Lecture 3/15/16 Diabetes

Question 1

Type I diabetes

Answer 1

Previously called insulin-dependent diabetes or juvenile onset diabetes. Peak diagnosis is at mid-teens. Results from beta cell damage, typically autoimmune, limiting the production of insulin. Injection of insulin is required

Question 2

Type II diabetes

Answer 2

Previously called non-insulin dependent, adult onset, insulin resistant, a disorder in which the cells primarily in the fat and muscle tissues do not use insulin properly. As demand for insulin rises, the beta cells in the pancreas gradually lose the ability to produce sufficient quantities of the hormone.

Question 3

Hyperinsulinemia

Answer 3

Not benign; causes hepatic triacylglycerol synthesis and raises blood triacylglycerol while decreasing HDL cholesterol. Both are risk factors for CVD. Pancreas gets exhausted, but not to the level of the diabetes I

Question 4

Diagnostics for T2D

Answer 4

High insulin when glucose levels are normal, high insulin with high glucose levels, or both of the two occurring at the same time.

Question 5

Diabetes prevalence

Answer 5

T2D 95% of diabetes cases, T2 predisposition increases with age, 29.1 million people (9.3% of US pop); cost 174bn; 600d/day; 5000 new cases per day.

Question 6

Prediabetes

Answer 6

78 Million U.S adults have it; condition in which individuals have high blood glucose or hemoglobin A1C levels but not high enough to be classified as diabetic. Have increased risk of developing T2D, CVD, and stroke, but not all progress to T2D. Lifestyle changes can change story.

Question 7

Nutritional plan for diabetics: weight Management

Answer 7

Attain and maintain desirable body weight (BMI

Question 8

Nutritional plan for diabetics: Carbohydrates percent of energy

Answer 8

55-65%

Question 9

Nutritional plan for diabetics: Monosaccharides and disaccharides

Answer 9

Use in moderation

Question 10

Nutritional plan for diabetics: polysaccharides

Answer 10

emphasize whole grains, legumes, and vegetables.

Question 11

Nutritional plan for diabetics: glycemic index

Answer 11

Eat low glycemic index foods

Question 12

Nutritional plan for diabetics: Fiber, total (g/day)

Answer 12

25-50 (15-25 g/1,000 kcal)

Question 13

Nutritional plan for diabetics: Protein % of energy)

Answer 13

12-16%

Question 14

Nutritional plan for diabetics: Total Fat

Answer 14

less than 30%

Question 15

Saturated fatty acids/trans-fatty acids (% of energy)

Answer 15

less than or equal to 10%

Question 16

Nutritional plan for diabetics: Monosaturated fatty acids % of energy

Answer 16

12-15%

Question 17

Nutritional plan for diabetics: polyunsaturated fatty acids (% of energy)

Answer 17

less than 10%

Question 18

Nutritional plan for diabetics: Cholesterol (mg/day)

Answer 18

less than 200 mg/day

Question 19

Metabolic Syndrome

Answer 19

Basic premise that certain CVD risk factors are associated with insulin resistance and compensatory hyperinsulinemia, and it established specific criteria to be used in making a clinical diagnosis to identify individuals at increased risk for CVD.

Question 20

Syndrome X

Answer 20

often used synonymously with MS, introduced to provide a physiologic basis to account for the interrelationship of insulin resistance, hyperinsulinemia, glucose intolerance, hypertension, high TG, and low HDL. Not meant to represent a diagnostic category.

Question 21

Metabolic syndrome: Elevated waist circumference

Answer 21

102 cm (40 in men); 88 cm ( 35 in for women)

Question 22

Metabolic syndrome: Elevated triacylglycerols

Answer 22

x> 150mg/dl

Question 23

Metabolic syndrome: Reduced HDL-C

Answer 23

X

Question 24

Metabolic syndrome: Elevated blood pressure

Answer 24

Systolic > or equal to 130 and/or diastolic> or equal to 85mmhg

Question 25

Metabolic syndrome: Elevated fasting glucose

Answer 25

x> or equal to 100mg/dl

Question 26

When is MS officially diagnosed?

Answer 26

When 3 or more of the diagnostic categories are met in an individual

Question 27

Why is there disagreement on its definition and use?

Answer 27

1) Can’t decide on a diagnosis criteria (which risk factors and how many need to be presented) 2) Medical value of diagnosis is unclear: does the syndrome diagnosis better predict CVD? Is treatment of the syndrome different that treatment for each of its components.