BC ADM Lifestyle Management & Patient Education 2 — Questions and Answers
Question 1: A patient with T2DM asks how resistance training affects insulin sensitivity. The MOST accurate response is that resistance training:
- Has no significant effect on insulin sensitivity compared to aerobic exercise
- Increases glucose transporter GLUT-4 expression in skeletal muscle (Correct answer)
- Only improves insulin sensitivity in patients with BMI >30
- Reduces insulin sensitivity acutely for up to 48 hours post-exercise
Correct answer: Increases glucose transporter GLUT-4 expression in skeletal muscle
Resistance training upregulates GLUT-4 expression in skeletal muscle, improving insulin-mediated glucose uptake independent of BMI.
Question 2: When counseling a patient with T1DM about alcohol consumption, which statement is MOST important to emphasize?
- Alcohol raises blood glucose acutely, so bolus insulin should be increased
- Alcohol should be avoided entirely as it always causes hyperglycemia
- Alcohol can mask hypoglycemia symptoms and inhibit hepatic gluconeogenesis (Correct answer)
- Moderate alcohol consumption has no meaningful effect on glycemic control
Correct answer: Alcohol can mask hypoglycemia symptoms and inhibit hepatic gluconeogenesis
Alcohol impairs hepatic gluconeogenesis and can blunt hypoglycemia awareness, increasing risk of prolonged hypoglycemia.
Question 3: A patient asks about the glycemic index (GI) of foods. Which guidance BEST reflects current evidence-based recommendations?
- Low-GI foods universally produce better glycemic outcomes than high-GI foods
- GI is the sole dietary metric patients should use for meal planning
- GI should be considered alongside total carbohydrate load (glycemic load) for practical guidance (Correct answer)
- GI values are identical across all cooking methods and food preparations
Correct answer: GI should be considered alongside total carbohydrate load (glycemic load) for practical guidance
Glycemic load, which accounts for both GI and portion size, provides more practical and accurate dietary guidance than GI alone.
Question 4: Which behavior change technique is MOST effective when helping a patient establish a regular physical activity routine?
- Providing a comprehensive written list of all possible exercises
- Using implementation intentions (if-then planning) to link activity to existing habits (Correct answer)
- Emphasizing long-term health benefits to motivate daily exercise
- Setting an ambitious goal of 60 minutes of vigorous exercise daily from the start
Correct answer: Using implementation intentions (if-then planning) to link activity to existing habits
Implementation intentions ('if X situation, then I will do Y') have strong evidence for bridging the gap between intention and action in behavior change.
Question 5: A 58-year-old patient with T2DM and peripheral neuropathy wants to start exercising. Which exercise recommendation is MOST appropriate?
- Avoid all weight-bearing exercise due to foot ulcer risk
- Swimming or cycling are preferred due to reduced plantar pressure (Correct answer)
- Running is preferred because it builds bone density
- Exercise is contraindicated until neuropathy is resolved
Correct answer: Swimming or cycling are preferred due to reduced plantar pressure
Non-weight-bearing or low-impact activities like swimming and cycling reduce plantar pressure risk in patients with peripheral neuropathy.
Question 6: In the context of diabetes self-management education (DSME), the '7 Self-Care Behaviors' framework includes which of the following?
- Healthy eating, being active, monitoring, taking medication, problem solving, reducing risks, healthy coping (Correct answer)
- Healthy eating, carb counting, weight loss, medication adherence, lab monitoring, podiatry, ophthalmology
- Insulin titration, glucose logging, A1C tracking, ketone testing, foot care, dental care, exercise
- Medication compliance, doctor visits, nutritional supplementation, stress avoidance, sleep hygiene, hydration, abstaining from alcohol
Correct answer: Healthy eating, being active, monitoring, taking medication, problem solving, reducing risks, healthy coping
The AADE7 Self-Care Behaviors are: healthy eating, being active, monitoring, taking medication, problem solving, reducing risks, and healthy coping.
Question 7: A patient reports eating late-night snacks frequently, which disrupts glycemic control. Which evidence-based strategy is MOST appropriate to recommend?
- Prescribe a strict 800-calorie daily diet to eliminate nighttime hunger
- Suggest time-restricted eating aligned with the patient's lifestyle and preferences (Correct answer)
- Recommend doubling the evening insulin dose to cover anticipated late-night intake
- Advise the patient to eat only protein after 6 PM regardless of preferences
Correct answer: Suggest time-restricted eating aligned with the patient's lifestyle and preferences
Time-restricted eating, tailored to patient preferences, has evidence for improving glycemic control and weight management without extreme dietary restriction.
BC ADM Lifestyle Management & Patient Education 2
A patient with T2DM asks how resistance training affects insulin sensitivity.
The MOST accurate response is that resistance training: