diabetes and obesity (W2)

Question 1

pancreas cell types

Answer 1

beta cells and alpha cells

Question 2

what switches acetyl CoA carboxylase off and on

Answer 2

on - phosphatase, insulin
off - kinase

Question 3

why does excess glucose convert to fat

Answer 3

excess insulin activates acetyl CoA carboxylase, which helps produce fat

Question 4

changes to reverse obesity trends - societal change?

Answer 4

content of processed foods (reduce sugar, salt, fat)
healthy & nutritious options available
restrict certain food marketing
support and encourage regular physical activity
taxation policy
social policy

Question 5

individual change to reduce obesity?

Answer 5

reduce energy intake from sugar and possibly fats (reduce processed food)
increase consumption of fruit, veg, whole grains, nuts
regular physical activity

Question 6

type 2 diabetes risk factors (10)

Answer 6

overweight/obesity
abdominal or central obesity
age
low socio-economic status
sedentary lifestyle
unhealthy diet choices
smoking
genetic ancestry
family history
psychosocial stress and depression

Question 7

diabetes mellitus presentation

Answer 7

asymptomatic hyperglycaemia (majority) or symptoms of hyperglycaemia

Question 8

hyperglycaemia meaning

Answer 8

elevated blood glucose

Question 9

hyperglycaemia symptoms

Answer 9

polyuria
polydipsia
fatigue
recurrent infections
weight loss (type 1)

Question 10

polyuria?

Answer 10

passage of large volumes of urine with an increase in urinary frequency

Question 11

polydipsia?

Answer 11

excessive thirst

Question 12

diabetes diagnosis - different tests?

Answer 12

random plasma glucose
fasting plasma glucose
haemoglobin A1c

Question 13

random plasma glucose level in diabetes

Answer 13

greater or equal to 11.1mmol/L

Question 14

fasting plasma glucose level in diabetes

Answer 14

greater or equal to 7.0mmol/L

Question 15

haemoglobin A1c level in diabetes

Answer 15

greater or equal to 48mmol/mol

Question 16

pre-diabetes features

Answer 16

impaired glucose tolerance
impaired fasting glucose

Question 17

name for glycated haemoglobin that is tested for in diabetes?

Answer 17

haemoglobin A1c

Question 18

why are haemoglobin A1c tests effective for diabetes

Answer 18

higher glucose is in the blood, the more glucose will bind to haemoglobin therefore the higher your haemoglobin A1c is.

Question 19

how long will a patient have to have diabetes symptoms for to have an increase in haemoglobin A1c levels

Answer 19

at least 4-6 weeks

Question 20

type 1 diabetes presentation

Answer 20

typically young
weight loss
ketones in blood
fast onset of symptoms
often has family history

Question 21

type 2 diabetes presentation

Answer 21

slow onset
variable symptoms
family history (but not to same extent as type 1)
normally after age 40

Question 22

type 1 diabetes treatment

Answer 22

insulin therapy

Question 23

type 2 diabetes pathogenesis

Answer 23

decreased incretin effect
increased lipolysis
increased glucose reabsorption
decreased glucose uptake
inflammation
neurotransmitter dysfunction
vascular insulin resistance
increased hepatic glucose production
decreased insulin secretion
increased glucagon secretion

Question 24

what component produced by the intestine stimulates insulin production

Answer 24

incretin

Question 25

most important treatment for type 2 diabetes

Answer 25

lifestyle advice!
-nutritional advice
-weight loss advice
-exercise
-stop smoking
-reduce alcohol

Question 26

weight loss advice specifics for type 2 diabetes

Answer 26

aim to lose 5-10% of original weight over 6-12 months

Question 27

drug treatment for type 2 diabetes

Answer 27

metformin

Question 28

metformin effects?

Answer 28

sensitizes insulin action
opposes action of glucagon
reduced hepatic gluconeogenesis
increase glucose uptake by muscle
causes weight loss

Question 29

metformin side effects?

Answer 29

GI upset

Question 30

target for Haemoglobin A1c for metformin treatment in type 2 diabetes?

Answer 30

48-53 mmol/mol

Question 31

most likely second line drug for type 2 diabetes treatment

Answer 31

SGLT2 inhibitor (flozins)

Question 32

flozins example?

Answer 32

canagliflozin

Question 33

complications of diabetes mellitus

Answer 33

hypertension
kidney disease
retinopathy
cardiovascular disease
neuropathy (peripheral or autonomic)
infections