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NFS284 > NFS284 Carb 2 > Flashcards

NFS284 Carb 2 Flashcards

Carbohydrate metabolism - CHO for energy - Regulation of blood glucose - Abnormal blood glucose

1
Q

How is glucose metabolized?

A

Cellular respiration / aerobic metabolism

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2
Q

How much energy is made per glucose?

A

38

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3
Q

What process is used to generate energy?

A

Cellular respiration / aerobic metabolism

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4
Q

1g carbs contains _ kcal

A

4

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5
Q

What cells can only use glucose for energy?

A
  • RBC

- Brain cells

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6
Q

What supplies energy for daily activities (normally)?

A

Carbs & fats

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7
Q

Glucose is especially important for energy during…

A

intense exercise

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8
Q

Why is CHO needed for intense exercise?

A

During intense exercise, O is limiting factor

CHO deliver more ATP per O than fat

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9
Q

4 steps of cellular respiration

A
  1. glycolysis
  2. Acetyl-CoA formation
  3. citric acid cycle
  4. electron transport chain
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10
Q

Glycolysis

A

Breaks glucose (6C) -> 2 pyruvate (3C units)

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11
Q

When there is no O, what is the pathway used to make ATP?

A
  1. Glycolysis

2. Pyruvate becomes lactate

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12
Q

Lactic acid inhibits…

A

glycoloysis

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13
Q

If there is excess rate of electrons going to the electron transport chain…

A

Will form oxygen radicals -> oxidative stress

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14
Q

What is the anaerobic part of metabolism?

A

Glycolysis

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15
Q

What is the aerobic part of metabolism?

A

Acetyl-CoA formation
citric acid cycle
electron transport chain

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16
Q

Gluconeogenesis

A

Make glucose from proteins

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17
Q

FA can be made in the body by…

A

Proteins

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18
Q

Excess proteins are…

A

made into glucose or fat (gluconeogenesis)

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19
Q

Blood glucose is regulated by…

A

Liver

Hormones secreted from pancreas

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20
Q

Antagonistic to insulin

A

glucagon

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21
Q

insulin produced by…

A

beta cells of pancreas

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22
Q

Insulin stimulates…

A
  • uptake of glucose by liver and muscle

- storage of glucose as glycogen in liver and muscle

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23
Q

What are the 2 types of glucose transporters?

A
  1. GLUT2

2. GLUT4

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24
Q

GLUT2 transporter

A

Sits on cell membrane that slowly transport glucose into cell. Act as sensors of glucose levels.
Does not require insulin

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25
Q

GLUT4 transporter

A

Insulin signal causes them to TRANSLOCATE to cell membrane from the cytoplasm. Fast transport of glucose.
Will be removed once insulin signal is gone.

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26
Q

Glucagon is produced by…

A

alpha cells of the pancreas

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27
Q

Glucagon stimulates…

A
  • breakdown of glycogen -> glucose

- gluconeogenesis

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28
Q

Describe blood glucose after consuming 80g of glucose.

A
  1. Blood glucose spikes
  2. Insulin secreted and lowers blood glucose
  3. Insulin causes blood glucose to be lower than normal
  4. Stimulates glucagon release
  5. Glucagon returns blood glucose levels back to normal
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29
Q

Fuel use: fasting

A
  • High glucagon (glucose level maintained by gluconeogenesis & glycogen breakdown)
  • Fat cell secrete FFA for use by muscle
  • FFA inhibit glucose use (try to keep blood glucose high)
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30
Q

Fuel use: post-prandial

A

Insulin

  1. Stops fat use
  2. GLUT4 transporter
  3. Store/use glucose in adipose tissue & muscles
  4. Stop gluconeogenesis
  5. Promote glycogen formation
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31
Q

2 routes of FA metabolism

A
  1. When CHO is available

2. When CHO is not

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32
Q

FA metabolism when CHO is available

A
  1. FFA -> acetyl coa
  2. citric acid cycle
  3. electron transport chain
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33
Q

FA metabolism when CHO is not available

A
  1. FFA -> acetyl coa

2. ketones

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34
Q

Ketones are…

A
  • Used for energy (brain)
  • Excreted in urine
  • Accumulates in blood
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35
Q

When are ketones produced?

A
  • Fasting / low glucose

- Insulin levels low enough

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36
Q

Where are ketones produced

A

In liver: FFA -> ketones

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37
Q

Where does gluconeogenesis happen?

A

liver

38
Q

Symptoms of hypoglycaemia

A
  • irritability
  • nervousness
  • sweating
  • anxiety, shakiness, rapid heart beat
  • hunger
  • weakness
  • headache
  • seizure, coma (overdose insulin)
39
Q

Diagnosis of hypoglycaemia

A
  • Display symptoms of hypoglycaemia AND

- Low blood glucose

40
Q

Types of hypoglycaemia

A
  1. Too much insulin (diabetes treatment)
  2. Reactive hypoglycaemia
  3. Fasting hypoglycaemia
41
Q

What is reactive hypoglycaemia?

A

When consuming CHO, insulin causes bld glucose to fall below normal

42
Q

What might cause reactive hypoglycaemia?

A

high insulin secretion

gastric emptying

43
Q

Treatment for reactive hypoglycaemia

A

small frequent meals
low sugars
high protein/fibre

44
Q

Cause of fasting hypoglycaemia

A

insulin secreting tumour

45
Q

What is the most common type of hypoglycaemia?

A

fasting hypoglycaemia

46
Q

What is fasting hypoglycaemia?

