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Pathophysiology I: Exam I > Obesity, Diabetes, and the Metabolic Syndrome > Flashcards

Obesity, Diabetes, and the Metabolic Syndrome Flashcards

1
Q

Components of the metabolic syndrome

A
  • Obesity
  • Hyperlipidemia
  • Coronary artery disease
  • Fatty heart (also liver)
  • Hypertension (high blood pressure)
  • Insulin resistance
  • Diabetes type II
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2
Q

Diabetes = High blood glucose levels

> ?

A

126 mg/dl or greater with fasting
glucose test

  • supposed to be 24 hours
    (guidelines) , but most go by 12 hours*
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3
Q

What is metabolic syndrome?

A

Insulin resistant syndrome linked to obesity

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4
Q

What is BMI?

A

Body weight in KG divided by height in meters squared

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5
Q

Formulas used in determining risk (?)

A
  1. BMI
  2. WHR (waist hip ratio)
  3. abdominal circumference only
  4. liver fat content
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6
Q

WHR

how to measure

A
  • Waist measured at the most narrow part of torso above umbilicus and below xiphoid
  • Hip measured at the max circumference of hips or buttocks
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7
Q

BMI

underweight

A

< 18.5

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8
Q

BMI

normal

A

18.5-24.9

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9
Q

BMI

overweight

A

25-29.9

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10
Q

BMI

obese (Class I)

A

30-34.9

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11
Q

BMI

obese (Class II)

A

35-39.9

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12
Q

BMI

obese (Class III)

A

>40

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13
Q

unused energy →

A

fat deposition

doesn’t matter what type of intake

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14
Q

How many calories in a pound?

A

3500

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15
Q

Cals per gram

fat

A

9

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16
Q

Cals per gram

carbs

A

4

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17
Q

Cals per gram

protein

A

4

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18
Q

Cals per gram

alcohol

A

7

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19
Q

diabetes

Casual plasma glucose

A

above 200 mg/dl

casual, not fasted

20
Q

diabetes diagnosis

Fasting plasma glucose

A

above 126 mg/dl

21
Q

75g glucose load test

A

2 hour test

measure at the end of an hour and then after 2 hours

measure above 200 mg/dl

22
Q

Pre-diabetic numbers

A

above 100 mg/dl

23
Q

Hb1ac is a measure of:

A

measure of average blood glucose over 2-3 months (6% = 126 mg/dl)

better to see the big picture

24
Q

Hb1ac

normal value

A

below 5.7%

25
Q

Hb1ac

pre-diabetic value

A

5.7 to 6.4%

26
Q

Hb1ac

diabetic

A

6.5% or higher

27
Q

What is type I

used to be called juvenile diabetes

A

IDDM: insulin dependent diabetes mellitus

Autoimmune destruction of β cells

28
Q

Type II diabetes

A
  • NIDDM
  • Relationship with obesity
    • Decreased number of insulin receptors
  • Mobilization of fat in the body
  • Protein depletion for energy
29
Q

Diabetes:

kidney effects

A
  • increased kidney filtration of glucose (DAMAGES KIDNEYS, large molecules going through)

↓↓↓↓↓

  • increased thirst
  • increased urination
30
Q

acidosis

A

increase acidity in the blood

Fat metabolism replacing carbohydrate- increases acidity from 1 to 10 mEq/liter

31
Q

acidosis

S/S

A
  • Rapid and deep breathing
  • fruity breath
  • ketone formation
  • coma
  • death
32
Q

pancreas functions

A
  1. endocrine (glands)
  2. digestive (fat storage)
33
Q

pancreas

digestion

A
  • acinar cells
    • secrete digestive enzymes
34
Q

pancreas

hormone secretion

A
  • Islets of Langerhans
  • Insulin and glucagon
35
Q

Islets of Langerhaans

3 major types of cells

A
  • Alpha- secrete glucagon
  • Beta- secrete insulin
  • Delta- secrete somatostatin
36
Q

Effects of Insulin binding to cell

(glucose, membrane, transcription, metabolic activity)

A
  • Glucose permeable to 80% of cells within seconds
  • Membrane permeable to amino acids, potassium, phosphate
  • DNA and RNA transcription of new proteins
    • Slower process
  • Intracellular metabolic activity
    • Slower process
37
Q

normal blood glucose

fasting

A
  • 80-90 mg/dl
  • Minimal insulin secretion-25 ng/min/kg weight
38
Q

blood glucose

Increased glucose- 2 to 3 X normal

A
  • Results in 10 fold increase in insulin in 3 to 5 minutes, returns to resting after 5 to 10 minutes
  • Negative feedback loop- triggered at 100 mg/dl
  • 15 minutes after initial secretion second increase which will plateau in 2 to 3 hours
39
Q

insulin resistance due to obesity

glucose absorption

A
  • Cells that normally use insulin to allow entrance of glucose do not function properly- insulin resistance
40
Q

insulin resistance due to obesity

lipid synthesis

A

However, insulin stimulated lipid synthesis (another role of insulin) occurs at increased rate due to an increase in lipid producing enzymes

41
Q

treatment goals

BMI

A

below 25%

42
Q

treatment goals

BP

A

below 125/75

43
Q

treatment goals

LDL

A

below 100 mg/dl

44
Q

treatment goals

triglycerides

A

below 150 mg/dl

45
Q

treatment goals

HDL

A
  • HDL above (men) 40 mg/dl (women) 50 mg/dl
  • HDL above 60 mg/dl for all
46
Q

treatment goals

blood glucose

A

below 100 mg/dl

Pathophysiology I: Exam I (6 decks)

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