Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which meal from a diabetes patient's diet recall requires the most modifications?

1. Breakfast: 1 cup raisin bran with 1 cup skim milk, 12 oz orange juice, 1/2 bagel

2. Lunch: Large taco salad with tortilla bowl and sour cream

3. Dinner: 2 cheeseburgers with side salad and black coffee

4. All meals need modifications

The correct answer is: Breakfast: 1 cup raisin bran with 1 cup skim milk, 12 oz orange juice, 1/2 bagel

The breakfast option requires the most modifications primarily due to its high carbohydrate content, particularly from the raisin bran and orange juice. Raisin bran, while a source of fiber, contains a significant amount of added sugars that can elevate blood glucose levels. Additionally, the 12 oz of orange juice contributes another substantial carbohydrate load without the benefits of fiber found in whole fruits, which can help slow the absorption of sugars. For individuals managing diabetes, it's essential to monitor carbohydrate intake closely to avoid spikes in blood glucose levels. Instead of quick-reacting carbohydrates like those found in cereal and juice, a more balanced breakfast could include high-fiber options like whole grains, proteins such as eggs, and low-glycemic index fruits. This rationale underscores why the breakfast meal stands out as needing significant modifications compared to the lunch and dinner options, which, while they may still require some adjustments, do not present as critical a risk for immediate blood glucose fluctuations as the breakfast meal does. The other meals contain a mix of carbohydrates and fats which can also be adjusted, but they are not as starkly problematic as the breakfast choice.