Diabetes Flashcards
What is insulin?
Insulin is produced by the beta cells in the pancreas and is released in response to elevated blood glucose.
What role does insulin play?
- Insulin stimulates liver, muscles and fat cells to remove blood glucose from the blood.
- Stimulates absorption of glucose into muscle and adipose tissue by changing cell permeability.
- Stimulates conversion of glucose into glycogen in liver & muscle.
- Promotes conversion of glucose into fats (lipogenesis).
5 Promotes glycolysis in cells.
What is the four different types of Diabetes?
Type 1 (During this asymptomatic period the insulin-producing beta cells of the pancreas become destroyed in an autoimmune response results in hyposecretion and or hypoactivity). Type 2 (The body is insulin resistance, but the body still produces insulin and as a result the glucose will accumulate in the bloodstream). Gestational Diabetes (Impaired ability to metabolise CHO due to temporary insulin deficiency) Other types of diabetes
What are the risk factors of Diabetes?
Being overweight or obese, having a close family member with Type 2 diabetes, having high blood pressure, having high blood cholesterol, older (>40) and ethnicity (South Asian, Middle East, Afro Caribbean).
What are the signs and symptoms of Diabetes?
Chronic hyperglycaemia (normal BG= 4-6mmol.l), feeling tired and lethargic (fatigue), feeling thirsty (polydipsia), increased urination (polyuria), having an increased hunger (polyphagia), developing patches of darker skin (under arms & around neck), itchy privates, thrush, blurred vision, cuts or sores taking a long time to heal and increased susceptibility to infections.
What are the safe levels of blood glucose prior to the start of activity for a diabetic client?
The safe levels of blood glucose is 5.5mmol/L to 13mmol/L.
What is the normal fasting plasma glucose level?
> 5.5mmol.L-1
What is diagnostic criteria for prediabetes?
IFG = Fasting plasma glucose 5.55 mmol.L-1 – 6.94 mmol.L-1
IGT = 2-h plasma glucose
7.77 mmol.L-1 - 11.04 mmol.L-1 during an OGTT
What is diagnostic criteria Diabetes Mellitus?
Symptomatic with casual glucose > 11.10 mmol.L-1
Fasting plasma glucose > 6.99 mmol.L-1
2-h plasma glucose > 11.10 mmol.L-1 during an OGTT
What is Glycosylated Haemoglobin (HbA1c)?
This is a specific blood test and reflects mean blood glucose control over the past 2 – 3 months (60 – 90 days), with the patient goal being < 6.5% HbA1c (48 mmol.mol-1) .
What are the problems associated with Diabetes?
Macrovascular: Stroke, Heart Disease and Hypertension, Peripheral vascular disease and foot problems.
Microvascular: Diabetic eye disease (retinopathy and cataracts), renal disease, neuropathy and foot .
What is the normal response to insulin and insulin resistance in the liver?
Normal response include: Glucose uptake
Glycogen synthesis
Suppressed glycogenolysis & gluconeogenesis
Insulin Resistance: Glucose release due to lack of suppression of glycogenolysis & gluconeogenesis
What is the normal response to insulin and insulin resistance in the muscle?
Normal response to insulin include: Glucose uptake
Glucose oxidation
Glycogen synthesis
Insulin response include:
Impaired glucose uptake, oxidation & storage
What is the normal response to insulin and insulin resistance in adipocytes?
Normal response to insulin include: Glucose uptake & utilisation
Triglyceride synthesis
Insulin response include: Impaired glucose uptake & utilisation
Inappropriate triglyceride catabolism
What is the normal response to insulin and insulin resistance in the brain?
Normal response to insulin include: Appetite suppression
Possible suppression of hepatic glucose output
Insulin response include: Increased appetite
Possible increase in hepatic glucose output
What are the short and long term risks of Diabetes Mellitus?
Short term: Risk of diabetic coma associated with hypoglycaemia.
Long term: Stroke, kidney disease (nephropathy).
What are the risk factors and implications of Autonomic Neuropathy?
Depresses HRmax
Increases HRrest
Increased risk of exercise-induced hypotension
Abnormal HR & SBP response to exercise
Silent Ischaemia (no angina pain)
Implications include: Low level activity and using RPE to supplement objective exercise intensity response (i.e. HR, BP) and monitor for signs/symptoms of hypoglycaemia.
What are the risk factors and implications of Peripheral Neuropathy?
Affects extremities (esp. lower legs & feet).
Loss of distal sensation & weakness that could lead to musculoskeletal injury or infection.
Balance problems.
Implications: Use non-weight bearing forms of activity; avoid skin irritation/trauma to lower legs and feet; appropriate footwear; regular foot inspections.
What are the risk factors and implications of Nephropathy?
Increase BP is a common precursor for kidney disease.
Implications: Avoid activities that cause SBP rises to 180-200mmHg (e.g. performing Valsalva Manoeuvre, high intensity aerobic/resistance work); stick to low-moderate intensity activities.
What are the implications and what to avoid if suffering from Retinopathy?
Implications: Avoid activities that cause increase in SBP to 180-200 mmHg (performing Valsalva Manoeuvre, high intensity aerobic / resistance work).
Avoid: Dramatic increases in BP, head down or jarring activities with arms overhead. Possible problems associated with vigorous intensity aerobic exercise.
Metformin is a common medication used by diabetics. What effect does it have when taken?
Metformin decrease hepatic glucose production which as a result lowers blood glucose. However the problem that comes with this is that stimulates insulin secretion (short term- palpitations, perspiration, sensation of anxiety and hunger, long term-mental confusion, seizures).
What effect does the ATP-CP system have on blood sugar levels?
Generally does not reduce blood sugar levels as glucose is not involved in energy production but can raise blood sugar levels when accompanied by heightened release of hormones.
What effect does the Lactic Acid System have on blood sugar levels?
An acute response would be an hormonal response of raised blood glucose due to response to the workload but in the long term could lead to hypoglycaemia
What is the training effects on fuel use on blood sugar levels?
Increased capacity to mobilise fat. Reduced use of blood glucose. Reduced need for additional CHO. Less dramatic endocrine response (training effect). More stable blood sugar level.
