Final Exam Prep Flashcards
When blood sugar levels are high, the pancreas does what?
Releases insulin
When blood sugar levels are low, the…
pancreas releases glucagon
Diabetes occurs when
the beta cells of the pancreas either stop producing or do not produce enough of the hormone insulin
Because there is not enough insulin, there is a low absorption of ______________ by the body’s cells
when there isn’t enough insulin,
There’s a low absorption of glucose in the body
What is the result of when there is insulin resistance or when there is a low absorption of glucose by the body’s cells?
high blood glucose levels, and a spillover of excess glucose into the urine.
What is insulin resistance?
Insulin resistance is when the body can’t make use of the available insulin.
What is it called where someone has high blood glucose levels?
hyperglycemia
Prediabetes is also called…
Impaired glucose tolerance (IGT) or impaired fasting glucose (IFG)
What is the mortality rate of Diabetes in 2023?
102,242 (8th leading cause of death)
75,578 in 2016
What is the prevalence of diabetes in the US?
Prevalence of diabetes in the US: 11.3% of the population with a total of 37.3 million children and adults
How many people who have diabetes are diagnosed?
The number of people who have diabetes that are diagnosed is 28.7 million
How many of those who have diabetes are undiagnosed?
Those who have diabetes that are undiagnosed total 8.6 million
What is the incidence rate of Diabetes?
1.5 million new cases per year
How many people, 18 or older have prediabetes?
96 million people (38% of adults)
How many of those that are 65 or older have prediabetes?
26.4 million people (48.8%)
What are the three ways that Type 1 Diabetes is also referred to as?
Insulin Dependent Diabetes Mellitus (IDDM), Type 1, and Juvenile Onset Diabetes
Which type of diabetes is considered to be an auto-immune disease?
Type 1 is considered to be an auto-immune disease
What percent of diabetics have Type 1
5-10%
When does the peak incidence rate occur for type 1 diabetes?
During puberty (10-12 in girls/12-14 in boys)
In which race group is type 1 diabetes most prevalent in? Is prevalence increasing, decreasing, or not changing?
Caucasians, prevalence is not increasing
What are the other two names that Type 2 diabetes is referred to as?
Non-insulin dependent Diabetes Mellitus (NIDDM), and Adult or Maturity Onset Diabetes
What precent of diabetics have type 2?
90-95% of all diabetics have type 2
What are the four main complications that may occur with diabetes?
CVD, Nephropathy, retinopathy, and neuropathy.
What can complications from diabetes lead to?
Amputations of lower limbs, impotence, perinatal (around the time of birth) mortality and morbidity,
The vast majority of diabetics have either Type 1 or Type 2. Which 2 other types are less prevalent?
Gestational Diabetes (GDM) and Latent Auto Immune Diabetes of the Adult (LADA)
Gestational Diabetes occurs in about _______% of all pregnancies.
Gestational Diabetes occurs in about (FOUR) 4% of all pregnancies.
When gestational diabetes occurs, it’s because pregnancy hormones can block _________ from doing its job
When gestational diabetes occurs, it’s because pregnancy hormones can block INSULIN from doing its job
Latent Autoimmune Diabetes in Adults (LADA) is also known as: __________________ and insulin is very _____ at diagnoses
TYPE 1.5, insulin is very LOW
What are the 8 symptoms of type 1 diabetes?
Polyuria, polydipsia, polyphagia, weight loss, cessation of growth, irritability, fatigue/drowsiness, coma
What are polyuria, polydipsia, and polyphagia?
Polyuria: excessive urination
Polydipsia- excessive thirst
Polyphagia- excessive eating
What are the 6 symptoms of Type 2 diabetes?
Type 2 is often asymptomatic, but can exhibit any of the symptoms for type 1 plus:
Frequent infections, blurred vision, cuts/bruises that are slow to heal, tingling/numbness in hands or feet, recurring skin, gum, bladder infections, UTI’s or vaginal infections
What is the diagnostic criteria for Fasting Plasma Glucose for diagnoses of Diabetes?
A value more than or equal to 126 mg/dL
What is a normal and impaired fasting plasma glucose level?
Normal= <100 mg/dL
Impaired= 100-125 mg/dL (also called prediabetes)
Give the values for an Oral Glucose Tolerance Test (OGTT)
Normal= Less than 140 mg/dL
Impaired glucose tolerance= 140-199 mg/dL (prediabetes)
Diagnostic Criteria= More than or equal to 200 mg/dL
Give the values for Hemoglobin (A1C)
Normal <5.7%
Impaired= 5.7-6.4% (also called prediabetes)
Diagnostic criteria = More than or equal to 6.5%
What are two main things that are monitored for diabetes?
