Pre Diabetes & Type 2 Diabetes - Lecture 24 Flashcards
4 Main Subtypes of Diabetes
Type 1, 2, Gestational Diabetes and Secondary Diabetes.
Type 1 Diabetes old names
Insulin Dependent, Juvenile-onset (not true anymore)
Type 2 Names old names
Adult-onset, Non-insulin dependent (not true anymore)
What is Secondary Diabetes
Side effects of medication.
What is the most common trait amongst the 4 diabetes
They all mean high blood sugar
What is the most common type of diabetes
Type 2 (90% of cases)
What’s does the term diabetes mean in latin
Sugar in the urine
What does pre-diabetes mean
Not diabetes, but having symptoms correlating to it.
What percent of Canadians are living with diabetes
30% (Most Type 2 and pre-diabetic)
How much does diabetes cost Canada/yr
3.8 Billion/yr destroying health care systems.
What is causing the expensiveness
The symptoms that come with diabetes, not the diabetes itself.
What are some symptoms of diabetes
Blindness, Kidney failure, nerve damage, etc.
What are the 2 key factors associated with developing T2D amongst males and females
Age and Ethnicity
Why is age a factor?
The risk of getting it increases exponentially as you age.
How is ethnicity a factor?
The genetics you have may predispose you and environment you’re placed in.
Does Diabetes reduce life expectancy?
Yes
Does Duration of disease predict mortality
No
Compared to Europeans what risk do Asians, South Asians and Carribeans have for Diabetes
Much higher risk for the ethnicities and ages listed
What about BMI and Diabetes Risk
Predicts some of the risk, but not all. Cutoffs for BMI are different for every ethnicity is different so risk is higher for some.
Estimated Risk of Developing Diabetes if born in 2000
32.8% Males and 38.5% Females in the US
Individuals diagnosed with diabetes have reduction in life expectancy. True or False?
True; but decrease in life expectancy depends on when you’ve been diagnosed with it.
Symptoms of T2D
- Central Obesity (Excess Visceral Fat)
- Unexplained weight loss (catabolization of glucose)
- Frequent Urination
- Thirst
- Fatigue
- Frequent Infection (risk goes up)
- Blurred Vision
Risk Factors for T2D
- Previous Prediabetes
- Overweight
- 45+ years of age
- Physical Inactive
- Family with T2D
- Had Gestational Diabetes or birth of a large baby
Difference between HbA1c and Oral Glucose Test
HbA1c does not require fasting prior to taking the test
How does HbA1c Test work?
Checks your Hb molecule for sugar coated on it. More sugar coating means more sugar in bloodstream
How does Oral Glucose Test work
Prick finger, check blood then drink juice and check after several minutes.
What is normal blood sugar on the HbA1c test?
Below 5.7%
What is pre diabetic number on HbA1c test?
Between 5.7-6.4%
What is diabetic number on HbA1c test?
6.5% and higher
What number on the oral glucose test confirms Diabetes
> 11.1 mM
Is the Oral Glucose Test the Gold Standard?
Yes; best for diagnosis but takes some time.
What does your glucose levels during fasting have to be to determine diabetes?
7.0 mmol/L
What does random glucose have to be in order to possibly have diabetes?
If glucose is randomly 11.1 then should get a proper check
How does T2D work?
- It makes the body insulin resistance (body resists the insulin it makes)
- Insulin sensitivity
Key and Lock Mechanism T2D
You have a lot of keys but none of them work on the door (insulin receptor)
Do people with T2D immediately start with insulin injections?
No; they take oral medications at first to improve the insulin getting into the receptor
Why do T2D patients take insulin later in life
Body starts to become insulin sensitive, so not enough insulin gets produced to fight the insulin resistance
Summary: What are the two problems that need to be fixed for T2D
Make enough insulin for signalling and make more doors to let glucose in.
What does exercise do for the two problems
Increases the likelihood of repairing the problem
What are the purpose of the plaques that develop in the pancreas in T2D
They cause insulin secretion to decrease; as well as stimulate the over production of the hormone glucagon
How can we fight back against T2D
Start to exercise and eat healthy when your insulin levels start to decrease.
What are the levels of insulin production, resistance and glucose production like for someone with pre-diabetes
Insulin resistance starts to increase, insulin production peaks and decreases, and glucose production starts to increase.
Can you reverse the conditions of someone in pre-diabetes
Yes; but once T2D its significantly harder to bring them back to normal.
What is the insulin production like for a healthy individual after a meal
After a meal theres a high release of insulin and then after a while a second smaller release for anything you eat after the meal.
What is insulin production like for an early T2D or late T2D
Insulin is hardly produced after the meal but produced for second phase. For late insulin first phase and second phase are skipped.
Why is best to push A1C% levels down
Increase in A1C is related to pre-mature risk for co-morbidities
T2D develops in multiple organs
There are several organs that actually contribute to the development of T2D
- Intestines
- Neurotransmitter dysfunction
- Pancreas (increased glucagon and decreased insulin)
- Muscle uptake decreases
- Lipid in bloodstream make insulin more resistance
- Increase uptake of glucose in kidneys
New England Journal Study on T2D
Took 3234 people living with pre-diabetes and randomized them to take a sugar pill, metformin, and change lifestyle
What is Metformin?
It works on the liver to make it less responsive to glucagon. Good with people who have T2D.
What did the study show?
Risk of developing T2D with lifestyle interventions was less compared to people who took Metformin or the placebo.
How much of a risk reduction was there in this group?
68% risk reduction
How can we manage T2D if we’re living with it
- Weight loss (caloric restriction; less simple carbs)
- Exercise Training (if weight loss doesn’t occur)
- Blood Sugar Monitoring
- Diabetes medications including insulin therapy
How many different medications are there for T2D?
12
Why are there so many medications for T2D
Because multiple organs are adding to blood sugar, so different medications target different organs.
What did DARE Trials Study show with exercise decreasing A1C levels
A combination of both aerobic and resistance decreased A1C levels.
