Answers to DEC’23-JAN'24

1. What is the diagnosis for a person with fasting blood glucose - 105 mg/dL and 2-hour post prandial blood glucose - 157 mg/dL?

b: Prediabetes Prediabetes is a state in which the blood sugar levels are high, but not high enough to be classified as Diabetes. The range for prediabetes is:

• Fasting blood sugar level: 100-125 mg/dL

• 2-hour post prandial blood glucose is 140-199mg/dL

• HbA1c 5.7 - 6.4

2. Which of the following is not a symptom of low blood glucose?

c: Increased frequency of urine - Low blood glucose (hypoglycaemia) occurs when the blood glucose levels are below normal. The common symptoms include sweating, hunger and tremors. Increased frequency of urine is one of the symptoms of high blood glucose (hyperglycaemia), where the body removes excess sugar from the body through urine.

3. Fasting is allowed in people with Diabetes on insulin treatment -

b: False - Fasting is not allowed in people with Diabetes, especially when they are on insulin treatment. Fasting can lead to hypoglycaemia and may even cause a diabetic coma. Hence it is advised that people with Diabetes should not fast.

4. The best method to assess insulin production is -

a: C-peptide - A C-peptide test measures the level of peptide in the blood. It is generally found in amounts equal to insulin, as insulin and C-peptide are linked when they are first produced by the pancreas. C-peptide levels in the blood indicate how much insulin is produced by the pancreas. A person whose pancreas does not make any insulin (Type 1 Diabetes) has a low level of insulin and C- peptide, whereas a person with Type 2 Diabetes has a normal or high level of C-peptide.

5. People with Diabetes and advanced heart disease require

b: Moderately good glucose control - The more aggressive the glucose control is, the higher the chance of hypoglycemia (the low sugar problem). A good marker of long term glucose control is HbA1c, which reflects the blood glucose over the past 3 months. In people with advanced heart disease, such aggressive control has been shown to be detrimental, as it causes more hypoglycaemia which is not good for the heart. Therefore, in order to minimize the hypoglycaemia-associated risk, only moderately good control is suggested. An HbA1c of about 7 per cent or even slightly higher is ideal for such cases.

6. Fibre in the diet helps control glucose by all except -

d: Causing insulin resistance - Dietary fibre (roughage) is an essential nutrient required for proper digestion of foods, functioning of the digestive tract at large and promoting satiety value (feeling of fullness). Also, it increases the bulk of faeces and slows down glucose absorption, which aids in controlling glucose levels in people with Diabetes. Conversely, insulin resistance is a physiological condition in which the cells fail to respond to normal actions of insulin.

7. Which of the following is a symptom of Vitamin B12 deficiency?

d: All of the above - Symptoms of B12 deficiency include fatigue, loss of appetite, pale skin, swollen red tongue, damage of nerve which leads to confusion or change in mental status, dementia, depression, loss of balance, numbness and tingling of hands and feet.

8. During mid-life (middle age) the most important component of the diet to adjust is?

a: Energy intake - During mid-life it is important to restrict our energy intake, as our physical activity decreases and we tend to lead a more sedentary life. Therefore, to avoid unnecessary weight gain and array of other problems with regards to diet, it is advised to reduce the energy intake.

9. A person suffering from hypertension should avoid...

b: Sodium Hypertension (high blood pressure) is associated with high salt (sodium) in the diet. The kidneys control the amount of salt in our body. If consumed in excess, the kidneys remove the excess salt via urine. However, prolonged and excessive salt intake tires the kidney, causing the exceeded salt to accumulate in the bloodstream. Since salt attracts water, excess salt in the blood draws in more water thus increasing the volume of blood, which in turn raises blood who suffers from hypertension should limit the amount of sodium in their diet.

10. What type of fibre helps to lower cholesterol and blood sugar?

a: Soluble fibre Soluble fibre binds with fatty acids and slows digestion; hence, blood sugars are released slowly into the body. It helps lower LDL (bad) cholesterol and regulates blood sugar levels in people with Diabetes. Sources of soluble fibre include oats and oat bran, barley, nuts, psyllium husk, legumes, oranges, apples, carrots, okra, soybeans, flaxseeds. Diet should include 25-30 g of fibre from foods every day.