Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Exercise Physiology > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is Diabetes Mellitus

A

a group of metabolic diseases - inability to produce sufficient amounts of insulin or to use it properly, or both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the result of diabetes mellitus

A

hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is hyperglycemia

A

high blood glucose - BG levels poorly managed, diabetic ketoacidosis, hyperosmolar nonketotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is hypoglycemia?

A

low blood glucose - too much insulin, too little carb, missed meals, excessive or poorly planned exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is hypersmmolar syndrome

A

your body tries to rid itself of of the excess blood sugar by passing it into your urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the key factors in the development of the complication

A

impaired glucose clearance from the circulation and an increase in the production of glucose by hepatocytes and portal adipocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are microvascular diseases

A

retinopathy, nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are macrovascular diseases?

A

cardiovascular, cerebrovascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are neuropathies

A

Autonomic and peripheral - when nerve endings are exposed to high blood glucose over time, those nerve endings lose function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is ketoacidosis

A

muscle cells are not able to get enough glucose in because of insulin resistance, switch to fatty acid metabolism which produces ketone bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diabetes afflicts ______ people in the US. Approximately ______ are undiagnosed and ____ with pre diabetes.

A

~34 million; 25%; ~88 million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some reasons for the epidemic?

A

increasing overweight and obesity, increasing sedentary lifestyle, aging of population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some risk factors for diabetes

A

age >/= 45 years, BMI >/= 25 kg/m^2 or central adiposity (defined by waist circumference), habitual physical inactivity, having a first degree relative with DM, african american latino native american asian american or pacific islander race/ethnicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the categories of diabetes

A

Type 1: beta cell destruction leading to insulin deficiency
Type 2: ranges from insulin resistance to insulin deficiency
Gestational

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is type 1 diabetes

A

A. immune mediate (autoimmune disease) - T lymphocytes attack beta-cells labeled with antigens
B. Idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is type 2 diabetes

A

could include insulin secretion defect, insulin resistance, or both; strong genetic influence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is gestational diabetes

A

glucose intolerance on with pregnancy; fetal hormonal secretions may impact insulin-receptor binding in the mother; increase mother BG -> increase Fetal BG -> increase fetal fat deposits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is glucose tolerance

A

assessment of physiological response to a normal glucose load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what does glucose tolerance consist of

A

Normal response by the pancreas
- secretion of insulin
- stop secreting glucagon
Normal response of muscle and adipose tissue to insulin
- insulin stimulated glucose uptake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

describe the molecular pathway responsible for insulin function

A

Insulin activates insulin receptor (IR)
IR associates with IRS proteins
IRS proteins activate PI3 kinase
PI3 kinase activates AKT
AKT facilitates:
- glycogen synthesis
- glucose intake
- protein synthesis
- cell growth, proliferation
AKT prevents:
- gluconeogenesis

21
Q

What is fasting plasma glucose

A

measures glucose levels in a person who has been fasting for at least 8 hours

22
Q

What is fasting plasma glucose

A

measures glucose levels in a person who has been fasting for at least 8 hours

23
Q

What is the 75 g oral glucose tolerance test

A

requires fasting before drinking a glucose solution. Following a 2 hour waiting period, blood is drawn

24
Q

What is the hemoglobin A1C test

A

does not require fasting, and measures the blood level of glycosylated hemoglobin over the past 2 to 3 months

25
Q

What is insulin resistance

A

normal amounts of insulin are inadequate to produce normal insulin response in adipose, muscle, and liver tissue; contributes to elevated BG levels

26
Q

Results of lack of insulin response in muscle and liver

A

reduced glucose uptake in skeletal muscle
inability to inhibit glycogenolysis and GNG in liver

27
Q

What is the primary cause of Type 2 Diabetes?