A

Having low blood sugar in the fasting state

47
Q

Symptoms of diabetes

A
  • excessive thirst
  • frequent urination
  • glucose in urine
  • blurred vision
  • frequent infections
  • poor wound healing
  • weight loss
  • pain/numbness in feet & legs
48
Q

Why is there glucose in the urine for diabetic people?

A

Kidney usually filters glucose from urine, but due to excessive glucose, kidney’s load is exceeded

49
Q

Type I diabetes

A

B cells destroyed by auto-immune process; insulin not secreted

50
Q

Types of diabetes

A
  1. type I
  2. type II
  3. gestational diabetes
51
Q

Gestational diabetes

A

Pregnancy causes stress on B cells -> decreased insulin secretion.
High blood glucose due to pregnancy.

52
Q

There are cutpoints for blood glucose. What are they based on?

A

Eat glucose -> measure blood glucose.

Certain marks indicate if normal, pre-diabetes, or diabetes.

53
Q

Diabetes is diagnosed by…

A

high blood glucose

54
Q

Diabetic retinopathy

A

Hemorrhages & aneurysms inside eye may cause blood clots. Blood clot lower O getting to eye. Eye will form more vessels to supply O, but those vessels are weak and break easily -> lead to blindness

55
Q

2 categories of diabetic retinopathy

A
  1. non-proliferative

2. proliferative

56
Q

Difference between non-proliferative & proliferative

A

Growth of abnormal blood vessels are only present in proliferative

57
Q

Treatment for retinopathy?

A

Laser: kills weak blood vessels

58
Q

Leading cause of blindness?

A

Diabetes

59
Q

Leading cause for kidney failure

A

diabetes

60
Q

Complications of diabetes

A
  1. Micro-vascular diseases
    Retinopathy
    Nephropathy
    Neuropathy (pain & numbness at extremities)
2. Macro-vascular disease
MI
Stroke
Poor circulation in feet and legs (amputation)
Increased infections (poor blood flow)
61
Q

Diabetes is related to what other health risk?

A

Obesity

62
Q

Trend of number of people with diabetes?

A

Increasing instances of diabetes

Rate of increase is faster than expected

63
Q

Is control of blood glucose necessary for type I diabetes?

A

Yes: controlling blood glucose reduces diabetes complications

64
Q

Treatment for type I diabetes

A

Intensive insulin therapy

Balance diet, exercise, insulin injections

65
Q

Intensive insulin therapy

A

3-4 insulin injections per day OR insulin pump

combine short & long acting insulins

66
Q

Insulin dose for type I diabetes is based on…

A

CHO consummed

Blood glucose monitors (checked 3-4 times per day)

67
Q

Usually, who gets type II diabetes?

A
  • Older people
  • Obese people
  • Obese children
68
Q

Ability of glucose to stimulate insulin is dependent on…

A

B cell function

69
Q

Ability of insulin to reduce glucose is dependent on…

A

insulin sensitivity

70
Q

Insulin sensitivity is dependent on…

A

genetics

obesity

71
Q

B cell function is dependent on…

A

Genetics

Obesity

72
Q

Good diet and exercise cause ___ insulin sensitivity and __ insulin secretion

A

Better

Lower

73
Q

Pregnancy cause insulin sensitivity to go…

and insulin secretion to go…

A

down

up

74
Q

When does pregnancy make mothers diabetic?

A

When she can’t secrete more insulin to compensate for the lack of sensitivity (maybe genetics)

75
Q

What will gestational diabetes predisposition you towards?

A

Higher risk for getting diabetes in the future

76
Q

What causes insulin resistance during pregnancy?

A

placental hormones

77
Q

Prevalence of gestational diabetes

A

Lower in non-Aboriginals

Higher in Aboriginals

78
Q

Complications due to gestational diabetes for mother

A

C-section
Pre-eclampsia
Birth trauma
Diabetes after pregnancy

79
Q

Complications due to gestational diabetes for infants

A 
Stillbirth
Birth defects
Macrosomia
Shoulder dystocia
Diabetes
80
Q

Pre-eclampsia

A

High BP

High protein in urine

81
Q

Macrosomia

A

Really heavy/big baby

82
Q

shoulder dystocia

A

head of baby can come out, but shoulder is stuck

83
Q

How to control complications of gestational diabetes?

A
  • Treatment with insulin
  • Diet, exercise
  • Examination of eyes, kidney, feet
84
Q

GDM treatment reduce risk for complications by…

A
  • Control blood glucose, lipids, BP

- Manage body weight

85
Q

Is there a diabetic diet?

A

No, just a normal “healthy” diet

86
Q

What has the Canadian diabetes association developed to help diabetics eat healthy?

A

Just the Basics

Beyond the Basics

87
Q

Just the Basics

A

simplified dietary plant:

  • use plate model to control portions
  • Limit simple sugars
  • More starch foods
  • Glass of milk & fruit every meal
  • Limit alcohol
88
Q

Plate model

A

1/2 vegetables
1/4 grains & starches
1/4 meat & alternatives

89
Q

Beyond the Basics

A

Foods divided into groups by CHO content by dietician.

Specific recommendations of how much CHO is consummed through fruits, meats, milk…etc.

90
Q

RDA for CHO

A

130g/day (amount brain uses)

Minimum amount

91
Q

AMDR for CHO

A

45-65%

92
Q

No more than __% of CHO consumed should be from refined sugars

A

25

NFS284 (16 decks)

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