Diabetes Flashcards
Definition of diabetes
WHO expert commitee on DM 1980
Diabetes is a state of chronic hyperglycemia that may result from many environmental and genetic factors often acting jointly
What is type 1 diabetes
diabetes.co.uk 2018
-auto immune disease directed at the pancreas which affects the beta cells of the pancreas resulting in an absolute deficiency of insulin
-trigger of auto immune response not specifically identified may be a toxin or virus
-genes play a role
-present underweight at diagnosis
4t’s symptoms
thirst, thinner, toilet, tired
what is type 2 dm
-average onset 60
-involves variable degrees of insulin secretion due to beta cell dysfunction and impaired insulin action ie secretion and uptake of insulin is impaired
-slower onset than 1 dm
sympoms often mild or absent initially so can go undiagnosed for many years
% of people with dm2 overweight
80% diabetes uk 2009
how does obesity cause 2dm
adipose tissue releases inflammatory chemical make body resistance
obesity triggers changes in body’s metabolism causes release of fat molecules into blood stream affect insulin sensitivity
prevalence of diabetes
diabetes.co.uk 2018 10% dm1 90% dm 2 -850,000 with 2 dm could be unaware diabetes uk 2017 3.7 million diagnosed with dm, 4.6 million including those undiagnosed nhs dpp, 22,000 die early in uk from dm IDF 2017 425 million worldwide, most 2dm due to ageing pop and obesity
treatment diabetes
diabetes.co.uk
diagnosis of diabetes
who criteria 2000
-random venous >11.1
-fasting plasma >7
ogtt >11.1
hba1c >6.5%
diagnosis of pre diabetes
hbaqc= 6-6.4
ogtt 7.8-11.1
fasting glucose 5.5 to 7
complications of diabetes
diabetes.co.uk
macra= cvd
mico= neph, neuro, reti,
complications of diabetes and glucose control
Diabetes control and complications trial 1993
-found that improving blood glucose control to a median HBA1C of 7% can reduce development and progression of mico comp by 35-76%
but improving blood glucose had no sig effect on cvd macro suggest important to control other risk factors
complications of diabetes and blood pressure control
UKPDS 1998 controlling BP has favourable effects on both macro and micro,
lowering bp to 144/82 sig reduced stroke 44%, heart failure and 37% micro complications
normal response and diabetes response to exercise reference
Robertson et al 2014
normal= decrease insulin, increase counterreg hormones, little blood glucose change as balance
dm 1 too much insulin= hypo versus too little insulin= ketosis
dm2 can get hypo if on meds such as insulin or su as otherwise respond normally as reduced hepatic glucose production if on su or insulin
reference pa enhances muscle insulin sensitivity
thorell et al 1995
what are the main complications for people exercising with dm
- fear of hypo
- hypo
- hyper
- mico and macra complication
reference for fear of hypo
younk, tate and davis 2009 fear of hypo causes overaeating to deliberately run a high BG before/during and after exercise thus the resulting hyper can increase HBA1C
what is a hypo
robertson et al 2014
-levels <4mmol/l shake,sweat,lip tingle,pale confused
-confuse with normal exercise response
-1dm or 2dm on meds
harder and longer activities and unfamiliar
hypo and youth reference
kelly hamilton and ridell 2010 hypo compromises sport performance by 20% and cognitive function and
spontaneous nature of pa in children ref
rowland 1998
hyperglycemia causes
type one only
2 situations not enough insulin or short term intensive activity so may need to let bg return to normal and inject insulin fast acting