Type 1 diabetes Flashcards
Prevalence of T1 in UK? Ref
7-8% - Whicher 2020
Cause of T1
An autoimmune diseases, where beta cells of the pancreas cannot produce insulin and leads to insulin resistance
Associated symptoms
- Weight loss
- Frequent urination
- Irritability
- Blurry vision
- Fruity breath due to high levels of ketones
Complications of T1
- hypoglycaemia and hyperglycaemia
- ketoacidosis
- neurological damage, specifically eyes, kidney, foot
What are the names of the most impacted neurological problems, and what causes them?
Retinopathy and nephropathy
- associated with high levels of HBA1c, therefore high levels of circulating glucose
Provide the ranges for fasting blood glucose levels
diabetic - 7<
pre - 5.6-7
healthy 3.9-5.5
Provide the ranges for post-prandial blood glucose levels
Diabetic - >11
Pre- 9-10.9
Healthy - 3.9-8.9
Provide ranges for HBA1c
Diabetic - >48%
Pre - 42-48%
Healthy - <42%
What component detaches from insulin chain, in presence of insulin
C-peptide
What measure can identify time within and out of range across a day
Continuous glucose monitor
What is ‘normal’ time in range’?
3.9-10mmol/L
What are the dangers associated with time out of range?
Hyperglycaemia and diabetic ketoacidosis
Hypoglycaemia
Symptoms of diabetic ketoacidosis event
- Sweaty breath
- Sick
- Coma
- Death
Symptoms of hypoglycaemia
- Sweating
- Paleness
- Lack of concentration
- Dizziness
This can lead to severe hypo - slurred speech, fainting, coma and death
What are the benefits of exercise for someone with T1
Improved insulin sensitivity
Reduced HbA1c levels - Umpierre, 2013
Improved beta cell function - Narendran, 2017
Reduced CVD risk
Improved QoL
What must someone with type 1 diabetes consider before exercising?
Insulin intake
CHO intake
Exercise type/intensity
What effect does aerobic exercise have on glucose levels?
- Large decrease during exercise - Yardley, 2012
- Followed by dramatic increase during recovery - Yardley, 2012
What effect does resistance training have on glucose levels?
- Smaller reduction in glucose levels, compared to aerobic - Yardley, 2012
- Smaller increase in recovery glucose - Yardley, 2012
- However, recovery increase in glucose after resistance dependent on number of reps and sets - Turner, 2015. This must be considered when analysing methodology
What should be considered when completing both aerobic and resistance exercise?
- Should consider glucose levels, to avoid hypo/hyper episode
- Usually resistance followed by aerobic
- this reduces the risk of nocturnal hypo - Yardley, 2012
- VV if significantly elevated glucose levels
When is it optimal for someone with type 1 diabetes to exercise
In the morning, which is beneficial on metabolism the following day and improves time in range - Gomez, 2015
What are the effects of HIIT on glucose levels
Smaller reductions in glucose due to greater number of recoveries
Provide a reference for why people with type 1 diabetes may not want to exercise
Kennedy 2018
