3 P's.

60

Open Ended

Tori notices Cheryl is exhibiting symptoms of T2D. What are some of the symptoms she might be noticing?

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-polyphagia

-polyuria

-polydipsia

-always tired

-slow wound healing

-blurry vision

-tingling in hands and feet​

-sexual problems​

Some text here about the topic of discussion.

Type 2 diabetes symptoms​

62

Open Ended

Cheryl experienced excessive urinating before she was diagnosed with Type 2 Diabetes. Why?

63

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-the kidney has a blood sugar threshold of 180 mg/dL​

-above this, it begins spilling glucose into the urine, increasing urine output.

Polyuria pathophysiology

64

Multiple Select

Who should be screened for T2DM? select all that apply.

1

Someone whose sister had GD

2

Overweight adults

3

Someone with PCOS

4

Someone with hypertension

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  • overweight/obese​

  • 45+ years old​

  • first degree familial diabetes

  • Low​ PA

  • Having GDM

  • Race/ethnicity

  • Prediabetes

  • PCOS

Type 2 Diabetes | Cheryl

T2DM Risk factors

66

Multiple Select

Because his twin has Type 2 Diabetes, Jason Blossom is at a higher risk. What can he do to reduce this risk? (Select all that apply)

1

Increase physical activity

2

Give insulin

3

Eat low carb diet

4

Eat low fat diet

67

Fill in the Blank

__ complications are a type of diabetes complication that involve larger arteries and include CVD and peripheral arterial disease.

68

Fill in the Blank

At the doctor's, Cheryl is prescribed a drug that will slow down glucose production in the liver, making her cells more sensitive to insulin. What drug is this?

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  • Mechanism: Slows down glucose production in the liver

  • Makes cells more sensitive to insulin

  • Fairly inexpensive

  • Contraindications

    -Kidney/liver/heart issues

    -Acute illness

Type 2 Diabetes | Cheryl

Metformin

70

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Discuss basic carb counting, advanced carb counting, and exchange lists. What are they, and what are their indications?​ Pros and cons of each?

Type 2 Diabetes | Cheryl

Let's Talk!

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the end

72

Multiple Select

bonus question: Dr Amaya loves it when you say "diabetes"

1

no

2

no

3

no

4

no

MNT: Diabetes

By Caroline Geist

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