Diabetes, Insulin & Metabolic Syndrome

Question 1

What is ‘diabetes mellitus’?

Answer 1

Group of conditions characterised by raised blood glucose levels (hyperglycemia)

Question 2

How does diabetes mellitus occur?

Answer 2

An absolute or relative deficiency of insulin

Question 3

Which form of diabetes requires insulin treatment?

Answer 3

Type 1 diabetes (T1DM)

Question 4

What changes occur within the bloodstream after eating a meal

Answer 4

Blood glucose increases above the normal homeostatic “set” point

Question 5

What hormone does the pancreas release to lower blood glucose levels?

Answer 5

Insulin

Question 6

What organ takes up excess glucose and stores it as glycogen?

Answer 6

The liver

Question 7

What changes occur within the bloodstream when missing a meal?

Answer 7

Blood glucose levels fall below the normal homeostatic “set” point

Question 8

What hormone is secreted to raise blood glucose levels?

Answer 8

Glucagon

Question 9

Which molecule is converted into glucose by the liver when blood levels are lower than normal?

Answer 9

glycogen

Question 10

What is the role of Endocrine pancreas cells?

Answer 10

Islets of Langerhans cells secrete hormones into the blood vessels

Question 11

What is the role of exocrine pancreas cells?

Answer 11

acinar cells secrete digestive enzymes into the pancreatic duct

Question 12

What are the 2 per-diabetic conditions

Answer 12

Impaired glucose tolerance (IGT) - blood glucose levels are higher than normal but not high enough to be classified as diabetes.

Impaired fasting glucose (IFG) - blood glucose levels are escalated in the fasting state but not high enough to be classified as diabetes.

Question 13

What is the name of diabetes formed during pregnancy?

Answer 13

Gestational diabetes

Question 14

What’s the term given to excessive glucose in the blood?

Answer 14

Hyperglycaemia

Question 15

Whats the term used to describe glucose in the urine

Answer 15

Glucosuria

Question 16

What does the term Polyuria mean?

Answer 16

Passing large amounts of urine

remember Uria=urine

Question 17

What does the term polydipsia

Answer 17

Excessive thirst

remember DIPsia > dip in the water

Question 18

What are some main ‘central’ symptoms of diabetes

Answer 18

Polydipsia
Polyphagia
Lethargy
Stupor

Question 19

What are some main ‘respiratory’ symptoms of diabetes?

Answer 19

Kussmaul breathing (hyperventilation)

Question 20

What are some main ‘gastric’ symptoms of diabetes?

Answer 20

Nausea
Vomiting
abdominal pain

Question 21

What are the main ‘urinary’ symptoms of diabetes?

Answer 21

Polyuria

Glycosuria

Question 22

Which tests are used to Dx T2DM?

Answer 22

Fasting blood glucose
HbA1c
OGTT

Question 23

What complications can arise from diabetes?

Answer 23

Several different neurological conditions 
cardiovascular disease 
diabetic retinopathy 
foot ulceration 
diabetic nephropathy

Question 24

What lifestyle factors decrease the risk of developing type 2 diabetes

Answer 24

Voluntary weight loss

physical activity

Question 25

Which lifestyle factors are responsible for increasing the risk of developing type 2 diabetes

Answer 25

Overweight and obesity abdominal obesity physical inactivity maternal diabetes

Question 26

What disease is responsible for the greatest number of deaths and non-fatal illness within people with T2DM

Answer 26

Cardiovascular disease

Question 27

What type of diabetes may require all of food/medication/insulin intervention?

Answer 27

Type 2

Question 28

What can losing less than 10% of body weight do for the body?

Answer 28

``` improve insulin sensitivity glycaemic control body fat blood pressure other cardiovascular risk factors ```

Question 29

What diet is recommended for people with diabetes?

Answer 29

no set diet that will help aid or cure diabetes other than a standard healthy diet rich in all foods Foods naturally occurring and high in fibre are recommended as they improve glycaemic control and lipid profile in patients with T1DM and T2DM

Question 30

Describe the diagnostic criteria for diagnosing metabolic syndrome

Answer 30

3 or more of the following: - Central obesity - Hypertension - High blood triglycerides - Low level of HDL (high-density lipoproteins) *The good cholesterol - Impaired glucose tolerance (IGT) or diabetes

Question 31

Define Glycaemic Index

Answer 31

Ranking of carbohydrate in food on a scale from 1 to 100 according to the extent by which foods raise blood sugar levels after eating in comparison with direct consumption of glucose

Question 32

Define Glycaemic Load

Answer 32

a number that estimates how much the food will raise a person's blood glucose level after eating it. One unit of glycaemic load approximates the effect of eating one gram of glucose Load = (GI x amount available carbohydrate) / 100

Question 33

What is the OGTT and how does it work?

Answer 33

Oral Glucose Tolerance Test Measures plasma glucose before and 2 hrs after 75g glucose taken orally

Question 34

Describe the 2 main risk factors for diabetes

Answer 34

Waist to Hip Ratio = Waist Circumference / Hip Circumference Waist Circumference

Question 35

What are the Waist to Hip ratio cut-offs for men and women?

Answer 35

Abdominal cut-offs are >0.9 for men and >0.85 for women

Question 36

What are the waist circumference measurements for increased and greatly increased risk of diabetes?

Answer 36

Increased risk: males >94cm; women >80cm Greatly increased risk: males >102cm; females >88cm

Question 37

Describe the action of insulin

Answer 37

i) Eating increases blood glucose levels to higher than normal set point ii) Causes the pancreas to release insulin into bloodstream iii) Signals liver to begin excess glucose uptake (stores it as glycogen) iv) Causes blood glucose levels to drop back to normal

Question 38

Describe the action of glucagon

Answer 38

i) Missing a meal brings glucose levels down below normal set point ii) Causes pancreas to secrete glucagon into bloodstream iii) Signals liver to begin converting stored glycogen into glucose iv) Raises blood glucose back to normal