Blood glucose and Hemoglobin A1C
What is Hemoglobin A1C also called, and what is it?
It is also called a glycosylated hemoglobin or AC1. It is a blood test where an average blood glucose concentration over a period of 2-3 hours is measured.
What is the American Diabetes Association (ADA) recommendation for a hemoglobin A1C percent?
The recommended percent is to be <7%, anything over 8% indicates poor glucose control
What are the two risk factors for Type 1 diabetes?
Family history and race (Caucasian)
What percent of of individuals with Type 2 diabetes need insulin?
40%
What are the two treatment goals for diabetes?
Control of blood glycose (A1C of <7.0%) and postponing/delaying medical complications
What are the 5 principle approaches for treatment of diabetes?
self monitoring of blood glycose (SMBG), drugs, diet, exercise, and patient education
What percent of type 2 diabetes can be controlled with diet and exercise?
-80% Type 2 can be controlled with diet and exercise
List the 5 dietary approaches for helping with diabetes
Moderate fat, low simple sugars and high in complex carbs, moderate in proteins, limited alcohol intake, increased intake of vitamin D and Magnesium
For diabetics, simple sugars should be replaced by
For diabetics, simple sugars should be replaced by MUFA
What is the glycemic index?
The glycemic index is the rise of blood glucose following ingestion of food as a percentage
for diabetics, what should the percent of protein be regarding total daily energy intake?
for diabetics, 15-20% of should make up the total daily energy intake
Does increased intake of vitamin D and magnesium increase, decrease, or not change the risk for T2DM?
Increased intake of vitamin D and magnesium decreases the risk for T2DM
Does exercise increase, decrease or have no effect on: Obesity, insulin resistance, and risk for CVD?
Exercise decreases obesity, insulin resistance, and risk for CVD`
How do you calculate BMI?
By putting weight (kg), over height (m^2)
what does waist to hip ratio indicate?
Regional distribution of fat (or fat body pattern) The two types are upper body/android obesity, and lower body/gynoid obesity
what is the high risk criteria for men and women with regards to waist circumference?
For men: >102 cm (about 40 inches)
For women: >88 cm (about 35 inches)
What is body composition?
Refers to fat weight (fat mass) expressed as a percentage of total body weight
What percentage of water is Fat mass?
14-22%
What % water is Fat free mass, and what is it made up of?
Fat free mass is 70-80%, made up of water, protein, and mineral components
What is the estimated number of annual deaths that can be attributed to obesity among US adults?
280,000
What is the relationship between BMI and excess mortality? When is the risk low? When it is the highest risk?
the relationship is a curvilinear increase in excess mortality with rising BMI. This risk is low with a BMI of 25 to 30 and increases as BMI increase. The highest risk is seen with BMI’s above 40
Obesity leads to increased Incidence of….
CHD/CAD (MI), cerebrovascular disease (CVA), PVD/PAD, AS, HTN, and dyslipidemia
Those who are obese are more likely to have…
Higher total cholesterol, Higher LDL, lower HDL, higher TG
Obese men had higher mortality rates for cancer of the:
colon and rectum, and prostate
Obese women had higher mortality rates for cancers of the
Gallbladder, bile ducts, breast, uterus and ovaries
What are other problems that can occur with obesity?
Respiratory problems, sleep apnea, infertility, complications of pregnancy, menstrual irregularity, gallbladder disease, carpal tunnel, and hormonal problems.
What are the 2 main lab methods and field methods for measuring body composition?
2 main lab methods: hydrostatic weighing and Dual energy x-ray absorptiometry (DEXA)
2 main field methods: Skinfolds and Bioelectrical impedance analysis (BIA)
What is NHANES?
National health and nutrition examination survey that does physical/physiological exams
What is BRFSS?
Behavioral Risk Factor Surveillance System, which is where data is collected through phone
What percentage of adults are obese according to the CDC?
41.9% of adults are obese according to the CDC
According to the CDC, what % of adults are either overweight or obese?
73.6% of adults are obese or overweight according to the CDC
What precent of adults are either normal body weight or underweight according to the CDC?
26.4% are either normal body weight or underweight according to the CDC
For the classification of BMI, what falls into the underweight category? What is the disease risk?
<18.5, increased risk
For the classification of BMI, what falls into the normal category? What is the disease risk?
18.5-24.9, normal
For the classification of BMI, what falls into the overweight category? What is the disease risk?
