CDE Nutrition Therapy 5 — Questions and Answers
Question 1: A patient with gestational diabetes asks what her carbohydrate intake should be at breakfast. What is the recommended range?
- 45–60g
- 30–45g
- 15–30g (Correct answer)
- 60–75g
Correct answer: 15–30g
For gestational diabetes, breakfast carbohydrate is typically limited to 15–30g because insulin resistance is highest in the morning.
Question 2: Which approach is MOST consistent with current ADA MNT guidelines for individualizing nutrition therapy?
- All patients with diabetes should follow the same meal plan
- Nutrition therapy should be tailored to each patient's preferences, culture, and metabolic goals (Correct answer)
- Low-fat diets are mandatory for all patients with diabetes
- Carbohydrate counting is the only valid approach for type 2 diabetes
Correct answer: Nutrition therapy should be tailored to each patient's preferences, culture, and metabolic goals
ADA guidelines emphasize individualized nutrition therapy that considers personal preferences, cultural traditions, metabolic targets, and lifestyle.
Question 3: What is the recommended frequency of MNT visits with a registered dietitian for a newly diagnosed patient with type 2 diabetes?
- One visit only
- 3–6 sessions in the first year, then annually as needed (Correct answer)
- Monthly visits indefinitely
- Only when A1C is above 10%
Correct answer: 3–6 sessions in the first year, then annually as needed
ADA recommends 3–6 MNT sessions with an RDN in the first year of diagnosis, with annual follow-up visits thereafter.
Question 4: A patient reports that they use the 'plate method' for meal planning. What does this method recommend for protein foods?
- Half the plate
- One quarter of the plate (Correct answer)
- One eighth of the plate
- The entire plate
Correct answer: One quarter of the plate
The plate method recommends filling one quarter of a 9-inch plate with lean protein foods at each meal.
Question 5: Which nutrient has the most direct and immediate effect on postprandial blood glucose levels?
- Dietary fat
- Dietary protein
- Dietary carbohydrate (Correct answer)
- Dietary cholesterol
Correct answer: Dietary carbohydrate
Dietary carbohydrate has the most direct and immediate impact on postprandial blood glucose, as it is broken down into glucose and absorbed into the bloodstream.
Question 6: A patient with type 2 diabetes is interested in intermittent fasting. What is the most important safety consideration to discuss first?
- Choice of fasting window (16:8 vs 5:2)
- Potential for hypoglycemia, especially with insulin or sulfonylureas (Correct answer)
- Vitamin D supplementation during fasting
- Whether to include coffee during fasting periods
Correct answer: Potential for hypoglycemia, especially with insulin or sulfonylureas
The primary safety concern with intermittent fasting in diabetes is hypoglycemia risk in patients on insulin or insulin secretagogues like sulfonylureas.
Question 7: What does the term 'glycemic load' account for that glycemic index alone does not?
- The fat content of the food
- Both the GI and the amount of carbohydrate actually consumed in a serving (Correct answer)
- The protein content of the food
- The cooking method used to prepare the food
Correct answer: Both the GI and the amount of carbohydrate actually consumed in a serving
Glycemic load = (GI × grams of carbohydrate per serving) ÷ 100, incorporating both the quality and quantity of carbohydrate in a realistic portion.
CDE Nutrition Therapy 5
A patient with gestational diabetes asks what her carbohydrate intake should be at breakfast.
What is the recommended range?