CANADIAN DIABETES EDUCATOR EXAM
QUESTIONS & ANSWERS WITH COMPLETE
SOLUTIONS GRADED A+
QUESTIONS AND ANSWERS
Diagnosis of Diabetes (FPG, A1C, 2hPG in a 75g OFTT, random PG). ANSWER -
FPG >/=7mmol/ml
A1c >/= 6.5%
2h PG in a 75g OGTT >/= 11mmol/L
random PG >/= 11.1mmol/L
Prediabetes (i.e. at high risk for developing diabetes) - A1C. ANSWER -6-6.4%
what medical conditions can cause A1C results to be misleading?. ANSWER --
hemoglobinopathies
-iron deficiencies
-hemolytic anemia
-severe hepatic or renal disease
Impaired Fasting glucose (IFG). ANSWER -FPG - 6.1-6.9mmol/L
Impaired glucose tolerance (IGT). ANSWER -OGTT (w/ 75g of glucose) 7.8-
11mmol/L
,Screening for T1D is ..... ANSWER -NOT recommended
Screening recommendations for T2D. ANSWER -use FPG and/or A1c every 3 years
in individuals >/=40yo or in individuals at high risk (using risk calculator)
macrosomic infant. ANSWER -infant that weighs over 8lbs at birth
microvascular complications. ANSWER -retinopathy, neuropathy, nephropathy
macrovascular complications. ANSWER -coronary, cerebrovascular, peripheral
Pharmacological therapies for PREVENTION of T2D (include by how much % it is
reduced by). ANSWER -1. Metformin (~30%)
2. Acarbose (~30%)
3. Thiazolidinediones (~60%)
ACCORD, ADVANCE and VADT were the three major trials that concluded what?.
ANSWER -intensive glycemic control - lowering A1C <6% resulted in higher
mortality, severe episodes of hypoglycemia - therefore targets should individualized!!
TARGET for A1C, FPG and RPG for MOST Diabetic (T1D and T2D) patients?.
ANSWER -A1c <7mmol/L
FPG 4-7mmol/L
PPG 5-10mmol/L (5-8mmol/L if A1c target not achieved)
,Who should have target of A1c <6.5%. ANSWER -in T2D to further decrease risk of
nephropathy and retinopathy (ensure there is a balance so as not to cause
HYPOGLYCEMIA)
Who should have target of 7.1-8.5% (7). ANSWER -1. limited life expectancy
2. High level of functional dependency
3. severe coronary artery disease/ increased risk for ischemic events
4. multiple comorbidities
5. HX of recurrent severe hypoglycemic episodes
6. hypoglycemic unawareness
7. Long standing diabetes that is difficult to reduce A1c<7% - despite appropriate
treatments
How and when should verification of the accuracy of SMBG monitors be done? What
is the acceptable difference?. ANSWER -When: annually or when A1C results do not
match
How: comparing FPG machine results with FPG from lab measurements
acceptable difference is 20%
If on insulin and planning exercise. What is the BG to watch out for to prevent
HYPOglycemia? What should be done if BG is at or past cut off?. ANSWER -BG <
5.5mmol/L
Take 15-30g of carbs PRE-exercise
exercise recommendation for diabetes?. ANSWER -150min/week of moderate
intensity aerobic exercise spread over 3 days with no more than 2 days of sedentary
2-3 times per week of resistance training
, How well can nutrition therapy reduce A1C?. ANSWER -Can reduce A1C by 1-2%
carbohydrates recommendation. ANSWER -no less than 130g/d (to maintain glucose
to brain)
no less than 45% of energy (60% if high in fibre and low glycemic index)
Dietary fiber recommendation. ANSWER -25-38g for women
21-30g for men
>51yo w/ diabetes
Recommended added sugars intake?. ANSWER -no more than 10% of total daily
energy (aka. 50-65g/day for a 2000-2600kcal/day diet)
Eating Well with Canada's Food Guide recommendation for fruit and veggies ?.
