Chronic Disease - Diabetes/Obesity

Question 1

how is obesity defined

Answer 1

abnormal or excessive fat accumulation that may impair health
BMI is most common measure - weight /height per metres squared

Question 2

outline the WHO BMI classification of obesity in adults

Answer 2

from 30 to >40kg/ metre squared

Question 3

how is BMI classified in children (5-19 years)

Answer 3

overweight = BMI for age greater than 1 standard deviation above the WHO growth reference median
obesity = greater than 2 standard deviations above WHO growth reference median

Question 4

is BMI a good measure for children?

Answer 4

not good but allows comparison of obesity prevalence in populations
does not account for fact body sizes have gone up in past decades
also children height increases differently

Question 5

what may be a better measure of health risk?

Answer 5

distribution of adipose tissue - upper/abdominal fat, lower body fat
men and women have different adipose phenotype

Question 6

what are other measures of total fat distribution

Answer 6

BIA (bioimpedance analysis)
DXA (dual X ray absorptiometry)

Question 7

what is the global prevalence of excess weight

Answer 7

38% were overweight or obese in 2020 - expected to rise to 51% in 2035

Question 8

what is the global prevalence of obesity

Answer 8

14% obese in 2020, expected to rise to 24% in 2035

Question 9

what is the prevalence of obesity in children

Answer 9

8-10% obese in 2020
expected to rise to 18-20% in 2035

Question 10

outline childhood obesity in under 5s

Answer 10

once considered a high income country problem but now on the rise in low and middle income countries
almost half the children under 5 overweight or obese in 2019 lived in asia

Question 11

how has childhood obesity increased

Answer 11

340 million children overweight or obese in 2016
the rise has occurred similarly in boys and girls

Question 12

what cause obesity / excess body fat

Answer 12

energy imbalance between calories consumed and calories expended - input and output
increased consumption of ‘energy dense’ foods
decrease in physical activity and increase in sedentary behaviour

Question 13

what are health problems associated with obesity

Answer 13

type 2 diabetes
high blood pressure
coronary heart disease
asthma
reduced fertility
osteoarthiritis
sleep apnoea

Question 14

how has cause of death changed from 1900 to now

Answer 14

from infectious disease to chronic disease - heart disease and cancer

Question 15

which country is the most obesogenic

Answer 15

mexico

Question 16

what is diabetes

Answer 16

condition in which the body cannot control blood sugar levels because of problems with insulin
- impaired insulin-mediated glucose uptake by peripheral muscles
- insulin sensitivity -> insulin resistance

Question 17

what is meant by insulin resistance

Answer 17

insulin is not able to become sensitive so muscles cannot take up blood sugar to provide energy to the muscles

Question 18

what are the 3 types of diabetes

Answer 18

gestational - in pregnancy
type I diabetes - autoimmune condition - body thinks pancreas is foreign agent
type II diabetes - lifestyle influenced

Question 19

what are risk factors for gestational diabetes

Answer 19

obesity
gestational diabetes in previous pregnancy
type II diabetes in parent or sibling
ethnicity - highest in south asian and black people

Question 20

what are consequences of gestational diabetes

Answer 20

high birth weight (macrosomia)
premature delivery
pre-eclampsia
jaundice

Question 21

outline type I diabetes

Answer 21

immune system attacks pancreatic beta cells that secrete insulin
tends to affect people before 40
patients require insulin and blood glucose control
10% of people with diabetes have type I in UK

Question 22

is the cause of type I diabetes known

Answer 22

exact cause is unknown

Question 23

what are potential risk factors for type I diabetes

Answer 23

genetics
family history
viruses
other environmental factors

Question 24

what are consequences of type I diabetes

Answer 24

heart disease, nerve damage, kidney damage
SYSTEMIC effect on body
skin and mouth conditions
pregnancy complications

Question 25

outline type II diabetes

Answer 25

chronic condition causing excess glucose in blood
control measures are diet, exercise, medication +insulin
suggested to be reversible via weight loss and drugs

Question 26

has there been an increase in the prevalence of diabetes

Answer 26

huge increase in global prevalence
1980 = 108 million
2014 = 422 million
90% of which is type II

Question 27

outline the time trends of diabetes prevalence

Answer 27

type 1 is static but type II is rising

Question 28

how could we prevent this from happening

Answer 28

prevent those with high blood sugar (hyperglycaemia) reaching threshold for diabetes

Question 29

what are risk factors for type II diabetes

Answer 29

genetic predisposition
ethnicity - higher risk in south asians linked to body fat distribution
increasing age - lifestyle changes, seen in younger people
energy dense diet
low physical activity
abdominal fat
overweight or obese

Question 30

what % of the risk for type II diabetes does central obesity account for

Answer 30

80-85%

Question 31

what is the trend with diabetes and obesity

Answer 31

they mirror eachother
it is a very important risk factor

Question 32

what are consequences of type II diabetes

Answer 32

similar to type 1
heart disease
nerve damage
sleep apnoea
slow healing
skin conditions