Diabetes

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. Which type of diabetes is most prevalent in the general population?

a) type 1
b) type 2
c) gestational diabetes

2. There are no known methods to prevent type 1 diabetes.

a) True
b) False

3. Drug metformin has been found effective in reducing the risk of developing diabetes. It is most effective among

a) young, heavier people.
b) older, not so overweight people.

4. Approximately what percent of people with diabetes remain undiagnosed?

a) 75
b) 60
c) 35
d) 10

5. Poorly controlled diabetes during the second and third trimester of pregnancy can result in excessively ___ babies.

a) small
b) large

6. Prevalence of diabetes in African Americans is much higher than in white Americans, which can partially be attributed to the _______ of “thrifty gene” in African Americans.

a) presence
b) absence

7. People with higher-than-normal levels of fasting insulin have _____ risk of developing type 2 diabetes.

a) an increased
b) a decreased

8. Excess weight carried above the waist is a stronger risk factor for diabetes than excess weight carried below the waist.

a) True
b) False

9. African-American children have a _______ rate of type 1 diabetes than white-American children.

a) lower
b) higher

10. Type 2 diabetes is common in American Indian children age 10 and older.

a) True
b) False

11. The incidence of type 1 diabetes in American Indians and Alaska Natives is much higher than in any other population subgroup.

a) True
b) False

12. Which of the following groups had the lowest incidence of type 2 diabetes?

a) Japanese-American men living in Seattle, Washington
b) Japanese-American men living in Hawaii
c) Japanese men in Japan

13. Which of the following values correctly reflects the new criteria for the diagnosis of diabetes?

a) fasting plasma glucose (FPG) value of 126 milligrams per deciliter (mg/dl) or greater
b) fasting plasma glucose value of 140 mg/dl or greater
c) oral glucose tolerance test value in the blood of 200 mg/dl or greater measured at the 2-hour interval

14. What is the recommended fasting plasma glucose (FPG) value to diagnose diabetes?

a) 105 mg/dL
b) 126 mg/dL
c) 140 mg/dL

15. Pre-diabetes is the same as impaired glucose tolerance (IGI) or impaired fasting glucose (IFG).

a) True
b) False

16. In the oral glucose tolerance test (OGTI) what level of blood glucose level is defined as diabetes?

a) > 125 mg/dL
b) > 140 mg/dL
c) > 200 mg/dL

17. People with prediabetes don’t often have symptoms.

a) True
b) False

18. The Diabetes Prevention Program (DPP) showed that the most effective way of preventing or delaying the development of type 2 diabetes is

a) lifestyle modification–healthy eating and exercise.
b) diabetes drug metformin.

19. Blood sugar levels below ______ mg/dL are almost always associated with a serious abnormality.

a) 120
b) 90
c) 60
d) 45

20. The islets of Langerhons in the pancreas contain alpha and beta cells. Which cells release insulin?

a) alpha
b) beta

21. People with diabetes can usually recognize when their blood sugar levels are dropping too low.

a) True
b) False

22. Oral glucose tolerance test (OGTT) provides a more accurate diagnosis of hypoglycemia.

a) True
b) False

23. Which of the following describes the hypoglycemia-causing disorder in a child with intolerance for milk?

a) insulinoma
b) growth hormone deficiency
c) galactosemia
d) hereditary fructose intolerance

24. Everyone, including people with diabetes, should eat some starches at each meal.

a) True
b) False

25. Which of the following is an example of 2 servings of vegetables?

a) 1/2 cup cooked green beans
b) 1/2 cup cooked carrots + 1 cup salad
c) 1/2 cup broccoli + 1 cup tomato juice

26. One banana is an example of ______ serving(s) of fruit.

a) one
b) two

27. Which of the following are examples of meat and meat substitutes?

a) beef
b) tofu
c) cheese
d) peanut butter
e) all of the above

28. Select the True statement from below:

a) Even when drugs and diet are able to control diabetes, the disease can lead to nephropathy and kidney failure.
b) Most people with diabetes do not develop nephropathy that is severe enough to cause kidney failure.
c) Most U.S. citizens who develop kidney failure are eligible for federally funded care.
d) Type 1 diabetes proportionately accounts for much greater share of kidney failures.
e) all of the above

29. In the course of kidney disease the flow of blood through the kidneys __________.

a) increases
b) decreases

30. What is the normal loss of albumin into the urine?

a) 5 micrograms per minute
b) 20 micrograms per minute
c) 200 micrograms per minute

31. For people with type 1 diabetes what is the average length of time to progress to kidney failure?

a) 5 years
b) 17 years
c) 23 years

32. What is the recommended blood pressure for people with diabetes?

a) 125/75 or lower
b) 130/85 or lower
c) 140/90 or lower

33. Which class of drugs has proven effective in preventing progression of the kidney disease to stages IV and V?

a) diuretics
b) beta-blockers
c) calcium channel blockers
d) ACE inhibitors

34. The survival of kidneys transplanted into patients with diabetes is about the same as the survival of transplants into people without diabetes.

a) True
b) False

35. Which would be the incorrect advice to give to a patient on hemodialysis?

a) Eat balanced amounts of foods high in protein. Animal protein is better used by the body than the protein found in vegetables and grains.
b) Avoid salt as it causes body to hold water.
c) Drink plenty of fluid.
d) Limit foods such as milk, cheese, nuts, dried beans, and soft drinks.

