Diabetes 4 Flashcards
reduced or obliterated insulin secretion
5-10% of people with diabetes
T1DM
increased insulin resistance and the inability of beta-cell to compensate for this resistance
90-95% of people with diabetes
T2DM
first surfaces during pregnancy
gestational diabetes mellitus (GDM)
blood sugar levels are higher than normal, but not yet diagnosed as type 2 diabetes
96 million adults, more than 1 in 3
pre-diabetes
3 factors that influence diabetes
- obesity
- cholesterol
- cytokines
obesity leads to __ which leads to diabetes
obesity leads to insulin resistance which leads to diabetes
high HDL, low LDL, TG lead to __ which leads to diabetes
high HDL, low LDL, TG lead to dyslipidemia which leads to diabetes
secretion of inflammatory cytokines leads to __ which leads to diabetes
secretion of inflammatory cytokines leads to immune dysfunction which leads to diabetes
2 measures of T2DM
- beta-cell dysfunction
- insulin resistance
__ can inhibit beta-cell secretion
leptin can inhibit beta-cell secretion
what amount of leptin is ideal
mid amount
U-shaped curve (too low or high is bad)
contributors to T2DM
Diabetes genes
Adipokines
Inflammation
Hyperglycemia
Free fatty acids
Other factors
what is insulin resistance?
When cells in muscle, fat, and liver don’t respond well to insulin and can’t easily take up glucose from your blood (NIDDK)
why does insulin resistance occur?
- High amounts of blood glucose cause more insulin to be secreted by the pancreas
- Over time, the organs become less responsive to the insulin, glucose builds up in bloodstream and pancreas cannot keep up with insulin demands
2 steps of insulin resistance
1) tissues unresponsive to insulin
2) impaired insulin secretion
how do tissues become unresponsive to insulin?
- secretion of adipokines
- inflammatory signaling
- abnormal fat distribution
- abnormal lipid profiles
__ and __ together impact T2DM greatly
overnutrition and inactivity together impact T2DM greatly
__causes dyslipidemia
insulin resistance dyslipidemia
3 things causing B-cell failure in T2DM
- metabolic overload in beta-cells
- ER stress
- accumulation of amyloid fibrils
ER stress is caused by
overload of protein folding capacity due to high insulin demand
major risk factors for developing T2DM
family history
obesity
poor diet
gestational diabetes
physical inactivity
2 lifestyle changes for diabetes
diet: MNT
physical activity
goal of pharmacotherapy
glucose/insulin homeostasis
4 treatments for diabetes
- lifestyle changes (diet and PA)
- pharmacotherapy
- weight loss surgery
- support
goals for MNT: specific goals for
blood glucose
blood pressure
lipids
A1c goal
< 7%
blood pressure goal
< 140/80 mmHg
LDL cholesterol goal
TG
HDL women
HDL men
LDL cholesterol goal: < 100 mg/dL
TG: < 150 mg/dL
HDL women: < 40 mg/dL
HDL men < 50 mg/dL
diabetes prevention
Optimal nutrition for maintaining a healthy body weight and preventing insulin resistance
diabetes pathogenesis
Beta-cell dysfunction
Insulin resistance
diabetes prognosis
Dietary/lifestyle changes can help in the management of disease
T2DM prevention and prognosis steps
- Identify Individuals at Risk
- Obesity Management (5-10% weight loss has large effect on diabetes risk)
- Healthy Eating (Less: refined grains, alcohol, red/processed meats, SSBs, More: fiber, whole grains, plants)
- Increase Physical Activity (30min MVPA, 5 days/week)
- Support Behavior Change
