39: Diabetes and Nutrition - O'Shea

Question 1

define diabetes

Answer 1

a group of metabolic disorders characterized by hyperglycemia, resulting from defects in insulin secretion, insulin action or both

Question 2

FPG for diabetic

Answer 2

greater than 125 mg/dL

Question 3

2hr plasma glucose for diabetic

Answer 3

200 mg/dL or greater

Question 4

HbA1C for diabetic

Answer 4

6.5% or greater

Question 5

*** diagnostic criteria DM

Answer 5

FPG greater than 126 after an overnight 8 hr fast OR RPG greater than 200 with classic symptoms of DM

PG greater than 200 2 hrs after a 75g oral glucose load

HbA1C greater than 6.5%

Question 6

insulin increases…

Answer 6

• glucose uptake in m. and adipose tissue
• aa uptake and prtn synthesis
• fa synthesis and esterification
• glycogen synthesis
• glycolysis

Question 7

insulin decreases…

Answer 7

• blood glucose levels
• gluconeogenesis
• lipolysis
• proteolysis

Question 8

stimulators of insulin

Answer 8

increased blood glucose
increased aa
increased fa
incretin hormone
acetylcholine

Question 9

repressors of insulin

Answer 9

leptin

symp nervous system

Question 10

glucagon increases…

Answer 10

• breakdown of glycogen (glycogenolysis)
• lipolysis
• gluconeogenesis
• ketogenesis

Question 11

glucagon decreases …

Answer 11

• synthesis of glyolytic enzymes
• rate of glycolysis
• glycogen synthesis

Question 12

stimulators of glucagon

Answer 12

low blood glucose
increased circulating aa
symp nervous system

Question 13

repressors of glucagon

Answer 13

hypeglycemia
increased fa
somatostatin

Question 14

fed vs. fasting state ***

Answer 14

fed: insulin increases, absorbed nutrients are utilized and stored, breakdown of stored nutrients suppressed
fasting: glucose levels fall, stored energy sources mobilized, insulin secretion falls, glucagon activity rises

Question 15

is metformin or lifestyle modification more effective in those with IGT?

Answer 15

lifestyle modification

Question 16

goals for the diabetic pt

Answer 16

A1c less than 7%
BP less than 140/80
LDL less than 100
Trigly less than 150
HDL greater than 40 men and greater than 50 women
body weight goal

Question 17

a measure of how quickly a food causes our blood sugar levels to rise

Answer 17

GI glycemic index

Question 18

GI times the carbohydrate content in the serving divided by 100

Answer 18

glycemic load GL

Question 19

best way to achieve glycemic control

Answer 19

total carbohydrate intake regulation

Question 20

at risk individuals should be tested every 2-3 yrs. who is at risk?

Answer 20

BMI greater than 25
1st degree  DM
gave birth to baby greater than 9 lbs
gestational DM
physically inactive
HDL less  than 35
Trig greater than 250
IGT
elevated FG
HTN
certain ethnicities

Question 21

why is abdominal fat so bad?

Answer 21

visceral fat releases FFA which promote hepatic gluconeogenesis and interfere with insulin signaling

hyperglycemia and insulin resistance causes increased insulin production

high insulin levels promote further WG, continuing cycyle

Question 22

components of insulin resistance/ metabolic syndrome ***

Answer 22

high trigs
HTN
central obesity
low HDL
hyperglycemia

Question 23

% of total calories that should be carbs

Answer 23

45-65%