25-29.9, increased
For the classification of BMI, what falls into the class 1 obesity category? What is the disease risk?
30.0-34.9, high
For the classification of BMI, what falls into the class 2 obesity category? What is the disease risk?
35-39.9, very high
For the classification of BMI, what falls into the class 3 (extreme obesity) category? What is the disease risk?
anything equal to or above 40, extremally high
Energy balance is a complex interaction between…
energy intake and energy expenditure
The body’s ideal weight thermostat is located where?
The hypothalamus
What is secreted by adipose tissue to decrease appetite?
Leptin
If there is a defective leptin receptor, then the risk for obesity…
Increases
How many excess kilocalories does it take to store 1 pound of adipose tissue?
3,500
Alcohol contains how many kcals?
7kcal
What was the purpose of the Bouchard study?
To examine differences in responses of different persons to long-term overfeeding
What subjects were apart of the bouchard study?
12 pairs of young adult male identical (monozygotic) twins
What were the methods of the bouchard study?
Subjects were overfed by 1000 kcal per days for 84 days during a 100 day period
What was the conclusion of the bouchard study?
A comparable surplus of energy doesnt cause identical Reponses with respect to body weight, body comp, or regional distribution of fat.
According to NHLBI guidelines, the treatment to lose weight is to do what to caloric intake and expenditure
Decrease caloric intake and increase caloric expenditure. (or do both)
How many pounds should your goal be to lose per week?
1-2 pounds per week or 1% of total body weight per week.
How many calories per day falls into the moderate deficit calorie diet?
> or equal to 1,200 kcal/day for women
or equal to 1,400 kcal/day for men
How many calories per day falls into the low calorie diet?
800-1,200 kcal/day for women
800-1,400 kcal/day for men
How many calories per day falls into the very low calorie diet?
less than or equal to 800 kcal per day for men and women
What is basal metabolic rate?
energy utilized at rest
How do you find BMR?
1.0 kcal/min * 60 (mins) * 24 hours= 1,440 kcal/day
What is the average BMR of females and males?
For females: 1,400 kcal/day
Males: 1,800kcal/day
What is the thermic effect of food? (TEF)
Energy expended to digest, absorb, transport, metabolize and store food
What is the total daily expenditure equation?
TDEE= RMR+TEF+ PA/Ex
How much does BMR decrease per decade after age 30?
1-2%
What is the second leading cause of death in the united states?
Cancer
How many new cases of cancer occur each year?
200,000 new cases
What is the lifetime risk for developing cancer within men and women?
50% for males, and 33% for females
What percent of cancers are diagnosed in persons 55 and older?
77%
Cancer is a large group of over 100 diseases characterized by what?
Uncontrolled growth and spread of abnormal cells
The study of cancer is called
Oncology
Cancers cause death by interfering with the vital functions of normal cells which leads to
Cachexia (general wasting and weight loss)
Groups of abnormal and unregulated cells are called
tumors or neoplasms
Malignant and cancerous means…
fast growing and can spread
Carcinogenesis is a long process which goes through what three stages?
Initiation, promotion and progression
__________________ is the spread of cancerous cells throughout the body
metastasis
If the cancer cells have not spread from layer of cells where they have developed, the cancer can be described as
in situ
________ are found in the surface cells of the skin, breasts, lungs, urinary, reproductive, and gastrointestinal tracts and glands of the body
Carcinomas
Carcinomas account for about what percent of all cancers?
80-90%
__________________ are found in the melanin producing cells of the skin, placenta, ovaries and testes
melanomas
What cancer type is found in the lymph nodes, spleen, and thymus gland?
Lymphomas
What type of cancers are found in the bone marrow?
Leukemias
What type of cancers are found in the connective tissue, bone, fat, blood vessels, lymph vessels, and muscle
Sarcomas
Sputum cytology is a screening used for which cancer
lung
The FOBT would be used to screen for:
colon and rectal cancer
In the US cancer results in about ________ deaths per year:
600,000
The most common form of cancers are:
carcinomas
The five year survival rate for lung cancer is:
21%
In the US which cancer causes most deaths:
lung
The spread of cancerous cells is called:
Metastasis
The five year survival rate for breast cancer is:
85%
The FDA had concerns that the artificial sweetener saccharin may increase cancer risk so they removed it from the ______ list:
GRAS
Exposure to which gas has been shown to increase cancer risk:
Radon
The ABCD acronym is used to screen for skin cancer. The letters stand for:
asymmetry, border, color, diameter
What is an example of a cruciferous vegetable:
Broccoli
