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.