Teaching packet

Megan, 28

28-year-old woman with prediabetes and a documented history of an eating disorder.

28 years old, female, A1c 5.8%

Conditions

Prediabetes

Medications

None.

The plan the engine produced

The engine refused to generate automated guidance for this profile. The refusal is the teaching point: guideline diet advice does not cover this population, so the tool routes the case to a named clinician instead of guessing.

Eating-disorder risk

Restrictive numeric targets and 'limit' lists can be harmful when eating-disorder risk is present, so automated targets are withheld.

Route to: Eating-disorder specialist / RDN

Case questions

1. Long-term metformin can lower which vitamin?

A. Vitamin C
B. Vitamin D
C. Vitamin B12
D. Folate

2. A patient takes atorvastatin. Which food should they avoid?

A. Bananas
B. Grapefruit
C. Spinach
D. Eggs

3. A patient on warfarin asks about leafy greens. The best advice is to:

A. Avoid all greens
B. Keep vitamin K intake consistent week to week
C. Eat as much as possible
D. Stop greens entirely

4. Stage 3b CKD plus an ACE inhibitor. A high-potassium dish should be:

A. Recommended freely
B. Limited or set aside
C. Required daily
D. Ignored

Answer key

1. C. Vitamin B12

Long-term metformin is associated with lower vitamin B12; periodic testing is suggested.

ADA Standards of Care 2026

2. B. Grapefruit

Grapefruit blocks intestinal CYP3A4, which can raise levels of atorvastatin and simvastatin. Pravastatin and rosuvastatin are not affected.

FDA Consumer Update; CMAJ 2013

3. B. Keep vitamin K intake consistent week to week

Warfarin needs steady vitamin K, not avoidance. Big swings in intake change the dose response; consistency is the goal.

MedlinePlus: Warfarin

4. B. Limited or set aside

Reduced kidney function plus an ACE inhibitor raises hyperkalemia risk, so high-potassium foods are limited and potassium is matched to serum levels.

KDOQI 2020; FDA labeling

Demo data. Educational use, not medical advice.