Diabetes Prevention and Non-Pharm Management

Question 1

ABCDES of Diabetes Care

Answer 1

A: A1C (under 7)
B: BP (under 130/80)
C: Cholestrol (LDL under 2)
D: Drugs to protect heart
E: Exercise/healthy eating
S: Screening for complications, smoking cessation, self management, stress, other barriers

Question 2

How much
1. Aerobic exercise
2. Resistance exercise
should you do a week?

Answer 2

1. 150 mins/week

2. 60-90 mins/week

Question 3

Exercise fuel paradox

Answer 3

Protect muscle glycogen but also want to protect blood glucose

Question 4

4 ways to control blood glucose

Answer 4

Block entry of glucose into some tissues
Mobilize glucose from the liver
Enhance gluconeogenesis in liver
Mobilize FFA from adipose tissue

Question 5

4 effects of insulin on the liver

Answer 5

Promotes glycogen synthesis/inhibits glycogenolysis
Promotes glycolysis/inhibits gluconeogenesis
Promotes lipid synthesis and storage
Promotes protein synthesis

Question 6

3 effects of insulin on the muscle

Answer 6

Promotes glucose uptake
Promotes glycogen synthesis
Promotes protein synthesis

Question 7

2 effects of insulin in adipose tissue

Answer 7

Promotes glucose uptake

Promotes lipid synthesis and storage

Question 8

Exercise inhibits all the functions of insulin except for what 2 things?

Answer 8

In the liver: promotes glycolysis

Muscle: promotes glucose uptake

Question 9

Effects of epinephrine on liver, muscle, fat and pancreas

Answer 9

Liver: promotes glycogenolysis and gluconeogenesis
Muscle: promotes glucose uptake, glycogenolysis, glycolysis
Adipose: promotes lipolysis
Pancreas: inhibits insulin secretion, promotes glucagon secretion
OVERALL: mobilizes fuel

Question 10

What is the main intramuscular glucose transporter?

Answer 10

GLUT4

Question 11

3 main actions of insulin binding to its receptor

Answer 11

Cell growth and proliferation
Activate glycogen synthesis
Translocation of glucose transporter GLUT4 to plasma membrane stimulating glucose uptake

Question 12

Exercise results in GLUT4 translocation independent or dependent of insulin?

Answer 12

Independent!

Question 13

3 goals of diabetes prevention

Answer 13

Delaying the onset of diabetes
Preserving beta cell function
Preventing or delaying microvascular and perhaps cardiovascular complication

Question 14

Which is the only drug recommended for diabetes prevention?

Answer 14

Metformin

Question 15

Why are drugs other than metformin not recommended for DM prevention?

Answer 15

Lack of preventive efficacy or modest benefit in reducing the incidence of diabetes in the short term
Side effects
Absence of proven CV benefit