Lecture 2 Flashcards
Diabetes
-the most endocrine disorder
INSULIN
- released by pancreatic beta cells
- enables cells to absorb glucose
IN DIABETES, THE BODY EITHER
- fails to properly respond to its own insulin
- does not make enough insulin
- or both of the above
GLUCOSE ACCUMLATES IN THE BLOOD, LEADING TO ADVERSE EFFECTS
Prevalence of Diabetes
83% of the population or ~26 million
DIAGNOSED
-20.9 in 2011
UNDIAGNOSED
-25 cases
TYPE 1
-about 5-10% of Americans with diabetes have Type 1
TYPE 2
-about 90-95% of Americans with diabetes have Type 2
OTHER SPECIFIC TYPES
-about 1-2% diagnosed cases
GESTATION
-affects about 2-10% of all pregnant women
PRE-DIABETES
-about 57 million americans
Impact of Diabetes
-7th leading cause of death in the U.S.
- estimated annual costs in the U.S. in 2007
- –$174 billion
- direct medical costs
- –$116 billion
- indirect costs
- –disability, work loss, premature mortality
- –$ 58 billion
-role of exercise professionals
Diagnosis
- medical history
- physical examination
- diagnostic tests
- —recommended for those with risk factors
Type 2 Diabetes
Metabolic Disorder
-strong genetic component
Due to
-insulin resistance are reduced insulin secretion
Insulin resistance
- normal amounts of insulin inadequate to produce a normal cell response
- —increased lipid mobilization, elevates plasma free-fatty acids
- muscle cells
- —reduced glucose uptake; leads to how glycogen stores
- liver cells
- —impaired glycogen synthesis and a failure to suppress glucose production
Pre-Diabetes
-Blood glucose higher than normal but below diabetic levels
- 1 in 4 US adults aged 20 years or older-or 57 million people had pre-diabetes in 2007
- –U.S. Department of HHS
-~15-30% of persons with pre-diabetes develop type 2 diabetes with in 5 years
- To prevent or delay diabetes
- —Lose 5 to 7% of body weight
- —perform 150 min of MVPA
- insulin resistance and pre-diabetes may be reversed by physical activity and weight loss
- statistics don’t include children
Risk Factor for Type 2 Diabetes
- Overweight and Obesity
- High abdominal fat
- History of Familial Diabetes
- Race/Ethnicity
- –African American, American Indian, Asian American, Pacific Islander, or Hispanic American/ Latino
- Physical Inactivity
- History of Gestational Diabetes
- –or birth of at least one baby weighing more than 9 pounds
- Hypertension
- Dyslipidemia
- Older Age
Gestational Diabetes
-Develops during 2nd or 3rd trimester
RISK FACTORS
- family history of gestational diabetes
- previous delivery of baby >9 lbs
- obesity
Large proportion of women eventually develop diabetes it does not have to turn into full blown diabetes
Acute Complications of Diabetes
HYPERGLYCEMIA ( >180 mg/dL) high glucose levels
- Diabetes out of control
- Diabetic Ketoacidosis
- Hyperosmolar nonketotic syndrome (Do not exercise)
- —person not in control
HYPOGLYCEMIA (60-70mg/dL) low glucose levels
Symptoms
-autonomic
-neuroglycopenic
—low blood glucose to the brain could result in unconsciousness, even sometimes a coma
Treatment of Acute Complications
HYPERGLYCEMIA
- drink water
- –because of dehydration
- monitor for blood glucose level
- possibly increase medication
HYPOGLYCEMIA
- test glucose level
- consume 15g of carbohydrate
- –120 ml or Orange Juice
- if patient unconscious
- —-glucagon injection
-sometimes happens in recovery from exercise. exercise normally decreases glucose level
Chronic Complications of Diabetes
MACROVASCULAR
- coronary artery disease
- myocardial infarction
- stroke
- PAD
MICROVASCULAR
- retinopathy (eyes)
- nephropathy (kidney)
NEUROPATHY
- peripheral [in terms of lost sensation]
- autonomic [innervates the vessels]
Treatment of Diabetes
- there is no cure
- Type 2 Diabetes is chronic and progressive
- treatments delay or prevent complication
- goals of treatment
- –control blood glucose
- –reduce complications
- –prevent premature mortality
- –preserve quality of life
Management of Diabetes
- Medical Nutrition Therapy
- Exercise
- Self-Monitoring
- Diabetes Self-Management Education
- Pharmacologic
- —met for min
- ——reduces liver release of glycogen from glycogen
- ——improves cellular uptake of glucose in body tissues
The Role of Physical Activity: Direct Effects
Improves glucose homeostasis
- acutely
- long term
Pancreas
-reduced insulin secretion
Liver
-decreased glucose production
Adipose Tissue
-greater fatty acid mobility
Skeletal Muscle
-greater expression of Glut-4
The Role of Physical Activity: Indirect Effects
- Higher Cardio-respiratory fitness
- lower blood pressure
- better blood lipid profile
- weight loss
- lower abdominal fat