36. Which of the following three types of peritoneal dialysis requires no machine or partner?

a) Continuous Ambulatory Peritoneal Dialysis (CAPD)
b) Continuous Cyclic Peritoneal Dialysis (CCPD)
c) Intermittent Peritoneal Dialysis (IPD)

37. According to DCCT findings, lowering blood glucose reduces the risk of eye, kidney and nervous disease by

a) 10-20 percent.
b) 50-75 percent.
c) over 90 percent.

38. About what percent of people with diabetes have some form of neuropathy?

a) 20
b) 50
c) 80

39. Which type of neuropathy causes hypoglycemia unawareness?

a) peripheral
b) autonomic
c) proximal
d) focal

40. Which type of diabetic neuropathy would cause changes in digestion, bowel and bladder function, and sexual response?

a) peripheral
b) autonomic
c) proximal
d) focal

41. In which type of diabetic neuropathy the onset of pain is sudden and severe?

a) periphera
b) autonomic
c) proximal
d) focal

42. Which of the following tests would detect damage done to internal organs, such as bladder, by diabetic neuropathy?

a) nerve conduction studies
b) electromyography (EMG)
c) qualitative sensory testing (QST)
d) ultrasound

43. Which medicine is used to relieve gastrointestinal problems caused by diabetic neuropathies?

a) aspirin
b) ibuprofen
c) tricyclic antidepressant medication
d) erythromycin

44. Gastroparesis is most often a complication of ______ diabetes.

a) type 1
b) type 2
c) gestational diabetes

45. There’s no cure for gastroparesis; it’s usually a chronic condition.

a) True
b) False

46. Which of the following tests for the diagnosis of gastroparesis requires the patient to fast?

a) barium x-ray
b) barium beefsteak meal
c) radioisotope gastric-emptying scan

47. Patients with gastroparesis are advised to make certain meal and food changes. Which of the following is not advised?

a) eat six small meals a day instead of three large ones
b) eat liquid meals
c) avoid fatty foods
d) eat high-fiber foods

48. Definition of impotence includes

a) a total inability to achieve erection
b) an inconsistent ability to do so
c) a tendency to sustain only brief erections
d) a lack of sexual desire
e) a, b, and c

49. During the erection process, blood flows into

a) urethra.
b) corpora cavernosa.
c) tunica albuginea.

50. What percent of cases of impotence are attributed to psychological factors?

a) 10 to 20
b) 50
c) 70

51. What percent of men with diabetes experience impotence?

a) 10
b) 35 to 50
c) over 90

52. Generally speaking, if nocturnal erections do not occur, then the cause of impotence is likely to be psychological than physical.

a) True
b) False

53. Which of the following oral drugs has been found to be most effective in treating impotence?

a) dopamine
b) trazodone
c) sildenafil citrate
d) yohimbine hydrochloride

54. To keep your heart and blood vessels healthy, LDL (bad cholesterol) number should be between 100 and 200.

a) True
b) False

55. The hemoglobin A1c test measures the fluctuations in the blood sugar level before and after meals and exercise.

a) True
b) False

56. How often should people with diabetes have a hemoglobin A1C test?

a) twice a day
b) once a month
c) at least twice a year
d) at every visit to the doctor

57. The hemoglobin A1c goal for people with diabetes is less than 7 percent.

a) True
b) False

58. Most people can tell what their blood sugar levels are simply by how they feel.

a) True
b) False

59. There’s no proof that lowering your hemoglobin A1c number can reduce your chances of getting serious eye, kidney and never disease.

a) True
b) False

60. Which of the following diabetes pills helps lower blood glucose by stimulating the pancreas to make more insulin?

a) sulfonylureas
b) biguanides
c) alphaglucosidane inhibitors
d) thiazolidinediones

61. For fastest action, insulin should be injected

a) into the thighs.
b) into the arm.
c) near the stomach.

