Diabetes Flashcards
What is type 1 diabetes?
An autoimmune condition where the body attacks the cells that make insulin, which means not enough insulin is created
Can type 1 diabetes be prevented?
Cannot be prevented
How can type 1 diabetes be managed?
through a combination of
medication, food choice and physical activity
What percent of diabetes cases are type 1?
approx. 10%
What age is type 1 diabetes mostly diagnosed in?
children (7-9 y) but can occur at any age
What is type 2 diabetes?
Cells either don’t produce enough insulin or don’t recognise that insulin is present
How can type 2 diabetes be managed?
food choice, physical activity and medication
Can type 2 diabetes be prevented?
Can be prevented in most people
What age is type 2 diabetes mostly diagnosed in?
adults (30-40 y) but increasing numbers of children and teenagers are being diagnosed
How many diabetes cases are type 2?
approx. 90%
What happens after we eat glucose in a ‘normal person’?
- Glucose appears in the bloodstream
- Insulin is then released in response
- Insulin causes translocation of glucose transporters to the surface of the cells
- Glucose is taken into cells
- Blood glucose levels decline
What happens after we eat glucose in someone with type 1 diabetes?
- No, or very little insulin is produced
- Glucose stays in the blood stream
- Not enough glucose gets into the cells and organs that need it for energy
What happens after we eat glucose in someone with insulin resistance?
- Insulin receptors stop responding appropriately to insulin
- More insulin is needed to trigger translocation of glucose transporters
- Insulin continues to be produced
- Blood glucose remains high for longer after a meal
What occurs in response to defective insulin response?
Hepatic gluconeogenesis occurs in response to defective insulin response
What happens eventually due to insulin resistance?
- Beta-cells atrophy and insulin production shows
- Fasting glucose levels start to rise
What happens when you have too much glucose in your blood?
Glucose travels to the kidney causing osmotic diuresis and polyuria
What does osmotic diuresis and polyuria cause?
Dehydration
What does osmotic diuresis and polyuria causing dehydration ultimately lead to?
Polydipsia (excessive thirst) and polyphagia (excessive hunger)
Higher concentrations of blood glucose over time results in…
an increase in the glycation of hemoglobin molecules (addition of glucose molecule to amino acid side chain)
How is type 2 diabetes diagnosed?
Glycated Hemoglobin (HbA1c)
- Measure of glycemic (blood sugar) control over previous 2-3 months
In NZ what HbA1c indicates diabetes?
> 50
In NZ what HbA1c indicates pre-diabetes?
41-49
In NZ what HbA1c indicates that diabetes is unlikely?
<40
What are the international HbA1c cut offs?
Diabetes = >48
Pre-diabetes = 42-47
Unlikely = <41
What percent of NZ have T2D?
5-7%
What percent of NZ have pre-diabetes?
20%
What are the long term consequences of diabetes?
- Stroke
- Blindness
- Heart attack
- Kidney failure
- Amputation
What are the risk factors for diabetes?
- High BMI
- Family history
- CVD
- Gestational diabetes
- Long term use of oral corticosteroids
- Severe mental illness
What is the biggest risk factor for diabetes?
High BMI
What lifestyle changes will help reduce the risk of type 2 diabetes? (4)
- Reduce energy intake
- Increase physical activity
- Increase fibre intake
- Reduce total and
saturated fat intake
How does weight gain contribute to diabetes risk?
increased fat
accumulation around muscle and organs, and increased inflammation, both of which are known to decrease peripheral insulin sensitivity
Increased triglyceride storage in the liver (due to prolonged excess energy intake) reduces…
Hepatic insulin sensitivity
Exposure of beta cells to fatty acids increases the rate of cell death and…
Decreases insulin production
How much do lifestyle interventions that incorporate a moderate PA component reduce diabetes incidence?
by 28-63% in participants with impaired glucose tolerance
Greater reductions are seen when PA interventions also induce…
weight loss (but exercise alone is still effective)
How much PA do you need to do for obesity prevention?
150 min a week is
probably NOT ENOUGH
need closer to 60 min per day
How does exercise affect insulin?
- Muscle contraction can
cause translocation of glut 4 without insulin - Exercise increases skeletal muscle insulin sensitivity
How does PA reduce the risk of diabetes?
- Improved endothelial function and capillarization
increased mitochondrial biogenesis and fibre ratios - Improved muscular respiratory capacity and fatty acid oxidation
- Increased expression and activity of glut 4 and glycogen synthase
What is the recommendation for fibres?
In adults, WHO recommends an intake of at least 25 g per day of naturally occurring
dietary fibre as consumed in foods (strong recommendation)
What does fibre improve?
Body weight, Blood pressure and Cholesterol
