Diabetes practical Flashcards
type 1 diabetes is managed through
medication mostly, but also food choice and physical activity
type 1 diabetes makes up what % of diabetes cases
10%
type 1 diabetes is an
autoimmune condition where the body attacks the cells that make insulin, which means not enough is created
type 1 diabetes is mostly diagnosed when
in children
type 2 diabetes makes up what proportion of diabetes cases
90%
what happens in type 2 diabetes
cells either don’t produce enough insulin or dont recognise that insulin is present
when is type 2 diabetes usually diagnosed
mostly diagnosed in adults, but increasing numbers of children and teenagers are being diagnosed
after we eat glucose appears in
the bloodstream
when glucose appears in the bloodstream what is released in response
insulin
when insulin receptors detect insulin what happens
insulin causes translocation of glucose transporters to the surface of the cells
what happens when glucose transporters are translocated to the surface of cells
glucose is taken into cells and blood glucose declines
what are the issues that occur in the glucose / insulin relationship in type 1 diabetes
no, or very little insulin is produced
glucose stays in the blood stream
not enough glucose gets into the cells and organs that need it for energy
what happens in a state of insulin resistance
insulin receptors stop responding appropriately to insulin
more insulin is needed to trigger translocation of glucose transporters
insulin is continued to be produced in insulin resistance because why
blood glucose remains high after a meal because glucose transporters are unable to transport it into the cells so the body continues to produce insulin to try and help
what occurs in response to defective insulin response, and after a while what starts to rise (also eventually or simultaneously what occurs)
hepatic gluconeogenesis
fasting glucose levels begin to rise
beta cells atrophy and insulin production slows
what happens when you have too much glucose in your blood
glucose travels to the kidney
causing osmotic diuresis and polyuria
polyuria leads to
what is HbA1c
Higher concentrations of blood glucose over time
higher concentrations of blood glucose overtime results in an
Higher concentrations of blood glucose over time results in an
increase in the glycation of hemoglobin molecules (addition of
glucose molecule to amino acid side chain)
HbA1c is a measure of
Measure of glycemic (blood sugar) control over previous 2-3
months
what are the HbA1c cut offs for diagnosing type 2 diabetes in NZ
> 50 = indicative of diabetes
41-49 = pre diabetes
<40 = diabetes unlikely
what are the HbA1c cut offs for diagnosing type 2 diabetes internationally
> 48 = indicative of diabetes
42-47 = pre diabetes
<41 = diabetes unlikely
what proportion of NZ had type 2 diabetes
Somewhere between 5 and
7% of the population
what proportion of NZ population have prediabetes
~20% of the population
what are the long term health consequences that can be a result of diabetes
-stroke
-Blindness
-Heart attack
-Kidney failure
-Amputation
what are the risk factors for diabetes
-High BMI
-PCOS
-CVD
-family history
-Gestational diabetes
-severe mental illness
-Long term use of oral corticosteroids
risk of diabetes increases with what
BMI
what lifestyle changes will help reduce the risk of type 2 diabetes
Reduce energy intake
Increase physical
activity
Increase fibre intake
Reduce total and
saturated fat intake
how does weight gain contribute to diabetes risk (positive energy balance)
Being in a state of prolonged positive energy balance is associated with increased fat
accumulation around muscle and organs, and increased inflammation, both of which are
known to decrease peripheral insulin sensitivity
how does weight gain contribute to diabetes risk (increased triglyceride storage)
Increased triglyceride storage in the liver (due to prolonged excess energy intake) reduces
hepatic insulin sensitivity
how does weight gain contribute to diabetes risk (exposure of beta cells)
Exposure of beta cells to fatty acids increases the rate of cell death and decreases insulin
production
lifestyle interventions that incorporate a moderate physical activity component reduce incidence diabetes by
Lifestyle interventions that incorporate a moderate physical
activity component reduce incidence diabetes by 28-63% in
participants with impaired glucose tolerance
Greater reductions are seen when the intervention also
induces weight loss (but exercise alone is still effective)
in obese prevention the goal of 150 min a week is probably …..
NOT ENOUGH needs be be closer to 60 mins per day
most common suggestion of physical activity to reduce the risk of diabetes
what is the effect of exercise
Being physically active helps to prevent obesity
how does physical activity reduce the risk of diabetes
Improved endothelial function and capillarization
increased mitochondrial biogenesis and fibre ratios
improved muscular respiratory capacity and fatty acid
oxidation
increased expression and activity of glut 4 and glycogen
synthase
what is the types of carbohydrates and their associated outcomes
Sugar
starches
Fibre
what is the recommended intake of sugar
Recommended intake <10%TE
what is the outcomes associated with sugar
Increased body weight
Increased rates of dental caries
fibre lowers the risk of
⬇️ Mortality
⬇️ CVD
⬇️ CHD
⬇️ T2
⬇️ colorectal cancer
fibre improves
Improved Body weight, Blood pressure and
Cholesterol
WHO recommends what for fibre intake
25 g per day
“Important messages
“Important messages are to consume
minimally processed plant foods, such as
whole grains, vegetables, whole fruit,
legumes, nuts, seeds and nonhydrogenated non-tropical vegetable oils,
while minimising the consumption of red
and processed meats, sodium, sugarsweetened beverages and refined grains.
