Question

1. People with prediabetes:
   1. Usually know they have it due to the symptoms they experience
   2. Are at high risk for developing type 2 diabetes
   3. Are at high risk for developing type 1 diabetes
   4. If they become pregnant, are at lower risk for developing gestational diabetes
   5. All of the above

2. Your grandmother has had type-2 diabetes. She asks you what she needs to do in order to avoid complications from her disease. Using your skills as a counselor (emulate counseling type-questions #11) and what you know from the module about how to monitor and avoid the complications of diabetes, outline what questions you would ask her and, after that, what information you would provide her.
3. Having diabetes and metabolic syndrome:
   1. Complicates treatment because of the number of risk factors that need to be managed.
   2. Can’t happen because you can only have one or the other.
   3. Reduces risk for heart disease
   4. Reduces risk for stroke
   5. All of the above

4. People who have diabetes, especially type 1 diabetes, need to:
   1. Match their intake of carbohydrate with their insulin dose
   2. Match their insulin dose with the amount of carbohydrate they plan to eat
   3. A little of both but mostly match how much insulin they take to match their meals.

5. Concerning the nutrient recommendations for people with diabetes:
   1. The overall nutritional recommendations for people with diabetes are pretty much the same as the dietary guidelines for people without diabetes.
   2. Carbohydrates for people with diabetes need to be balanced with medications (especially insulin) for diabetes.
   3. People with diabetes often benefit from a Mediterranean-style eating pattern.
   4. Clinicians working with people with diabetes should collaborate with their clients to developed individualized eating plans that take culture, preferences, food access, and health literacy into consideration.
   5. All of the above.
6. How would the diagnosis of pre-diabetes be made?

Answer 1

1.signs and symptoms that suggest prediabetes to type 2 diabete sinclude:

• Increased thirst.
• Frequent urination.
• Fatigue.
• Blurred vision.

Prediabetes means the blood glucose levels are higher than normal but not highenough to be diagnosed as diabetes. Prediabetes usually occurs in people who already have some insulin resistance or whose beta cells in the pancreas are not making enough insulin to keep blood glucose in the normal range.

Prediabetes patients are at high risk of developing type 2 diabetes.If they are pregnant they are at high risk of developing gestational diabetes.

3.Type 1 diabetes patients match their intake of carbohydrates with their insulin dose.

Bolus – Carbohydrate coverage

The bolus dose for food coverage is prescribed as an insulin to carbohydrate ratio. The insulin to carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin.

Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can vary from 6-30 grams or more of carbohydrate depending on an individual’s sensitivity to insulin. Insulin sensitivity can vary according to the time of day, from person to person, and is affected by physical activity and stress.

Bolus – High blood sugar correction
(also known as insulin sensitivity factor)

The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin will drop the blood sugar.

Generally, to correct a high blood sugar, one unit of insulin is needed to drop the blood glucose by 50 mg/dl. This drop in blood sugar can range from 30-100 mg/dl or more, depending on individual insulin sensitivities, and other circumstances.

Examples.

To calculate the carbohydrate coverage dose, high blood sugar correction dose and the total mealtime insulin dose.

Example #1: Carbohydrate coverage at a meal

First, you have to calculate the carbohydrate coverage insulin dose using this formula:

CHO insulin dose =
    Total grams of CHO in the meal
÷ grams of CHO disposed by 1 unit of insulin
(the grams of CHO disposed of by 1 unit of insulin is the bottom number or denominator of the Insulin:CHO ratio).

For Example #1, assume:

• You are going to eat 60 grams of carbohydrate for lunch
• Your Insulin: CHO ratio is 1:10

To get the CHO insulin dose, plug the numbers into the formula:

CHO insulin dose =
    Total grams of CHO in the meal (60 g)
÷ grams of CHO disposed by 1 unit of insulin (10) = 6 units

You will need 6 units of rapid acting insulin to cover the carbohydrate.

Example #2: High blood sugar correction dose

Next, you have to calculate the high blood sugar correction dose.

High blood sugar correction dose =
     Difference between actual blood sugar and target blood sugar*
÷ correction factor.

*Actual blood sugar minus target blood sugar

For Example #2, assume:

• 1 unit will drop your blood sugar 50 points (mg/dl) and the high blood sugar correction factor is 50.