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1. A 45-year-old male patient with type 2 diabetes mellitus
is admitted to the hospital for a foot ulcer. He reports that
he has been following a low-carbohydrate diet for the past
six months to control his blood glucose levels. Which of
the following statements is true regarding his dietary
choice?
A) A low-carbohydrate diet is beneficial for patients with
type 2 diabetes mellitus as it reduces the need for insulin
and oral hypoglycemic agents.
B) A low-carbohydrate diet is not recommended for
patients with type 2 diabetes mellitus as it can cause
ketoacidosis and hypoglycemia.
C) A low-carbohydrate diet is acceptable for patients with
type 2 diabetes mellitus as long as it is balanced with
adequate protein and fat intake.
D) A low-carbohydrate diet is contraindicated for patients
with type 2 diabetes mellitus as it can worsen the risk of
cardiovascular complications and renal damage.
Answer: D
Rationale: A low-carbohydrate diet can lead to increased
production of ketone bodies, which can cause metabolic
acidosis and electrolyte imbalance. It can also lower the
serum HDL cholesterol and raise the serum LDL
cholesterol and triglycerides, which can increase the risk of
atherosclerosis, myocardial infarction, and stroke.
Moreover, a low-carbohydrate diet can impair the renal
function by increasing the glomerular filtration rate and
proteinuria, which can exacerbate the diabetic nephropathy.
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