Diabetes Guest Lecture Flashcards
what is the typical age for someone with T2D?
over 40 years of age
is the onset of T2D gradual or quick?
gradual
are there symptoms with T2D?
may or may not have symptoms, related to complications
is insulin required for T2D?
required for some (have endogenous insulin)
what is gestational diabetes?
glucose intolerance with onset or first recognition during pregnancy.
what is prediabetes?
term for impaired fasting glucose (IFG) & impaired glucose tolerance (IGT) place individuals at risk of developing diabetes and its complications.
- impaired fasting glucose (6.1-6.9 mmol/L) or impaired glucose tolerance (7.8-11 mmol/L).
what factors are included with metabolic syndrome?
–Prediabetes/diabetes
–BP > 130/85 mm/Hg
–TG > 1.7 mmol/L
–HDL < 1.0 mmol/L (men); 1.3 (women)
–Abdominal obesity > 102 cm (men); 88 (women)
what are the three factors of T2D?
obesity, sedentary lifestyles, aging population
- Is a heterogeneous disorder
what metabolic defects characterize T2D?
- insulin resistance;
- an insulin secretory defect that is not autoimmune-mediated; and
- an increase in glucose production by the liver.
- Incretin hormones and the gut
what nutrition advice is given to people with T2D?
- Nutrition counselling by a Registered Dietitian.
- Follow Canada’s Food Guide
- Choose low glycemic index carbohydrates.
- Minimizing sucrose and sucrose-containing foods
- Consume < 7% of total daily energy from saturated fats and should limit intake of trans fatty acids to a minimum.
- Other dietary patterns –Mediterranean & Vegan!
what are protective factors associated with Mediterranean diet:
higher intake of vegetables, legumes, fruits, nuts, whole grains, cheese/yogurt, fish and monounsaturated fats
intermittent fasting is a good treatment for obesity. t or f
t
do LCD or VLCD improve weight loss?
improvements in weight loss, diabetes remission and lipid profiles
what physical activity advice should be given to people with T2D?
- Accumulate 150 minutes of aerobic exercise/week (spread over at least 3 days of the week).
- Resistance exercise at least 2 times per week
- People with possible CVD or microvascular complications should be assessed
- Prolonged sitting is the new smoking – covid-19
- Think HIIT or fitness snacks
How does smoking affect diabetes and chronic conditions?
- Smoking in people with diabetes is an independent risk factor for all cause mortality.
- Increases risk of MI, stroke and progression to end stage renal disease (chronic kidney disease).
what stress management advice should be given to people with T2D?
- should be screened routinely for psychological distress and psychiatric disorders.
- Interview or by standardized questionnaires.
- Should offer stress management strategies (coping skills training, behavioural therapy, family therapy, case management and/or pharmacotherapy if required)
what does structured lifestyle modification include for T2D?
moderate weight loss and regular physical activity
CPG’s address lifestyle modification to prevent/delay T2DM in some with:
a) healthy eating; & b) increasing physical activity.
what medications can help regulate metabolic hormones, help with weight loss?
incretins
what is involved in T2D remission?
- Achieving glycated hemoglobin (A1C between 6.0% and 6.4%)
- no medications for 3 months
- Low-calorie (~800 to 850 kcal/day) diets with meal replacement products (3 to 5 months) aimed at achieving >15 kg body weight loss.
- Exercise training (aiming for 240 to 420 min/week of structured physical activity spread over 5 days per week) to promote modest weight loss (~5% to 7% of initial body weight)
what 3 factors are involved in NCD prevention?
- healthy eating (sodium restriction, high fibre)
- physical activity (wt loss, cardio/wt training)
- healthy lifestyle (smoking cessation, stress management an alcohol intake)
studying what can help provide organisms hereditary info?
studying the genome
Genome wide association studies (GWAS) are being led to determine what?
cardiovascular and metabolic phenotypes in humans
what does studying our environment geographically involve?
urbanization, pollution, walkability, bike friendly cites
what does studying the chemical environment involve?
studying the chemicals that are disrupting our endocrine system (mimic estrogens)…known as obesogens.
is DNA mutated?
no, but expressed differently
- Occurs as early as in utero.
- Ex. Tributyltin, bisphenol A, DEHP, nicotine.
what are the biggest risk factors for NCD?
- tobacco use
- unhealthy diet
- physical activity
- harmful use of alcohol (stress)
