There are 2 types of parenteral nutrition, Total Parenteral Nutrition (TPN) and Peripheral Parenteral Nutrition (PPN). TPN must be administered using:

Choice A reason: Cataract development is a common issue in people with diabetes due to the high blood sugar levels that affect the lens of the eye. However, it is not the primary cause of visual impairment. Cataracts cause the lens to become cloudy, leading to blurred vision, but the impact is generally less severe compared to the microvascular complications of diabetes.

Choice B reason: Exophthalmos, or bulging of the eye, is not typically associated with diabetes. It is more commonly seen in conditions like Graves' disease, an autoimmune disorder affecting the thyroid. Therefore, while it is important to be aware of various conditions that can impact eye health, exophthalmos is not a primary complication of diabetes.

Choice C reason: Abnormal metabolism in the lens can contribute to the formation of cataracts, but it is not the main reason for diabetic visual impairment. The primary issue in diabetes-related visual impairment is damage to the small blood vessels in the retina, not just changes in the lens metabolism.

Choice D reason: Microvascular changes in the eye, particularly diabetic retinopathy, are the primary cause of visual impairment in people with diabetes. High blood sugar levels can damage the blood vessels in the retina, leading to leakage, swelling, and the formation of new, abnormal blood vessels. This can result in significant vision loss and even blindness if not properly managed. Regular eye examinations and control of blood glucose levels are crucial in preventing and managing diabetic retinopathy.

Choice A reason: Increased lipid breakdown does not directly cause the release of insulin. Insulin is a hormone that facilitates glucose uptake by cells and helps regulate blood sugar levels. Lipid metabolism is primarily regulated by other mechanisms and hormones, such as glucagon and epinephrine.

Choice B reason: Decreased blood glucose level would not stimulate insulin release. In fact, low blood glucose levels would signal the pancreas to reduce insulin secretion. Instead, glucagon would be released to increase blood glucose levels by stimulating the conversion of glycogen to glucose in the liver.

Choice C reason: Increased protein breakdown does not directly trigger the release of insulin. Protein metabolism involves amino acids and other metabolic pathways, but insulin release is primarily regulated by blood glucose levels.

Choice D reason: The release of insulin is caused by increased blood glucose levels. When blood glucose levels rise, such as after eating a meal, the beta cells in the pancreas secrete insulin to help cells absorb glucose from the bloodstream, thereby lowering blood glucose levels and maintaining homeostasis.