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MED 310 > energy balance > Flashcards

energy balance Flashcards

1
Q

what is the primary control of insulin secretion

A

negative feedback between beta cells and glucose concentration in the blood

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2
Q

what does diabetes refer to

A

large volume of urine produced by diabetics

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3
Q

mellitus meaning

A

sweet urine- assocaited with hyperglycemia and glucose output in the urine

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4
Q

insipiddus meaning

A

tasteless urine- diabetes that is not associated with hyperglucemia but with ADH deficiency

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5
Q

IDDM

A

autoimmune destruction of B cells
in children or before 40 yrs
regular insulin injections required

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6
Q

what happens in IDDM when insulin absence is occuring

A

glucagon release from a cells is triggered- glucose sensing fails in the a cells leading to additional glucose in the blood thorugh glucagon action

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7
Q

what is possible therapy for IDDM

A

insulin and GHIH (somatostatin) to inhibit glucagon secretion

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8
Q

what is A1C a measure

A

glycosylation state of hemoglobin

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9
Q

how often is the turnover of Hb in RBC

A

every 3 months therefore testing is done every 3 months

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10
Q

what is %glycosylation a function of

A

average glucose levels over time (1-3 months prior)

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11
Q

what is the A1C value for non diabetics

A

5%

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12
Q

what is the A1C value for diabetics

A

greater than 6.5-7%

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13
Q

what is an important indicator of diabetes control

A

A1C monitoring

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14
Q

why is uncontrolled glucose a problem

A

advanced glycation end products- AGEs- interfere with physiological systems such as arterial stiffness in diabetes mellitus

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15
Q

gestational diabetes

A

gestational diabetes mellitus refers to glucose intolerance with onset or first recognition during pregnancy

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16
Q

what is a risk during GDM- gestational diabetes mellitus

A

fetal malformations at early gestational time points

risk of macrosomia and metabolic complications with late gestation GDM

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17
Q

what are the risk factors of GDM

A

> 35 yrs
on cortisol therapy
race
obesity
pre diabetic condition
T2DM in the family
PCOS

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18
Q

how many pathways lead to type D diabetes

A

multiple

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19
Q

what is a precursor state of diabetes type 2

A

prediabetes

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20
Q

what can happen in type 2 diabetes

A

progress to type 1

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21
Q

what is the normal fastsing range

A

less than 6mmol/L

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22
Q

what does chronic over eating lead to

A

inc in blood glucose
inc in insulin secretion
dec sensitivity of target cells to insulin- insulin resistance

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23
Q

what is type 2 diabetes assocaited with

A

hypertension and hyperlipidemia

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24
Q

what is hyperlipidemia and hypertension

A

metabolic disease

25
Q

what percentage of people who develop type 2 diabetes are overweight

A

90%

26
Q

what is the smoking gun

A

B cells deteriorate during diabetes

27
Q

why do b cells deteriorate during diabetes

A

they are more vulnerable to the by products of their own metabolism bc they are the sensors for insulin release

28
Q

what are the by products of beta cells

A

ROS, endoplasmic reticulum stress, AGE

29
Q

what does chronic insulin secretion lead to

A

beta cell exhaustion leading type 2 to progress to type 1

30
Q

what are the insulin sensitizing drug class for type 2 DM

A

thiazolidinediones TZDS

31
Q

what improves A1C and glucose control

A

TZDS for type 2 DM

32
Q

what is TZDS mechanism of action

A

increased fat storage in the adipocyte, effectively reducing circulating FA, blood glucose and hyperinsulinemia

33
Q

what are the side effects of TZDS

A

bone density, cancer, CVD

34
Q

what are some estimates of adiposity

A

BMI and waist circumference

35
Q

waist circumference

A

used to determine regional adiposity
helps estabolish if body fat is peripheral or central obseity
gender specific
higher risk of obesity associated illness

36
Q

high risk waist circumference sizes

A

more than 35 in women and 40 in men

37
Q

what provides accurate esitimate of body fat and health risk

A

BMI and waist circumference

38
Q

what does diabetes do to your lifespan

A

decreaeses it by 15 yrs

you have the same health risk as someone 15 yrs younger than you

39
Q

Type 2 diabetes treatments

A

moderate energy intake
exercise routine
balanced physique: adipose to muscle ratio

40
Q

body energy

A

energy intake - energy output

41
Q

energy input

A

foods we eat, digest and absorb

42
Q

energy output

A

work and heat/ waste

43
Q

what is BMR dictated by

A

gender, lean muscle mass, level of activity, food ingestion, thyroid hormones and catecholamines, metabolic efficiency/ genetics

44
Q

what does food ingestion do to BMR

A

spike it

45
Q

appetite or hunger

A

desire for food

46
Q

satiety

A

sense of fullness or satisfaction

47
Q

what are the two control centres for the hypothalamus with regards to food

A

feeding centre
satiety center

48
Q

what are the 4 types of input to the hypothalamus

A

neural input from the cerebral cortex
neural input from the limbic system (amugdala, hypocampus, cinguate gyrus)
peptide hormmones from the GI tract
Adipokines from adipose tissue

49
Q

glucostatic theory

A

theory proposes that blood glucose levels ultimately control feeding and satiety centers

50
Q

lipostatic theory

A

theory that proposes that level of body fat regulates feeding and satiety centres
discovery of several peptides from adipose tissue seems to support this theory

51
Q

Ghrelin resposne to body fat

A

inc to decreased body fat

52
Q

ghrelin and muscle mass

A

increase to increased muscle mass

53
Q

what is ghrelin impacted by

A

macronutrient content of meals and can be regulated by diet

54
Q

when is the highest ghrelin post prandial suppresion

A

carb then protein and finally fat

fat is last bc it is used as a mechanism for weight gain associated with high fat diets

55
Q

leptin and obesity

A

does not work exogenously with majority of obese individuals and therefore it is not as significant as animal models

leptin reistance occurs when there is high expose to high cituclating concentration

56
Q

contributions to net energy excess and adipose storage

A

adipokine imbalance
lack of physical exertion
variation in the efficiency of energy extraction from foods
endocrine disorders such as hypothyroidism
energy dense food availability; modern expecations
genetics, mental health, eating behaviour

57
Q

what do calorie restricted diets do

A

significantly lengthen the life span of many species including humans

58
Q

metabolic syndrome

A

high blood glucose
high blood pressure
high triglycerides
low HDL
abdominal obesity

MED 310 (47 decks)

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