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Chronic Disease > Type 2 Diabetes > Flashcards

Type 2 Diabetes Flashcards

1
Q

What is type 1 diabetes?

A

Beta-cells which make insulin are destroyed, common in childhood

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2
Q

What is type 2 diabetes?

A

Insulin resistance and beta cell dysfunction, most common in obesity

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3
Q

What are the 2 hybrid forms of diabetes?

A

Slow evolving immune-mediated diabetes of adults

Ketosis-prone type 2

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4
Q

What is slowly evolving immune mediated diabetes of adults?

A

Features of a metabolic syndrome

GAD autoantibody

Retains greater b-cell function

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5
Q

What is ketosis prone diabetes?

A

Presents with ketosis and insulin deficiency

Not immune-mediated

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6
Q

What are monogenic diabetes

A

Specific gene mutation

Determines chances of development and treatment

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7
Q

What is the diagnostic criteria for diabetes?

A

Fasting plasma at more than 7.0mmol/L

Hba1c at more than 48mmol/mol

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8
Q

What is Hba1c?

A

How much glucose is attached to the haemoglobin in the red blood cells

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9
Q

How is type 2 disease a complete trait?

A

Involves both genetic predisposition and life style choices

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10
Q

How many specific gene loci were associated with gene loci?

A

Over 600

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11
Q

What is the function of FTO gene?

A

Increase weight and BMI

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12
Q

What increases the genetic risk of type 2 diabetes?

A

Having multiple polymorphisms that are associated with disease risk.

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13
Q

Recent studies have tried to put a number on the effect of diet compared to genetic risk of type 2 diabetes, how is this done?

A

Novel polygenic scores to evaluate the presence of additive or multiplicative gene or diet interactions on the development of T2D

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14
Q

What was the result of the polygenic risk score study for type 2 diabetes?

A

For each Standard Deviation of the polygenic risk score your risk of T2D increased by 29%

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15
Q

According to the polygenic risk score study how much do genetics which affect the beta cell dysfunction increase the risk of type 2 diabetes?

A

26%

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16
Q

According to the polygenic risk score study how much do genetics which affect the impaired insulin synthesis increase the risk of type 2 diabetes?

A

14%

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17
Q

According to the polygenic risk score study how much do genetics which affect the obesity mediated insulin resistance increase the risk of type 2 diabetes?

A

9%

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18
Q

According to the polygenic risk score study how much do genetics which affect the body fat distribution increase the risk of type 2 diabetes?

A

23%

19
Q

According to the polygenic risk score study how much do genetics which affect the lipid or hepatic metabolism increase the risk of type 2 diabetes?

A

11%

20
Q

How to assess diet quality?

A

AHEI score

Alternative healthy eating index

21
Q

According to the polygenic risk score study how much does a lower diet quality increase?

A

Estimated at 30% for low, intermediate, high genetic factors.

Found to not significantly be connected

22
Q

Does healthy diet reduce the risk of type 2 diabetes?

A

Found to decrease the risk of diabetes by 30% for all genetic risk individuals.

23
Q

Is insulin resistance the same for the whole population?

A

No some individuals can have higher insulin resistance but their pancreas matches that of

24
Q

What is the function of insulin in the muscles?

A

Glucose uptake and storage increases

This is called glycogenolysis

25
Q

What is the function of insulin on the liver?

A

Increase glucose storage

Decrease glucose production (glycogenesis)

26
Q

What is the function of insulin in adipose tissue?

A

Decrease fat breakdown (lipolysis)

27
Q

What is the single cause that links insulin resistance and impaired beta cell function

A

Dysregulation in storage of fat (in the liver)

28
Q

What is the twin cycle hypothesis?

A

An acute negative energy balance (surgery eg) will normalise insulin sensitivity and restore normal insulin response

29
Q

What is a normal amount of liver fat?

A

Less than 5%

30
Q

Where is the first place fat is moved from when an individual loses a significant amount of weight?

A

The liver

31
Q

Can weight loss surgery affect muscle insulin sensitivity?

A

No, only affected by genetics and physical activity.

32
Q

Why use a liquid diet for weight loss?

A

Safe and effective

Complete nutrition

Lack of hunger

Complete break from food decision

Motivation from rapid weight loss

Break habits

Triggers stand out

Blank slate

33
Q

Does liquid diet work for diabetes remission

A

Yes due to high weight loss

34
Q

What does it mean for someone to be in diabetes remission?

A

Must be measured at least 3 months after stopping glucose lowering medications

Hba1c below 48mmol/mol

35
Q

Main principles of remission.

A

Type 2 diabetes

More likely in short duration

Significant weight loss

Not a cure

Maintaining lower weight

36
Q

Why could some people not achieve remission?

A

Insufficient weight loss

Damage to beta cells too high

Going back to old habits

37
Q

How long does remission last after bariatric surgery?

A

5 years

38
Q

How long did the liquid low calorie diet offer remission?

A

2 years

39
Q

Why is temporary remission worth it?

A

People who achieved it even for short periods of time continued to benefit from lower exposure to hyperglycaemia lower the risk of cardiovascular disease

Requires weight loss of 10%

40
Q

How many people with a BMI over 40 don’t have diabetes?

A

70%

41
Q

What percentage of T2D people have a normal BMI?

A

15%

42
Q

What is the personal fat threshold hypothesis?

A

Proposes that we all have a level of body fat that we can cope with and if we go above me increase our risk of type 2 diabetes even if not overweight.

43
Q

For normal BMI participants what was the level of remission for the weight loss study?

A

70%

Chronic Disease (15 decks)

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