CDE Nutrition Therapy 4 — Questions and Answers
Question 1: A patient with diabetes is on insulin and plans to exercise for 45 minutes. Which nutritional strategy is most appropriate to prevent hypoglycemia?
- Skip the pre-exercise meal entirely
- Consume 15–30g of fast-acting carbohydrates before exercise (Correct answer)
- Double insulin dose before exercise
- Eat a high-fat meal immediately before exercise
Correct answer: Consume 15–30g of fast-acting carbohydrates before exercise
Consuming 15–30g of rapidly absorbed carbohydrates before moderate exercise helps prevent exercise-induced hypoglycemia in insulin-dependent patients.
Question 2: What percentage of total daily calories from fat is currently recommended by the ADA for adults with diabetes?
- Less than 10%
- Less than 20%
- No specific percentage — fat quality matters more than quantity (Correct answer)
- 35–45%
Correct answer: No specific percentage — fat quality matters more than quantity
The ADA no longer specifies an ideal fat percentage; current guidance emphasizes fat quality (type) rather than total fat quantity.
Question 3: A patient with type 2 diabetes reports drinking 2 glasses of red wine nightly. What is the primary concern regarding alcohol and diabetes management?
- Alcohol raises blood glucose immediately in all patients
- Alcohol can cause delayed hypoglycemia, especially in insulin users (Correct answer)
- Alcohol always improves insulin sensitivity
- Alcohol has no effect on lipids in diabetic patients
Correct answer: Alcohol can cause delayed hypoglycemia, especially in insulin users
Alcohol inhibits hepatic glucose production and can cause delayed hypoglycemia 12–24 hours after consumption, particularly in patients on insulin or sulfonylureas.
Question 4: Which statement best describes the effect of dietary fiber on glycemic control in type 2 diabetes?
- Soluble fiber speeds gastric emptying and raises blood glucose
- Insoluble fiber is absorbed and lowers blood glucose directly
- Soluble fiber slows gastric emptying and reduces post-meal glucose spikes (Correct answer)
- Both types of fiber have identical effects on blood glucose
Correct answer: Soluble fiber slows gastric emptying and reduces post-meal glucose spikes
Soluble fiber forms a gel that slows gastric emptying and carbohydrate absorption, which helps blunt post-meal blood glucose increases.
Question 5: A 58-year-old patient with type 2 diabetes is following a very low calorie diet (VLCD) of 800 kcal/day. Which monitoring parameter is most important during this intervention?
- Daily weight only
- Blood glucose levels and medication adjustments (Correct answer)
- Dietary cholesterol intake
- Vitamin C levels
Correct answer: Blood glucose levels and medication adjustments
VLCDs can dramatically lower blood glucose, requiring close monitoring and medication dose reduction to prevent hypoglycemia.
Question 6: What is the recommended protein intake for a non-pregnant adult with well-controlled type 2 diabetes and normal kidney function?
- 0.4–0.6 g/kg/day
- 0.8–1.0 g/kg/day (Correct answer)
- 1.5–2.0 g/kg/day
- 2.5–3.0 g/kg/day
Correct answer: 0.8–1.0 g/kg/day
The ADA recommends 0.8–1.0 g/kg/day of protein for adults with diabetes and normal kidney function, consistent with general population guidelines.
Question 7: Which plant-based food is particularly beneficial for people with diabetes due to its high content of both soluble fiber and protein?
- White rice
- Legumes (beans, lentils, chickpeas) (Correct answer)
- Iceberg lettuce
- Corn syrup
Correct answer: Legumes (beans, lentils, chickpeas)
Legumes provide soluble fiber that blunts glucose absorption and plant-based protein, making them especially valuable in diabetic meal planning.
CDE Nutrition Therapy 4
A patient with diabetes is on insulin and plans to exercise for 45 minutes.
Which nutritional strategy is most appropriate to prevent hypoglycemia?