C4 Diabetes and Hypoglycemia

Question 1

What are the types of diabetes?

Answer 1

Type 1 Diabetes: Autoimmune condition where immune system attacks pancreatic cells and impairs insulin production. Usually occurs before 30 y/o and are dependent on exogenous insulin.

Type 2 Diabetes: Condition where the body becomes resistant to insulin or doesn’t produce enough insulin to maintain normal blood sugar levels. Not dependent on exogenous insulin, may require it for glycemic control.

Gestational Diabetes Mellitus: A condition of glucose intolerance affecting pregnant women during pregnancy.

Pre-diabetes: A metabolic stage of impaired fasting glucose or impaired glucose tolerance, a precursor to type 2 diabetes.

Question 2

Describe the causes of hyperglycemia in type 2 diabetes.

Answer 2

Intestines: In people with type 2 diabetes, the intestine may absorb too much glucose or absorb it too quickly, leading to high blood sugar levels.

Muscles and adipose tissue: Insulin helps muscle and adipose tissue cells take up glucose from the blood and use it for energy. In type 2 diabetes, these cells may become resistant to insulin and don’t take up as much glucose.

Pancreas: Pancreas increases secretion of insulin due to insulin resistance. Over time, the pancreas may not be able to keep up with the demand for insulin and may produce less and less of the hormone.

Liver: the liver may produce too much glucose and release it into the bloodstream, even when blood sugar levels are already high.

Question 3

A patient is suffering from hyperglycemia, suggest to him about fat and cholesterol intake.

Answer 3

Fat intake should be 25-30% of total energy where:
- SAFA <7%
- PUFA 10%
- MUFA 10-15%
- Minimize the intake of trans-fat
- Lower dietary cholesterol to <200 mg per day.

2 or more servings of fish is encouraged to provide omega-3 PUFA.

Question 4

Is it okay for a diabetic patient to take alcohol?

Answer 4

• It is ok for a diabetic to take alcohol so long as the patient does not suffer from nocturnal hypoglycemia and hypertriglyceridemia.
• The patient should take alcohol in moderate amounts, (i.e., 1 drinks/day and 2 drinks/day for women and men respectively)

Question 5

Provide recommendations for carbohydrate intake for a diabetic patient.

Answer 5

• Carbs should take up 50-55% of total energy
• Diabetic patient should choose low GI carbs (GI < 55)
• Use non-nutritive sweeteners to substitute sucrose

Question 6

What are the lifestyle changes a diabetic can do to improve his situation?

Answer 6

• Eat a healthy diet
• Increase moderate intensity exercises
• Lose weight if overweight or obese
• Avoid smoking