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HUNT 243 > Practical 8 - Diabetes Lecture > Flashcards

Practical 8 - Diabetes Lecture Flashcards

1
Q

type 1 diabetes is managed through

A

medication mostly, but also food choice and physical activity

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2
Q

type 1 diabetes makes up what % of diabetes cases

A

10%

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3
Q

type 1 diabetes is an

A

autoimmune condition where the body attacks the cells that make insulin, which means not enough is created

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4
Q

type 1 diabetes is mostly diagnosed when

A

in children

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5
Q

type 2 diabetes makes up what proportion of diabetes cases

A

90%

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6
Q

what happens in type 2 diabetes

A

cells either don’t produce enough insulin or dont recognise that insulin is present

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7
Q

when is type 2 diabetes usually diagnosed

A

mostly diagnosed in adults, but increasing numbers of children and teenagers are being diagnosed

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8
Q

after we eat glucose appears in

A

the bloodstream

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9
Q

when glucose appears in the bloodstream what is released in response

A

insulin

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10
Q

when insulin receptors detect insulin what happens

A

insulin causes translocation of glucose transporters to the surface of the cells

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11
Q

what happens when glucose transporters are translocated to the surface of cells

A

glucose is taken into cells and blood glucose declines

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12
Q

what are the issues that occur in the glucose / insulin relationship in type 1 diabetes

A

no, or very little insulin is produced

glucose stays in the blood stream

not enough glucose gets into the cells and organs that need it for energy

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13
Q

what happens in a state of insulin resistance

A

insulin receptors stop responding appropriately to insulin

more insulin is needed to trigger translocation of glucose transporters

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14
Q

insulin is continued to be produced in insulin resistance because why

A

blood glucose remains high after a meal because glucose transporters are unable to transport it into the cells so the body continues to produce insulin to try and help

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15
Q

what occurs in response to defective insulin response, and after a while what starts to rise (also eventually or simultaneously what occurs)

A

hepatic gluconeogenesis

fasting glucose levels begin to rise

beta cells atrophy and insulin production slows

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16
Q

what happens when you have too much glucose in your blood

A

glucose travels to the kidney

causing osmotic diuresis and polyuria

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17
Q

polyuria leads to

A

dehydration and polydipsia, and polyphagia

18
Q

what is HbA1c

A

glycated haemoglobin

19
Q

higher concentrations of blood glucose overtime results in an

A

increase in the glycation of hemoglobin molecules (addition of glucose molecule to amino acid side chain)

20
Q

HbA1c is a measure of

A

glycemic (blood sugar) control over previous 2-3 months

21
Q

what are the HbA1c cut offs for diagnosing type 2 diabetes in NZ

A

> 50mmol/mol = diabetes

41-49mmol/mol = pre diabetes

<40mmol/mol = diabetes unlikely

22
Q

what are the HbA1c cut offs for diagnosing type 2 diabetes internationally

A

> 48mmol/mol = diabetes

42-47mmol/mol = pre diabetes

<41mmol/mol = diabetes unlikely

23
Q

what proportion of NZ had type 2 diabetes

A

somewhere between 5-7%

24
Q

what proportion of NZ population have prediabetes

A

~20% of the population

equivalent to 2/3 of auckland

25
Q

what are the long term health consequences that can be a result of diabetes

A
  • stroke
  • blindness
  • heart attack
  • kidney failure
  • amputation
26
Q

what are the risk factors for diabetes

A
  • High BMI
  • family history
  • PCOS
  • CVD
  • long term use of oral corticosteroids
  • severe mental illness
  • gestational diabetes
27
Q

risk of diabetes increases with what

A

increasing BMI

28
Q

what lifestyle changes will help reduce the risk of type 2 diabetes

A
  1. reduce energy intake
  2. increase physical activity
  3. increase fibre intake
  4. reduce total and saturated fat intake
29
Q

how does weight gain contribute to diabetes risk (positive energy balance)

A

being in a state of prolonged positive energy balance is associated with increased fat accumulation around muscle and organs, and increased inflammation, both of which are known to decrease peripheral insulin sensitivity

30
Q

how does weight gain contribute to diabetes risk (increased triglyceride storage)

A

increased triglyceride storage in the liver (due to prolonged excess energy intake) reduces hepatic insulin sensitivity

31
Q

how does weight gain contribute to diabetes risk (exposure of beta cells)

A

exposure of beta cells to fatty acids increases the rate of cell death and decreases insulin production

32
Q

lifestyle interventions that incorporate a moderate physical activity component reduce incidence diabetes by

A

28-63% participants with impaired glucose tolerance

greater reductions are seen when the intervention also induces weight loss (but exercise alone is still effective)

33
Q

in obese prevention the goal of 150 min a week is probably …..

A

not enough …. need to be closer to 60 mins per day

34
Q

most common suggestion of physical activity to reduce the risk of diabetes

A

being physically active helps to prevent obesity

physical activity can influence diabetes risk both in the presence and absence of obesity

35
Q

what is the effect of exercise

A

exercise increases skeletal muscle insulin sensitivity

muscle contraction can cause translocation of GLUT 4 without insulin

36
Q

how does physical activity reduce the risk of diabetes

A
  • improved endothelial function and capillarization
  • increased mitochondiral biogenesis and fibre ratios
  • improved muscular respiratory capacity and fatty acid oxidation
  • increased expression and activity of GLUT 4 and glycogen synthase
37
Q

what is the types of carbohydrates and their associated outcomes

A

higher consumption of sugars associated with poorer outcomes

higher consumption of starch associated with better outcomes

38
Q

what is the recommended intake of sugar

A

<10% total energy

39
Q

what is the outcomes associated with sugar

A

increased body weight

increased rate of dental caries

40
Q

fibre lowers the risk of

A

mortality

CVD

CHD

cholorectal cancer

41
Q

fibre improves

A

body weight, blood pressure and cholesterol

42
Q

WHO recommends what for fibre intake

A

at least 25 grams per day of naturally occurring dietary fibre as consumed in foods

HUNT 243 (31 decks)

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