Diabetes

Question 1

define diabetes. how many types are there?

Answer 1

Metabolic disease where blood glucose is not effectively controlled due to impaired insulin production or sensitivity 
3 types  
--Type 1
--Type 2 
--Gestational

Question 2

define insulin. what is it produced by? what does it stimulate?

Answer 2

Hormone that controls glucose homeostasis
Produced by pancreas (beta cells)
Stimulates glucose uptake by liver, muscle and fat

Question 3

what is type 1 diabetes? how is insulin delivered? when is onset?

Answer 3

Autoimmune disease that destroys pancreatic beta cells that produce insulin
–Insulin deficiency
Insulin delivered by injection or pump
Onset usually before age 30: Previously referred to as juvenile onset diabetes
5-10% of cases

Question 4

what is type 2 diabetes? what was it previously referred to as?

Answer 4

Body is producing enough insulin, but cells are less sensitive to it
–Insulin resistance
Previously referred to as adult - onset diabetes

Question 5

what are the treatments for type 2 diabetes?

Answer 5

Treatments: lifestyle and pharmacological management

Question 6

how does insulin resistance work in type 2 diabetes

Answer 6

1. IR starts in skeletal and other tissues
2. Glucose uptake is impaired, and
3. “starved “ muscles send message to liver to increase glucose output
4. Liver increases glucose output = excess blood glucose
5. Pancreas increases production/secretion of insulin to reduce blood glucose
6. Eventually, beta cells of pancreas become overworked and dysfunctional
7. Impaired ability to secrete insulin → blood glucose levels remain elevated
8. High blood sugar levels damage healthy tissue

Question 7

what are the signs and symptoms of diabetes?

Answer 7

Frequent urination 
Extreme hunger/thirst 
Weight loss 
weakness/tiredness 
Repeated or hard to heal infections 
Blurred vision
Tingling or loss of feeling in the hands and feet

Question 8

what are the risk factors of type 1 diabetes?

Answer 8

genetics/family history

Viral exposure

Question 9

what are the risk factors of type 2 diabetes?

Answer 9

Obesity 
genetics/family history 
Physical inactivity 
Smoking 
High blood pressure/cholesterol 
race/ethnicity

Question 10

what are the 3 main tests used to diagnose diabetes?

Answer 10

HbA1c (aka A1C or glycated hemoglobin)
Fasting blood glucose test
Oral glucose tolerance test

Question 11

what is the fasting blood glucose test?

Answer 11

Measures blood glucose after fasting for > 8 hours

Convenient and inexpensive to administer

Question 12

what is the oral glucose tolerance test?

Answer 12

Measure blood glucose after ingesting high carbohydrate drink (75g)
Fast for >8 hours, drink glucose-high beverage, blood test 2 hours later
More sensitive than fasted test, but less convenient

Question 13

what does the HbA1c (aka A1C or glycated hemoglobin) monitor? is there fasting involved? what does it show? what does it measure? what does it indicate?

Answer 13

Used to diagnose and monitor type 1 and type 2
Blood draw lab test - no fasting or waiting
Shows your average blood sugar level for the past 2-3 months
Specifically measures what percentage of your hemoglobin is coated with sugar (glycated)
The higher the A1C level, the poorer your long-term blood sugar control
—-An indicator of “long term” control
Indicates increased risk of diabetes complication

Question 14

what are Gestational Diabetes ? when do they usually occur?

Answer 14

Diabetes that develops during pregnancy

Usually occurs later in pregnancy - 3rd trimester

Question 15

what are the risk factors of gestational diabetes?

Answer 15

Risks: obesity and history of diabetes

Question 16

what does Gestational Diabetes do to blood glucose? what does increases the risk of?

Answer 16

Leads to high blood glucose that can affect the health of the baby
—Requires close monitoring and treatment
Usually goes away after pregnancy, but increases risk for type 2 diabetes

Question 17

how does Gestational Diabetes affect the baby?

Answer 17

Mother has elevated blood glucose
Goes to placenta
Baby’s pancreas makes extra insulin to counter
*Baby is getting more energy than it needs and extra energy stored as fat
Increased risk for diabetes/obesity in baby

Question 18

what health complications are elevated blood glucose levels associated with? (5 complications listed)

Answer 18

CVD: heart attack or stroke 
Kidney failure (#1 cause) 
Blindness or retinal damage (#1 cause) 
Circulation problems → lower limb amputations 
Nerve damage

Question 19

how can someone manage type 1 diabetes?

Answer 19

key: keep blood glucose levels under control
Insulin delivered by injection or pump
Lifestyle management

Question 20

how can someone manage type 2 diabetes?

Answer 20

Check blood glucose levels at least once per day 
Lifestyle management 
Medication: 
---Insulin sensitizers 
----Insulin (when pancreas is dead)

Question 21

what is the relationship between exercise and diabetes 2?

Answer 21

Inverse relationship between PA levels and risk of T2 DM

Question 22

how does PA reduce diabetes risk?

Answer 22

• improves body’s response to insulin and glucose

- Helps maintain/reduce weight

Question 23

3 things exercise appears to do in relation to diabetes?

Answer 23

1. Prevents diabetes in those without it
2. Reverses insulin resistance
3. May also reverse full blown diabetes with significant weight loss