Lecture 16: Diabetes Prevention and Management

Question 1

Diabetes

Answer 1

• 29% of Canadians have diabetes or prediabetes
• metabolic disorders –> glucose
  
  • hypoglycemia (blood glucose is above normal)
• symptoms
  
  • frequent urination
  • increased thirst
  • increased hunger
• increased risk for south asian, asian, african, hispanic or first nations (~15% higher)

Question 2

Blood Sugar Regulation

Answer 2

Insulin: decreases blood glucose (beta)
Glucagon: increases blood glucose (alpha)
Insulin Resistance:
- the cells are resistant to insulin —> pancreas increases insulin (hyperinsulinemia) –> hyperglycemia

Question 3

Types of Diabetes

Answer 3

1) Type 1 Diabetes
- 5-10% of cases
- Autoimmune disorder –> destroys the insulin-secreting cells of the pancreas

2) Type 2 Diabetes
- 90% of cases
- incapable of responding to insulin –> insulin resistance –> Beta Cell dysfunction

3) Gestational Diabetes
- blood sugar levels are high during pregnancy in women –> increases T2DM risks later in life

4) Pre-Diabetes
- A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L)

Question 4

Diabetes andCVD

Answer 4

• Hyperglycemia –> decrease NO
• Obesity underlies many T2DM cases
• Metabolic syndrome
  
  • obesity, elevated BP, high triglycerides, elevated blood sugar, low HDL cholesterol

Question 5

Blood Sugar Assessments

Answer 5

• Glucose Test
  
  • fasting blood sugar (FBS) (12-14h fast)
  • glucose tolerance test
  • postprandial glucose test (PC)
• A1C
  
  • average blood glucose over the past 3 months

Question 6

Risk for Diabetes

• similar/different to FRS

Answer 6

website

Similarities:

• screening tools
  
  • sex, age, CVD diagnosis

Differences:

• considers other variables
  
  • weight, waist size, physical activity, diet, family history, ethnicity

Question 7

Canadian Diabetes Association Clinical Practice Guidelines

Answer 7

??

Question 8

the Glycemic Response

Answer 8

• the measurement of the elevation of blood glucose and insulin in response to a food item
• Glycemic Load (GL)
  
  • GL = GI x Carbs / 100
• factors affecting GI
  
  • time of day of test, body size, weight, blood volume, metabolic rate
  • food prep (al dente pasta vs. soft cooked)
  • food’s ripeness
  • food combinations

Question 9

Sugar alternatives

Sucralose

Answer 9

Sucralose (Splenda)

 - 600X sweeter than sugar
 - heat stable
 - ADI: 9mg/kg (1 packet = 12mg)

Question 10

Sugar Alternatives (Aspartame)

Answer 10

• 200X sweeter than sugar
• break down in high temperatures
• energy: 4kcal/g
• ADI: 40mg/kg

Question 11

Sugar Alternatives
(Saccharin)

Answer 11

• 300-400X sweeter than sugar
• heat stable
• ADI: 15mg/kg

Question 12

Sugar Alternatives

Ace K: Acesulfame potassium

Answer 12

• 200X sweeter than sugar
• heat, PH stable
• ADI: 15mg/kg

Question 13

Paleo Diet. How is it different from Keto?

Answer 13

-