Chapter 13

Question 1

The Diabetes Epidemic

Answer 1

Diabetes is the latest worldwide disease epidemic
Rising rates are directly related to the global increase in obesity
Diabetes affects 8.3 percent of adults worldwide
9.4 percent of the U.S. population has been diagnosed with diabetes

Question 2

Three Types of Diabetes

Answer 2

Type 1 diabetes: High blood glucose levels resulting from destruction of the insulin-producing cells of the pancreas
Type 2 diabetes: High blood glucose levels due to the body’s inability to use insulin normally or inability to produce enough insulin
Most common form of diabetes

Question 3

Effects of Insulin

Answer 3

Insulin, a hormone produced by the pancreas, facilitates the passage of glucose into cells
Glucose is a source of energy for cells

Cells become starved for glucose
Cell and tissue functions decline, resulting in:
Elevated triglycerides and blood pressure
Hardening of arteries
Chronic inflammatio

Question 4

Symptoms of Elevated Glucose Levels

Answer 4

Increased thirst
Headaches
Difficulty concentrating
Blurred vision
Frequent urination
Fatigue
Feeling weak or tired
Weight loss

Question 5

Health Consequences of Diabetes

Answer 5

Short-term consequences
Blurred vision, frequent urination, weight loss, infection, increased susceptibility to infection, delayed wound healing, and extreme hunger and thirst
Long-term consequences
Heart disease, hypertension, nerve damage, blindness, kidney failure, stroke, and amputation of limbs

Question 6

Type 2 Diabetes

Answer 6

Most likely to occur in overweight, obese, or inactive people
Diabesity: Describes the close relationship between obesity and diabetes
Usually develops in people over the age of 40, but it is becoming more common in children and adolescents

Question 7

Prediabetes

Answer 7

Characterized by impaired glucose tolerance, or fasting blood glucose levels of 100 to 125 milligrams per deciliter (m g/d L)
Risk factors include abdominal obesity, inactivity, and genetic predisposition
Medical nutrition therapy is associated with reduced progression to type 2 diabetes
Reduce body weight, increase physical activity, and switch to healthy eating practices

Question 8

Insulin Resistance

Answer 8

A condition in which cell membranes have reduced sensitivity to insulin
More insulin than normal is required to transport a given amount of glucose into cells
Characterized by elevated levels of serum insulin, glucose, triglycerides, and increased blood pressure

Question 9

Insulin Resistance

Answer 9

With insulin resistance, cell membranes “resist” the effects of insulin
Pancreas overworks to makes more insulin
Eventually insulin production slows and blood glucose rises
Reduced glucose supplies to cells forces the body to mobilize triglycerides from liver, muscle, and fat stores to meet the body’s need for energy
Increased blood levels of triglycerides promote the development of fatty liver disease

Question 10

Fatty Liver Disease

Answer 10

Officially called nonalcoholic fatty liver disease (N A F L D)
A reversible condition characterized by fat infiltration of the liver
Fat infiltration: 10 percent or more by weight
Advanced forms of fatty liver disease can produce liver damage and other disorders

Question 11

Metabolic Syndrome

Answer 11

Involves a spectrum of metabolic abnormalities that increase the risk of heart disease and type 2 diabetes
Waist ≥40 inches or more in males and ≥35 inches in females
Blood pressure ≥130/85 millimeters of mercury (m m/H g)
Triglycerides ≥150 m g/d L
H D L <40 m g/d L in males, <50 m g/d L in women
Elevated fasting blood glucose ≥100 m g/d L

Question 12

Managing Type 2 Diabetes

Answer 12

Weight loss (if overweight)
Lose 5 to 10 percent of body weight
Weight loss surgery (if medically necessary)
Regular physical activity
150 minutes or more per week

Question 13

Managing Type 2 Diabetes

Answer 13

Dietary management recommendations
Vegetables and fruits
Whole grains and whole-grain products
Legumes
Fish and shellfish
Vegetables and fruits
Whole grains and whole-grain products
Legumes
Fish and shellfish

Question 14

Glycemic Index (G I)

Answer 14

Resistant starch: Starches that do not release glucose within the small intestine but are consumed or fermented by bacteria in the colon released as fatty acids

A measure of the extent to which blood glucose levels are raised by consumption of an amount of food that contains 50 grams of carbohydrate compared to 50 grams of glucose

Question 15

Carbohydrate Food Lists

Answer 15

Carbohydrate content, in grams, of common foods
One teaspoon of honey: 5 grams
One teaspoon of sugar: 4 grams
Fruit
One medium apple: 19 grams
Half a cup of cantaloupe: 15 grams
One medium orange: 14 grams

Question 16

Glycemic Load (G L)

Answer 16

A measure of the extent to which blood glucose level is raised by a given amount of a carbohydrate-containing food
Calculated by multiplying a food’s G I by its carbohydrate content

Question 17

Carbohydrate Counting

Answer 17

Carbohydrate counting basically involves the following three steps:
Keeping a food log that includes amounts of food and beverages consumed
Identifying the significant sources of carbohydrate in the food log
Quantifying the carbohydrate content of the foods consumed

Question 18

Prevention of Type 2 Diabetes

Answer 18

In one study, people with prediabetes reduced their risk of developing type 2 diabetes by:

Other protective measures include:
Diet rich in whole grains and fiber
Consumption of coffee 1 to 4 cups per day of coffee 
Moderate consumption of alcohol
One to two drinks per day

Losing weight (approximately 7 percent of body weight)
Exercising 150 minutes per week

Question 19

Type 1 Diabetes

Answer 19

An autoimmune disease that produces an insulin deficiency
Accounts for 5 to 10 percent cases of diabetes
Develops when the immune system destroys insulin-producing beta cells in the pancreas
An autoimmune disease is initiated by the destruction of the body’s own cells
Components of the immune system mistakenly recognize the cells as harmful

Question 20

Managing Type 1 Diabetes

Answer 20

Diets are designed to match insulin doses to keep blood glucose levels within normal ranges
Carefully planned meals are consumed in specific amounts at specific times

Question 21

Gestational Diabetes

Answer 21

In the United States, 9.2 percent of women develop gestational diabetes during pregnancy
Risk depends on age, body weight, and ethnicity
Infants born to women with poorly controlled diabetes are at greater risk for developing diabetes later in life
Gestational diabetes often disappears after delivery
Increased risk of type 2 diabetes after delivery or later in life

Question 22

Hypoglycemia

Answer 22

Hypoglycemia is a disorder resulting from abnormally low blood glucose levels (<70 m g/d L)
Symptoms of hypoglycemia include irritability, nervousness, weakness, sweating, and hunger