62. Insulin can be taken either as a pill or shot.

a) True
b) False

63. Which of the following alternative therapies for diabetes relies upon relaxation and stress-reduction techniques?

a) acupuncture
b) biofeedback
c) mineral supplements

64. Which of the following mineral supplements has been clinically found to be effective and accepted by the mainstream medical establishment in the treatment of diabetes?

a) chromium
b) magnesium
c) vanadium
d) none of the above

65. What is the most significant drawback of intensive treatment of diabetes?

a) time and expense of intensive management
b) weight gain
c) hypoglycemia
d) private insurance does not cover intensive treatment of diabetes

66. In the Diabetes Prevention Program (DPP) which approach lowered the incidence of type 2 diabetes the most?

a) lifestyle modification
b) treatment with metformin
c) standard medical advice

67. Lifestyle intervention to prevent or to delay the onset of diabetes is most effective in people age 60 and older.

a) True
b) False

68. Diet and exercise can reverse impaired glucose tolerance (IGI).

a) True
b) False

69. Which test is recommended by the American Diabetes Association for doctors to screen their patients for diabetes?

a) fasting blood glucose test
b) oral glucose tolerance test

70. Which test is more sensitive?

a) fasting blood glucose test
b) oral glucose tolerance test

71. The drug metformin is currently approved for treating, not preventing, type 2 diabetes.

a) True
b) False

72. Women with gestational diabetes have _______ insulin.

a) little or no
b) plenty of

73. Which of the following is not a reliable indicator of who will develop diabetes during pregnancy?

a) obesity
b) family history of diabetes
c) history of sugar in the urine
d) having given birth previously to a very large infant

74. At what point in the pregnancy the screening test for gestational diabetes is usually performed?

a) before the 13th week
b) between the 24th and 28th week
c) toward the end of the pregnancy

75. Which of the following statements describes “macrosomia?”

a) obesity in a pregnant woman
b) a baby that is considerably larger than normal
c) sleeping disorder
d) high level of blood sugar and high level of insulin

76. For a woman with gestational diabetes proper diet alone often keeps blood sugar levels in the normal range.

a) True
b) False

77. If a woman is at a desirable weight for her body size before becoming pregnant, what is the recommended weight gain for her through pregnancy?

a) 20 lbs
b) 24 to 27 lbs
c) 28 to 36 lbs

78. Which of the following statements describes the cause of gestational diabetes?

a) insufficient production of insulin by the pregnant woman
b) “contra-insulin” effect caused by the placenta
c) growing fetus takes up a large share of mother’s insulin
d) excessive weight gain by the mother during pregnancy

79. Moderate amount of alcohol during pregnancy helps control glucose levels in the blood and prevent preeclampsia.

a) True
b) False

80. Which of the following has been found to be definitely detrimental to the fetus?

a) caffeine
b) salt
c) alcohol/smoking
d) megavitamins
e) all of the above

81. Which of the following artificial sweeteners is recommended for use by pregnant women?

a) saccharin
b) aspartame
c) sorbitol
d) mannitol

82. Women with gestational diabetes should avoid having a bedtime snack.

a) True
b) False

83. The following foods have almost the same calcium content but they vary in calories. Which has the lowest calories?

a) 4 8oz. glasses of whole milk
b) 4 8oz. glasses of 2% milk
c) 4 8oz. glasses of skim milk
d) 2 8oz. glasses of skim milk plus 3oz. American processed cheese

84. After delivery, women who breast-feed usually lose more weight than women who bottle-feed.

a) True
b) False

85. Which of the following tests are used to monitor the baby’s heart rate before delivery?

a) fetal monitoring
b) non-stress test
c) stress test (oxytocin challenge test)
d) all of the above

86. High-blood sugars in the mother produce high-blood sugar in the baby immediately after delivery.

a) True
b) False

87. For most women with gestational diabetes blood sugar level returns to normal immediately after the baby is born.

a) True
b) False

88. Babies born of mothers with gestational diabetes almost always have diabetes, juvenile-onset type.

a) True
b) False

89. People with insulin resistance generally have _____ than normal insulin levels.

a) higher
b) lower

90. Which of the following drugs used to treat people with type 2 diabetes causes hypoglycemia?

a) metformin
b) troglitazone
c) sulfonylureas

91. What are the effects of acute alcohol consumption (i.e., single episodes of alcohol consumption) on glocuse levels in nondiabetic people?

a) increase in glucose levels
b) decrease in glucose levels
c) no changes
d) variable results

92. Long-term (i.e., chronic) alcohol consumption in well-nourished diabetic patients results in ______ blood sugar levels.

a) increased
b) decreased

93. Long-term alcohol ingestion n in diabetics who are not adequately nourished results in ______ blood sugar levels.

a) increased
b) decreased

94. Ketoacidosis typically occurs in patients with _______ diabetes.

a) type 1
b) type 2

95. LDL (“bad”) cholesterol levels tend to be ______ in alcoholics than in nondrinkers.

a) higher
b) lower

96. Which of the following lipid abnormalities occur as a result of heavy drinking?

a) elevated triglyceride levels in the blood
b) reduced levels of LDL cholesterol
c) elevated levels of HDL cholesterol
d) all of the above

97. In the study cited in this chapter, which of the following groups suffered the highest death rates from cardiovascular disease?

a) moderate drinkers
b) heavy drinkers
c) complete abstainers