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HUNT243 Exam > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is type 1 diabetes?

A

An autoimmune condition where the body attacks the cells that make insulin, which means not enough insulin is created

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2
Q

Can type 1 diabetes be prevented?

A

Cannot be prevented

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3
Q

How can type 1 diabetes be managed?

A

through a combination of
medication, food choice and physical activity

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4
Q

What percent of diabetes cases are type 1?

A

approx. 10%

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5
Q

What age is type 1 diabetes mostly diagnosed in?

A

children (7-9 y) but can occur at any age

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6
Q

What is type 2 diabetes?

A

Cells either don’t produce enough insulin or don’t recognise that insulin is present

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7
Q

How can type 2 diabetes be managed?

A

food choice, physical activity and medication

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8
Q

Can type 2 diabetes be prevented?

A

Can be prevented in most people

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9
Q

What age is type 2 diabetes mostly diagnosed in?

A

adults (30-40 y) but increasing numbers of children and teenagers are being diagnosed

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10
Q

How many diabetes cases are type 2?

A

approx. 90%

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11
Q

What happens after we eat glucose in a ‘normal person’?

A
  • 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
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12
Q

What happens after we eat glucose in someone with type 1 diabetes?

A
  • 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
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13
Q

What happens after we eat glucose in someone with insulin resistance?

A
  • 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
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14
Q

What occurs in response to defective insulin response?

A

Hepatic gluconeogenesis occurs in response to defective insulin response

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15
Q

What happens eventually due to insulin resistance?

A
  • Beta-cells atrophy and insulin production shows
  • Fasting glucose levels start to rise
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16
Q

What happens when you have too much glucose in your blood?

A

Glucose travels to the kidney causing osmotic diuresis and polyuria

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17
Q

What does osmotic diuresis and polyuria cause?

A

Dehydration

18
Q

What does osmotic diuresis and polyuria causing dehydration ultimately lead to?

A

Polydipsia (excessive thirst) and polyphagia (excessive hunger)

19
Q

Higher concentrations of blood glucose over time results in…

A

an increase in the glycation of hemoglobin molecules (addition of glucose molecule to amino acid side chain)

20
Q

How is type 2 diabetes diagnosed?

A

Glycated Hemoglobin (HbA1c)
- Measure of glycemic (blood sugar) control over previous 2-3 months

21
Q

In NZ what HbA1c indicates diabetes?

A

> 50

22
Q

In NZ what HbA1c indicates pre-diabetes?

A

41-49

23
Q

In NZ what HbA1c indicates that diabetes is unlikely?

A

<40

24
Q

What are the international HbA1c cut offs?

A

Diabetes = >48
Pre-diabetes = 42-47
Unlikely = <41

25
Q

What percent of NZ have T2D?

A

5-7%

26
Q

What percent of NZ have pre-diabetes?

A

20%

27
Q

What are the long term consequences of diabetes?

A
  • Stroke
  • Blindness
  • Heart attack
  • Kidney failure
  • Amputation
28
Q

What are the risk factors for diabetes?

A
  • High BMI
  • Family history
  • CVD
  • Gestational diabetes
  • Long term use of oral corticosteroids
  • Severe mental illness
29
Q

What is the biggest risk factor for diabetes?

A

High BMI

30
Q

What lifestyle changes will help reduce the risk of type 2 diabetes? (4)

A
  • Reduce energy intake
  • Increase physical activity
  • Increase fibre intake
  • Reduce total and
    saturated fat intake
31
Q

How does weight gain contribute to diabetes risk?

A

increased fat
accumulation around muscle and organs, and increased inflammation, both of which are known to decrease peripheral insulin sensitivity

32
Q

Increased triglyceride storage in the liver (due to prolonged excess energy intake) reduces…

A

Hepatic insulin sensitivity

33
Q

Exposure of beta cells to fatty acids increases the rate of cell death and…

A

Decreases insulin production

34
Q

How much do lifestyle interventions that incorporate a moderate PA component reduce diabetes incidence?

A

by 28-63% in participants with impaired glucose tolerance

35
Q

Greater reductions are seen when PA interventions also induce…

A

weight loss (but exercise alone is still effective)

36
Q

How much PA do you need to do for obesity prevention?

A

150 min a week is
probably NOT ENOUGH
need closer to 60 min per day

37
Q

How does exercise affect insulin?

A
  • Muscle contraction can
    cause translocation of glut 4 without insulin
  • Exercise increases skeletal muscle insulin sensitivity
38
Q

How does PA reduce the risk of diabetes?

A
  • 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
39
Q

What is the recommendation for fibres?

A

In adults, WHO recommends an intake of at least 25 g per day of naturally occurring
dietary fibre as consumed in foods (strong recommendation)

40
Q

What does fibre improve?

A

Body weight, Blood pressure and Cholesterol

HUNT243 Exam (19 decks)

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