ENERGY BALANCE Flashcards
Insulin and glucagon regulate _____ levels
Blood glucose
Increasing Blood glucose = increase or decrease in insulin secretion?
Increase
Decrease Blood glucose = increase or decrease in insulin secretion?
Decrease
Insulin’s job is to remove ___ from blood stream
Glucose
The term _____ refers to large volume of urine produced by diabetics
Diabetes
_____ refers to “sweet urine” = diabetes associated with hyperglycaemia and glucose output in the urine
Mellitus
______ refers to “tasteless urine” = diabetes that is not associated with hyperglycaemia but is associated with ADH deficiency
Insipidus
High protein meals do or do not change blood glucose ?
Do not
Type ____ diabetes :
-autoimmune destruction of beta cells
- usually develops in children or before age 40
- regular insulin injections required for survival and a full life
1
Insulin absence triggers ______ release from the alpha cells leading to additional glucose in the blood through glucagon action; therefore, therapy for IDDM may be insulin + GHIH to inhibit _____ secretion
Glucagon
Glucagon
Diagnosis of diabetes is fasting glucose > ____mmol/L
And glucose > ______mmol/L 2 hrs after oral glucose
7mmol/L
11mmol/L
______ is a measure of the glycosylation state of hemoglobin (Hb)
A1C
Hb in RBC’s run over every ___ months
3
% glycosylation is a function of average ____ levels over time
Glucose
Non diabetics have a A1C test result of approximately ____%
5
diabetics have a A1C test result of approximately ____%
6.5-7
____ monitoring is an important indicator of diabetes control
A1C
Targets for most people with diabetes
A1C - ___% or less
Fasting blood glucose- ___ to ____ mmol/L
Blood glucose 2 hrs after meal - ___ to ___ mmol/L
7
4-7
5-10
Is uncontrolled glucose a problem ?
Yes
Does uncontrolled glucose interfere with physiological systems ?
Yes
This type of diabetes ________ refers to glucose intolerance with onset or first recognition during pregnancy
Gestational diabetes mellitus
Type ___ diabetes mellitus
-characterized by impaired insulin secretion and/or resistance of target cells to its effects
- generally a later age of onset
-multiple pathways leading to this type
- majority of diabetics are this type
-prediabetes is a precursor state
-can progress to the other type
2
Type 2 diabetes is characterized by impaired ___ secretion or resistance of target cells to its effects
Insulin
Does type 1 or type 2 diabetes have a later age of onset ?
2
Majority of diabetics are type ___
2
Type ___ DM can progress to type ____
2 , 1
Formal fasting range is < ___mmol/L
6
Are diabetes rates going up or down?
Up
90% of people who develop type 2 diabetes are ____
Over weight
Does chronic over eating increase or decrease blood glucose ?
Increase
Since the ___ cells are the “sensors” for insulin release, they may be more vulnerable to the by-products for their own metabolism
Beta
Chronic insulin secretion can cause ___ cell exhaustion therefore type 2 progresses to IDDM, type 1
Beta
___ drugs for type 2 DM
-improved A1C and glucose control as single drugs
-,echanisms of actions ; increased fat storage in the adipocyte, effectively reducing circulating fatty acids, blood glucose, and hyperinsulinemia
TZD
BMI for :
Underweight -
Normal -
Overweight -
Obesity -
<18.5
18.5- 24.9
25- 29.9
>30
______ is useful to determine regional adiposity
Helps establish if body fat is peripheral or central obesity
Gender specific
Higher risk for obesity associated illness
Waist circumference
Waist circumference
High risk = ____ inches women
____ inches for men
> 35
40
Subcutaneous fat is located where ?
Under fat
Visceral fat is unhealthy because it is close to our ___
Organs
Name some Type 2 diabetes treatments
Exercise
Healthy food
_____= energy intake - energy output
Body energy
______= food we eat, digest , absorb
Energy input
____= work+ heat(waste)
Energy output
____= energy required at rest
-dictated by age , male/female , lean muscle mass, level of activity , food ingestion, thyroid hormones and catecholamines, metabolic efficiency (genetics)
BMR
____= desire for food
Appetite
_____ sense of fullness
Satiety
Hypothalamus contains 2 key control centres : ____ centre and ___ centre
Feeding and satiety
4 types of input to the hypothalamus :
-neural input from _____
Neural input from ___ system
-___ hormones from GI tract
-adipokines from ___ tissue
Cerebral
Limbic
Peptide
Adipose
______ theory
Theory proposes that blood glucose levels ultimately control the feeding and satiety centres
Glucostatic theory
____ theory
- theory proposes that the level of body fat regulates the feeding and satiety centres
Discovery of several peptides from adipose tissue seems to support this theory.
Lipostatic
______
Increases in response to decreased body fat
Increases in response to increased muscle mass
Is impacted by macronutrient content of meals and can be regulated by diet
Ghrelin
> __ % of adults are overweight /obese
25% are obese
50
25