  1. inactivity
  2. hypercaloric diet
  3. genetic predisposition
  4. inflammation
  5. smoking
  6. air pollution
A
  1. inflammation
28
Q

What are adipocytes

A

major cells in fat tissues:
- storage of lipids, carbohydrates
- secretion of inflammatory mediators

29
Q

What are hepatocytes

A

(70-80% of the liver mass):
- protein synthesis and storage
- carbohydrate metabolism
- synthesis of cholesterol, bile salts, and phospholipids
- detoxification, modification and excretion of exogenous and endogenous substances
- secretion of inflammatory mediators

30
Q

What is another reason for insulin resistance other than inflammation?

A

hyperglycemia and hyperlipidemia - causes stress to ER and mitochondria, induces Reactive Oxygen Species (ROS) –> ER stress and ROS further activates MAP kinases such as JNK (inhibits insulin signaling

31
Q

What can cause endothelial dysfunction?

A

high serum glucose levels induce reactive oxygen species

32
Q

Inflammatory complications of diabetes: Kidney Failure

A

caused by excessive expression of inflammatory mediators and exposure to ROS. Will damage the endothelium

33
Q

Inflammatory complications of diabetes: eye complications

A

retinopathy (loss of blood supply)

34
Q

Inflammatory complications of diabetes: diabetic wound

A

reduced ability in wound repair because reduced levels and activities of progenitor cells and blood supply

35
Q

What are signs and symptom’s of diabetes

A

polydipsia (excessive thirst)
polyuria (frequent urination)
polyphagia (increase appetite)
infections and cuts that are slow to heal
blurry vision
fatigue

36
Q

_____% of those with T2DM do not know it

A

25%

37
Q

What does a physical exam focus on?

A

potential diabetes complications:
- elevated resting HR
- loss of sensation
- loss of reflexes (esp. lower extremities)
- foot sores or ulcers with poor healing
- excessive bruising
- retinal vascular abnormalities

38
Q

Cardiovascular exercise testing is indicated for those with one or more of _______

A
  • age > 40 yr diabetics with or without CVD risk factors
  • age >30 yr diabetics and
    type 1 or type 2 diabetes for >10 yr, hypertension, dyslipidemia, retinopathy, nephropathy
39
Q

What should be tested 1-2 times a year in diabetic adults >45 yrs?

A

HbA1C testing, dilated eye exam, foot exam, blood pressure, blood lipid assessment, renal functioning testing

40
Q

What is medical nutrition therapy

A

may ultimately focus on large weight loss from a complete meal replacement diet or bariatric surgery

41
Q

Oral glucose lowering medication types

A

sulfonylureas (first and second gen)
Biguanides (metformin)
Dipeptidylpeptidase-4 inhibitors
Alpha-glucosidase inhibitors
Insulin

42
Q

What is sulfonylureas (first and second gen)

A

increases insulin production by the beta cells in the pancreas

43
Q

What is Biguanides (metformin)

A

decreases hepatic production of glucose

44
Q

What is Dipeptidylpeptidase-4 inhibitors

A

prolong and enhance the activity of the insulin by limiting its breakdown

45
Q

What is Alpha-glucosidase inhibitors

A

reduce the rate of digestion of carbs in the proximal small intestine, primarily lowering postprandial glucose concentrations as they inhibit intestinal alpha-glucosidase enzymes

46
Q

What is insulin

A

the last line of treatment and is reserved for those patients who fail to respond adequately to a combo of orals and injectable antidiabetic agents

47
Q

Why do we give T2DM patients insulin if they still produce it?

A

insulin has many pathways of action to cause glucose uptake into cell

48
Q

Which diabetic medication could be contraindicated for exercise?

  1. insulin
  2. sulfonylurea
  3. biguanides
  4. glucosidase inhibitors
A
  1. insulin
    exercise and insulin together can significantly decrease blood glucose causing diabetic coma. Have to wait 1 hour after insulin injection before exercise
49
Q

How does exercise increase glucose uptake for diabetics?

A

exercise induces an increase in glut4 transporter translocation from separate storage sites
glucose uptake is increased in active muscle fibers, but not in inactive muscle

Clinical Exercise Physiology (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions