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Rationale of the Week | Best Intervention to address Elevated LDL?

For last week’s practice question, we quizzed participants on the best intervention to address elevated LDL. 40% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question

Question:

MK is 67 years old and is concerned about cardiovascular disease risk and diabetes. Their last lab result showed an A1C of 6.8%, HDL of 38 and LDL of 132. MK started reading food labels and is concerned about their total fat intake each day and wants to make diet changes to reduce CVD risk.

According to the 2024 ADA Standards of Care, which evidence-based statement is most accurate when counseling MK about their fat intake?

Answer Choices:

  1. There is no one optimal percentage of calories from fat for people with diabetes.
  2. Try to limit saturated fat to less to 7% of calories each day.
  3. We suggest including 1 gram per day of Omega-3 supplement for prevention of cardiovascular events.
  4. The best approach is to reduce total fat to less than 30% of total calories per day.

Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.

Answer 1 is correct. GREAT JOB!  39.89% chose this answer, “There is no one optimal percentage of calories from fat for people with diabetes.” The Standards of Care 2024 states, “There is no optimal percentage of calories from fat for people with diabetes or at risk for diabetes, and macronutrient distribution should be individualized.”   In addition, there is no optimal percentage of calories from fat or saturated fat for people with diabetes and CVD prevention goals; however, they recommend to “limit” daily saturated fat consumption.  The type of fat consumed is more important than the total amount of fat from calories.

Answer 2 is incorrect. 24.87% of you chose this answer. “Try to limit saturated fat to less to 7% of calories each day.” The standards of care do not have a recommended limit for saturated fat consumption but suggest that “people with diabetes or at risk for diabetes follow recommended guidelines for the general population.” The Dietary Guidelines for Americans 2020-2025 recommends less than 10% of calories from saturated fat. Even if considering tighter American Heart Association recommendations, they allow 5-6% of calories from saturated fat. Some eating patterns, such as the TLC diet from 2005, the DASH diet, or the Mediterranean diet, may include food choices where saturated fat is less than 7% of calories, but this is not a general population guideline.  

Answer 3 is incorrect. About 13.43% of respondents chose this. “We suggest including 1 gram per day of Omega-3 supplement for prevention of cardiovascular events.” There is no recommendation for omega-3 supplementation in all persons with diabetes. Current evidence within the standard of care states that 1 gram of Omega 3 supplementation showed no benefit in preventing cardiovascular disease; however, within the REDUCE-IT trial, supplementation of pure EPA at 4 grams each day did lower cardiovascular events.

Answer 4 is incorrect. 21.81% chose this answer. “The best approach is to reduce total fat to less than 30% of total calories per day.” There is no specific recommendation for total fat amount to limit in a meal plan. The standards of care state, “The type of fat consumed is more important than the total.” They recommend following a Mediterranean-like eating pattern, which includes foods like fatty fish, nuts, and seeds and is rich in polyunsaturated and monounsaturated fats.

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!


Want to learn more about nutrition and the ADA Standards?

Level 3 | DiabetesEd Certification Boot Camp
with Coach Beverly, RN, MPH, CDCES &
Christine Craig, MS, RDN, CDCES

Airs live on February 13th – March 19th, 2024, at 11:30 am PT

Class Topics & Webinar Dates:

  • February 13, 2024 – Boot Camp 1: Diabetes | Not Just Hyperglycemia | 1.75 CEs 
  • February 15, 2024 – Boot Camp 2: Standards of Care & Cardiovascular Goals | 1.8 CEs
  • February 20, 2024 – Boot Camp 3: Meds for Type 2 | What you need to know | 1.75 CEs 
  • February 22, 2024 – Boot Camp 4: Insulin Therapy | From Basal/Bolus to Pattern Management | 1.75 CEs
  • February 27, 2024 – Boot Camp 5: Insulin Intensive & Risk Reduction | Monitoring, Sick Days, Lower Extremities | 1.75 CEs 
  • February 29, 2024 – Boot Camp 6: Medical Nutrition Therapy | 1.75 CEs 
  • March 12, 2024 – Boot Camp 7: Microvascular Complications & Exercise | Screen, Prevent, Treat | 1.75 CEs
  • March 14, 2024 – Boot Camp 8: Coping & Behavior Change | 1.75 CEs 
  • March 19, 2024 – Boot Camp 9: Test-Taking Coach Session (48 Questions) | No CE 

Intended Audience: This library of critical information is designed for individuals or groups of diabetes specialists, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with diabetes and preparing for the BC-ADM or the CDCES certification Exam.

Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast

Instructors: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 15 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert.  

Christine Craig, MS, RD, CDCES, winner of the 2023 Impact on Diabetes Award, is a leader in the field of nutrition, technology, and diabetes care. Her years of expertise combined with her person-centered approach and work ethic, make her a perfect speaker for this nutrition and activity focused content.


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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.