Diabetes: Types, Causes and Management

• A. To break down proteins into amino acids
• B. To allow glucose to move from the bloodstream into cells ✓
• C. To produce red blood cells in the bone marrow
• D. To regulate body temperature

Why: Insulin is a hormone produced by the beta cells of the pancreas. It signals cells, especially muscle, fat, and liver cells, to take up glucose from the blood, which lowers blood sugar levels and provides cells with energy.

• A. Type 2 diabetes
• B. Gestational diabetes
• C. Type 1 diabetes ✓
• D. Prediabetes

Why: Type 1 diabetes is an autoimmune condition in which the immune system mistakenly attacks and destroys the beta cells, leading to little or no insulin production. It usually develops in childhood or young adulthood, though it can occur at any age.

• A. Having blood type O
• B. Being physically active several times a week
• C. Excess body weight, particularly abdominal fat ✓
• D. Drinking water regularly

Why: Excess body weight, especially fat stored around the abdomen, is one of the strongest risk factors for Type 2 diabetes because it contributes to insulin resistance. Physical activity and adequate hydration are protective or neutral, not risk factors.

• A. The pancreas has stopped producing any insulin
• B. Cells respond poorly to insulin, so more insulin is needed to achieve the same effect ✓
• C. The body produces insulin that is too strong and causes dangerously low blood sugar
• D. The kidneys are unable to filter insulin from the blood

Why: Insulin resistance means that the body's cells, particularly in muscle, fat, and liver, do not respond efficiently to insulin. The pancreas compensates by producing more insulin, but over time blood glucose can still rise, which is a key feature of Type 2 diabetes.

• A. Fasting blood glucose test
• B. Random blood glucose test
• C. Oral glucose tolerance test
• D. Hemoglobin A1c (HbA1c) test ✓

Why: The HbA1c test measures the percentage of hemoglobin in red blood cells that is coated with glucose. Because red blood cells live about three months, this test reflects average blood glucose over roughly the previous two to three months.

• A. Insulin resistance in muscle and fat cells
• B. Autoimmune destruction of insulin-producing beta cells in the pancreas ✓
• C. A diet high in refined sugars over many years
• D. Excessive production of glucagon by the liver

Why: Type 1 diabetes is an autoimmune condition in which the immune system attacks and destroys the beta cells of the pancreatic islets, leading to little or no insulin production.

• A. Adults over 65 years
• B. Children and young adults ✓
• C. Pregnant women only
• D. Adults who are overweight

Why: Type 1 diabetes is most often diagnosed in children, adolescents, and young adults, although it can develop at any age.

• A. Gradual weight gain over several years
• B. Excessive thirst, frequent urination, and unexplained weight loss ✓
• C. Constipation and dry skin only
• D. Increased appetite with no other changes

Why: High blood glucose causes the kidneys to excrete sugar, pulling water with it. This produces excessive thirst and urination, and without insulin the body breaks down fat and muscle, causing weight loss.

• A. Their bodies produce too much insulin
• B. Their bodies produce little or no insulin because beta cells are destroyed ✓
• C. Insulin cures the autoimmune process
• D. Their cells have become immune to glucose

Why: Because the beta cells are destroyed, the body cannot produce enough insulin to regulate blood glucose, so external insulin must be supplied to survive.

• A. It usually develops slowly over decades with mild symptoms
• B. It often develops relatively quickly, with symptoms appearing over days to weeks ✓
• C. It is always preceded by a long period of obesity
• D. It can be reversed by lifestyle changes alone

Why: Type 1 diabetes typically presents relatively rapidly once a significant portion of beta cells is lost, often over days to weeks, and it is not reversed by lifestyle changes.

• A. Family history of diabetes
• B. Physical inactivity ✓
• C. Advancing age
• D. Ethnic background

Why: Physical inactivity is a modifiable risk factor because regular exercise improves insulin sensitivity and helps control weight. Family history, age, and ethnicity are non-modifiable risk factors that a person cannot change.

• A. Metabolic syndrome
• B. Insulin resistance
• C. Prediabetes ✓
• D. Ketosis

Why: Prediabetes describes blood glucose levels above normal but below the diagnostic threshold for diabetes. It is an important window for lifestyle intervention to prevent progression to type 2 diabetes.

