Type 1 Diabetes Flashcards
What is the onset of type 1 diabetes?
Sudden onset
Usually occurs in children (<18 years old)
Typically between ages 8-13 years old
What is the prevalence of type 1 diabetes in diabetes diagnosis?
8%
Is type 1 diabetes influenced by lifestyle?
No
What causes type 1 diabetes?
Beta cell functions stops producing insulin
Beta cells are effected by autoimmune response
Causes attacking on pancreas, the organ which releases insulin and causes inhabitation of insulin production
What are the main symptoms of type 1 diabetes prior to diagnosis?
Weight loss
Frequent urination
Irritability
Blurry vision
Fruity breath
What is the main main symptom of type 1 diabetes?
Fruity breath
How does type 1 diabetes control blood glucose ?
Exogenous insulin
What is the issue of a HbAIc test for testing type 1 diabetes?
The timing range could differ but will still lead to same average
Does not show variability
Makes it inappropriate for type 1 diabetes
How does the C-Peptide test determine type 1 diabetes?
Low C-Peptide (<0.51 ng/ml) and High blood glucose
What is ELSA testing?
Antibody testing for children
Early diagnosis of Type 1 in Children
How does ELSA testing determine likelihood of developing type 1 diabetes?
By the number of antibodies positive
1 antibody= lower risk
2 antibody= high risk
3 antibody= higher risk
4 antibody= highest risk
Why is prescribing exercise to type 1 diabetes challenging?
Muscle energy source uses:
1) ATP from C-Peptide initially
2) Glucose from muscle glycogen
3) Glucose from liver glycogen
4) Glucose from gluconeogenesis
Prolonged aerobic metabolism
- FFA and Ketones are the main fuel
Increasing intensity and duration increases glucose usage
- Mediated by falling insulin, increasing glucagon
- Intense exercise causes increase in catecholamines and later growth hormone
What are the effects of exercise on glucose in individuals with type 1 diabetes?
Aerobic exercise
- Expect a drop in glucose levels
Strength exercise
- Expect spikes in glucose levels
Mixed exercise
- Expect glucose levels to fluctuate, can drop or spike
What are internal barriers to exercise for people with type 1 diabetes?
Kennedy et al. 2018
Time and environmental
Social and Personal
Psychological
What are the medical barriers to exercise for people with type 1 diabetes?
Kennedy et al. 2018
Lascar 2014
Hypoglycaemia- Biggest fear
Lack of knowledge
Other health problems
Overwhelming by the diagnosis
Is exercise beneficial at reducing HbAIc in people with type 1 diabetes?
Umpierre et al. 2013
Yes
Can also lead to a preservation of B-Cell function
How does aerobic and resistance exercise effect glucose levels in individuals with type 1 diabetes?
Yardley et al. 2012
Resistance exercise resulted in much smaller declines in blood glucose during exercise than aerobic exercise or no exercise in individuals with type 1 diabetes
Resistance exercise was also associated with relatively stable early postexercise glucose concentration
Aerobic exercise was associated with greater increases in glucose levels during early recovery, which resulted in a trend toward higher glucose concentrations in late recovery
How does repeated resistance exercise influence glucose levels?
Turner et al. 2015
Blood glucose significantly climbs above rest for 1hour after 1/2 sets of resistance exercise but a 3rd set attenuated the exercise-induced hyperglycaemia and returns blood glucose levels
How does performing resistance exercise influence glucose levels depending if its performed before or after aerobic exercise?
Yardley et al. 2012
Perform resistance exercise first if they tend to develop exercise associated hypoglycaemia
- leads to lower reliance on glucose supplementation during exercise
- decreases the severity of potential nocturnal hypoglycaemia
How does performing resistance exercise influence glucose levels and hypoglycaemia depending if its performed in the morning or afternoon?
Gomez et al. 2015
Significantly fewer hypoglycaemic events if the exercise was conducted in the morning
Most episodes of postexercise hypoglycaemia occur between 15 and 24 hours after the cessation of exercise
Exercise in the morning improves metabolic control on the subsequent day and maintains patients in the euglycemic range for a longer time
How does intermittent high-intensity exercise influence glucose levels compared to moderate exercise?
The decline in blood glucose is less with intermittent high-intensity exercise during both exercise and recovery
however
the risk of hypoglycaemia is increased with moderate exercise
What influences the effect of resistance exercise on glucose levels?
Volume of exercise
- sets
- volume
What is ICE?
Insulin
Carbohydrate
Exercise type
Why do you have fruity breath when you have type 1 diabetes?
Ketones level are higher when glucose levels are increased repetitively
What is the energy source order during exercise?
Muscle energy source uses:
1) ATP from C-Peptide initially
2) Glucose from muscle glycogen
3) Glucose from liver glycogen
4) Glucose from gluconeogenesis
What is Hyperinsulinemia?
Happens when you have a higher amount of insulin in your blood than what is considered normal