ANSWER -7-10 servings / day
Recommendation for Fat intake? saturated fats?. ANSWER -20-35% of energy intake
saturated fats <7% of total daily
what type of fats are preferred?. ANSWER -monounsaturated fats (MUFA)
polyunsaturated fats (PUFA)
long chain omega 3 FA
included up to 10% of total energy intake
QUESTIONS & ANSWERS WITH COMPLETE
SOLUTIONS GRADED A+
QUESTIONS AND ANSWERS
Diagnosis of Diabetes (FPG, A1C, 2hPG in a 75g OFTT, random PG). ANSWER -
FPG >/=7mmol/ml
A1c >/= 6.5%
2h PG in a 75g OGTT >/= 11mmol/L
random PG >/= 11.1mmol/L
Prediabetes (i.e. at high risk for developing diabetes) - A1C. ANSWER -6-6.4%
what medical conditions can cause A1C results to be misleading?. ANSWER --
hemoglobinopathies
-iron deficiencies
-hemolytic anemia
-severe hepatic or renal disease
Impaired Fasting glucose (IFG). ANSWER -FPG - 6.1-6.9mmol/L
Impaired glucose tolerance (IGT). ANSWER -OGTT (w/ 75g of glucose) 7.8-
11mmol/L
,Screening for T1D is ..... ANSWER -NOT recommended
Screening recommendations for T2D. ANSWER -use FPG and/or A1c every 3 years
in individuals >/=40yo or in individuals at high risk (using risk calculator)
macrosomic infant. ANSWER -infant that weighs over 8lbs at birth
microvascular complications. ANSWER -retinopathy, neuropathy, nephropathy
macrovascular complications. ANSWER -coronary, cerebrovascular, peripheral
Pharmacological therapies for PREVENTION of T2D (include by how much % it is
reduced by). ANSWER -1. Metformin (~30%)
2. Acarbose (~30%)
3. Thiazolidinediones (~60%)
ACCORD, ADVANCE and VADT were the three major trials that concluded what?.
ANSWER -intensive glycemic control - lowering A1C <6% resulted in higher
mortality, severe episodes of hypoglycemia - therefore targets should individualized!!
TARGET for A1C, FPG and RPG for MOST Diabetic (T1D and T2D) patients?.
ANSWER -A1c <7mmol/L
FPG 4-7mmol/L
PPG 5-10mmol/L (5-8mmol/L if A1c target not achieved)
,Who should have target of A1c <6.5%. ANSWER -in T2D to further decrease risk of
nephropathy and retinopathy (ensure there is a balance so as not to cause
HYPOGLYCEMIA)
Who should have target of 7.1-8.5% (7). ANSWER -1. limited life expectancy
2. High level of functional dependency
3. severe coronary artery disease/ increased risk for ischemic events
4. multiple comorbidities
5. HX of recurrent severe hypoglycemic episodes
6. hypoglycemic unawareness
7. Long standing diabetes that is difficult to reduce A1c<7% - despite appropriate
treatments
How and when should verification of the accuracy of SMBG monitors be done? What
is the acceptable difference?. ANSWER -When: annually or when A1C results do not
match
How: comparing FPG machine results with FPG from lab measurements
acceptable difference is 20%
If on insulin and planning exercise. What is the BG to watch out for to prevent
HYPOglycemia? What should be done if BG is at or past cut off?. ANSWER -BG <
5.5mmol/L
Take 15-30g of carbs PRE-exercise
exercise recommendation for diabetes?. ANSWER -150min/week of moderate
intensity aerobic exercise spread over 3 days with no more than 2 days of sedentary
2-3 times per week of resistance training
, How well can nutrition therapy reduce A1C?. ANSWER -Can reduce A1C by 1-2%
carbohydrates recommendation. ANSWER -no less than 130g/d (to maintain glucose
to brain)
no less than 45% of energy (60% if high in fibre and low glycemic index)
Dietary fiber recommendation. ANSWER -25-38g for women
21-30g for men
>51yo w/ diabetes
Recommended added sugars intake?. ANSWER -no more than 10% of total daily
energy (aka. 50-65g/day for a 2000-2600kcal/day diet)
Eating Well with Canada's Food Guide recommendation for fruit and veggies ?.
ANSWER -7-10 servings / day
Recommendation for Fat intake? saturated fats?. ANSWER -20-35% of energy intake
saturated fats <7% of total daily
what type of fats are preferred?. ANSWER -monounsaturated fats (MUFA)
polyunsaturated fats (PUFA)
long chain omega 3 FA
included up to 10% of total energy intake