• A. Glucagon
• B. Cortisol
• C. Insulin ✓
• D. Adrenaline

Why: Insulin, produced by the beta cells of the pancreas, promotes the uptake of glucose into cells and its storage, thereby lowering blood glucose. Glucagon raises blood glucose, while cortisol and adrenaline also tend to increase it.

• A. They become overactive and produce excess insulin indefinitely
• B. They gradually lose function and insulin output declines ✓
• C. They multiply rapidly to compensate for resistance
• D. They are unaffected, and the problem lies only in the liver

Why: In type 2 diabetes, the pancreas initially compensates for insulin resistance by producing more insulin. Over time, beta cell function progressively declines, reducing insulin output and worsening blood glucose control.

• A. Low blood pressure
• B. Abdominal obesity ✓
• C. Elevated HDL cholesterol
• D. Low triglyceride levels

Why: Abdominal (visceral) obesity is a central component of metabolic syndrome and contributes to insulin resistance. The other options are either healthy values or not characteristic features of the syndrome.

• A. Diabetes that was present before pregnancy and continues afterward
• B. Glucose intolerance first diagnosed during pregnancy that usually resolves after delivery ✓
• C. A genetic disorder that causes insulin deficiency from birth
• D. Diabetes caused by long-term use of corticosteroids

Why: Gestational diabetes is glucose intolerance first recognized during pregnancy. Most cases resolve after delivery, although affected women have a higher long-term risk of developing type 2 diabetes.

• A. The pancreas stops producing insulin entirely
• B. Placental hormones such as human placental lactogen, progesterone, and cortisol antagonize insulin action ✓
• C. Increased physical activity raises glucose requirements
• D. The kidneys begin excreting insulin in the urine

Why: Hormones produced by the placenta raise maternal blood glucose to supply the fetus. They counteract insulin, so insulin resistance rises. Women whose beta cells cannot compensate develop gestational diabetes.

• A. Fasting plasma glucose alone
• B. Hemoglobin A1c measured at the first prenatal visit
• C. Urine dipstick for glucose
• D. Oral glucose tolerance test with a 50 g or 75 g glucose load ✓

Why: The oral glucose tolerance test, using a 50 g glucose challenge screen followed by a 100 g or 75 g diagnostic test depending on protocol, is the standard method for diagnosing gestational diabetes. Glycosuria is common in pregnancy and is not diagnostic, and A1c is less sensitive for this purpose.

• A. Fetal macrosomia (excessive birth weight) ✓
• B. Early onset of puberty
• C. Fetal hypoglycemia at birth only
• D. Premature closure of the fetal skull sutures

Why: Maternal hyperglycemia crosses the placenta and stimulates fetal insulin production, promoting excess fetal fat and growth. This increases the risk of macrosomia, shoulder dystocia, and birth injury. Neonatal hypoglycemia can also occur after birth, but macrosomia is the classic hallmark.

• A. Maturity-onset diabetes of the young (MODY) ✓
• B. Hashimoto diabetes
• C. Addison diabetes
• D. Graves diabetes

Why: MODY is a monogenic form of diabetes caused by single-gene mutations affecting beta-cell function, usually presenting in young people with autosomal dominant inheritance. Hashimoto, Addison, and Graves are autoimmune or endocrine disorders, not recognized diabetes types.

• A. Fasting plasma glucose
• B. Random blood glucose
• C. Hemoglobin A1c (HbA1c) ✓
• D. Oral glucose tolerance test

Why: HbA1c reflects the percentage of hemoglobin that has glucose attached to it. Because red blood cells live about 120 days, the test gives an average of blood glucose over roughly the past 2 to 3 months.

• A. Below 100 mg/dL
• B. 100 to 125 mg/dL
• C. 126 mg/dL or higher ✓
• D. 150 mg/dL or higher

Why: A fasting plasma glucose of 126 mg/dL or higher, confirmed on repeat testing or with other criteria, meets the diagnostic threshold for diabetes. Values of 100 to 125 mg/dL indicate prediabetes (impaired fasting glucose).

• A. That the patient's insulin levels are elevated
• B. That recent food intake does not affect the glucose reading ✓
• C. That the patient has eaten a high-carbohydrate meal
• D. That the test can be done without a blood sample

Why: Eating raises blood glucose, so fasting for at least 8 hours allows the measurement to reflect baseline glucose metabolism rather than the effects of a recent meal.

• A. Continuous glucose monitoring
• B. Capillary blood glucose testing ✓
• C. Venous plasma testing
• D. Urine glucose testing

Why: Capillary blood glucose testing uses a small drop of blood from a fingertip, read by a glucometer that gives an immediate result. Continuous glucose monitors instead measure interstitial fluid glucose through a sensor worn on the body.

• A. Sudden shakiness and sweating
• B. Increased thirst and frequent urination ✓
• C. Rapid weight gain in the abdomen only
• D. Persistent cold intolerance

Why: High blood glucose causes osmotic diuresis, leading to frequent urination and thirst. Shakiness and sweating are typical of hypoglycemia (low blood glucose), not hyperglycemia.

• A. Eliminating all carbohydrates from the diet
• B. Focusing on high-fiber, whole-food carbohydrates and balanced portions ✓
• C. Eating large meals only once per day
• D. Consuming only fruit juice to maintain blood sugar

Why: Whole-food, high-fiber carbohydrates digest more slowly, helping to prevent sharp spikes in blood glucose. Balanced portions support consistent blood sugar control, whereas eliminating carbohydrates entirely is not necessary or sustainable for most people.

• A. It causes the pancreas to produce more insulin immediately
• B. It helps muscles take up glucose more effectively, lowering blood sugar ✓
• C. It permanently cures diabetes in all patients
• D. It eliminates the need for any medication

Why: During and after exercise, muscles use glucose for energy and become more sensitive to insulin, which helps lower blood sugar. Exercise supports management but does not cure diabetes or replace prescribed medication without medical guidance.

• A. To measure how much protein a food contains
• B. To rank how quickly a carbohydrate-containing food raises blood glucose ✓
• C. To determine the calorie count of a meal
• D. To indicate the vitamin content of foods

Why: The glycemic index ranks carbohydrate foods by how rapidly and how much they raise blood glucose compared with a reference food. Choosing lower-GI foods can help reduce post-meal blood sugar spikes.

• A. Skipping meals to lose weight quickly
• B. Getting adequate sleep and managing stress ✓
• C. Smoking as a way to control appetite
• D. Avoiding all forms of monitoring blood glucose

Why: Poor sleep and high stress can raise blood glucose through hormonal effects and affect food choices and adherence to treatment. Adequate sleep and stress management are part of comprehensive diabetes care, while smoking worsens cardiovascular risk and skipping meals can cause dangerous fluctuations.

• A. Exercise always raises blood sugar dangerously
• B. Exercise can increase the risk of hypoglycemia, so glucose levels should be monitored and adjusted with a healthcare provider ✓
• C. Exercise is completely forbidden for all people with diabetes
• D. Exercise has no effect on blood sugar in any situation

Why: Physical activity increases glucose uptake by muscles and can lower blood sugar, sometimes to hypoglycemic levels, especially with insulin or sulfonylureas. Monitoring glucose and discussing medication adjustments with a healthcare provider helps exercise remain safe and beneficial.

• A. Glucagon
• B. Insulin ✓
• C. Cortisol
• D. Thyroxine

Why: Type 1 diabetes is an autoimmune condition in which the beta cells of the pancreas are destroyed, leading to little or no insulin production. Insulin is needed to move glucose from the blood into cells, so without it blood sugar rises.

• A. Metformin ✓
• B. Warfarin
• C. Levothyroxine
• D. Furosemide

Why: Metformin is usually the first-line oral drug for type 2 diabetes because it lowers glucose production in the liver, improves insulin sensitivity, is inexpensive, and has a good safety record.

• A. Cataract only
• B. Diabetic retinopathy ✓
• C. Glaucoma only
• D. Conjunctivitis

Why: Chronically high blood sugar damages the small blood vessels of the retina, causing diabetic retinopathy. Regular dilated eye examinations are recommended to detect and treat it early.

• A. Current fasting blood glucose only
• B. Average blood glucose over roughly the past 2 to 3 months ✓
• C. Urine ketone levels
• D. Daily insulin dose requirements

Why: HbA1c reflects the percentage of hemoglobin coated with glucose. Because red blood cells live about 3 months, the result gives an average picture of blood sugar control over that period.

• A. Walking barefoot to improve circulation
• B. Daily foot inspection and proper footwear ✓
• C. Soaking feet in hot water for an hour
• D. Avoiding all foot exams

Why: Diabetes can cause nerve damage (neuropathy) and reduced blood flow, so people may not feel injuries. Daily foot checks for cuts, blisters, or sores and wearing well-fitting shoes help prevent serious infections and ulcers.