Week 2: Nutrition & Diabetes Flashcards
What is the role of insulin?
Signals high nutrient availability and the time to utilize glucose while building energy stores
As glucose rises and insulin rises, what happens in adipocytes?
GLUT4 transporters move to the surface, increasing glucose uptake.
Lipoprotein lipase activity in capillaries is activated, increasing uptake of fatty acids from chylomicrons and VLDLs.
Lipogenesis is activated; increasing storage of triacylglycerol (fat)
Intracellular lipolysis is inhibited, decreasing the amount of fatty acids released.
With increase in glucose and increase in insulin, what happens in the muscle cells?
GLUT4 transporters move to the surface of adipocytes, increasing glucose uptake
Glycogen synthesis is activated, increasing muscle glycogen
Glycolysis is activated; increasing use of glucose to generate ATP
Protein synthesis is activated
Fatty acid oxidation is inhibited
With increase in glucose and then insulin that occurs in the liver?
Glycogen synthesis is activated, increasing liver glycogen stores
Glycolysis is activated, increasing glucose oxidation for ATP generation
Lipogenesis is activated, increasing synthesis of fatty acids, triacylglycerols and cholesterol
Glycogen breakdown and gluconeogenesis are both inhibited, decreasing glucose secretion
Fatty acid oxidation is inhibited
One hour after eating, what processes occur in our body?
Glycogen synthesis and Glycolysis
After eating a meal of mixed energy sources (carbs, proteins, fats), what process is inhibited in adipocytes?
Lipolysis and then subsequently fatty acid oxidation
Define Type 1 diabetes
Front of card
Type 1 diabetes
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Back of card
Autoimmune destruction of pancreatic beta cells results in not being able to secrete enough insulin. While this most commonly occurs in children, it can present in any decade of life. Patients with type 1 diabetes must take exogenous insulin to prevent diabetic ketoacidosis. Hypoglycemia caused by injecting too much insulin relative to the amount of carbohydrate consumed can be acutely deadly
Define Type 2 diabetes
A combination of insulin resistance and insufficient insulin secretion to overcome the resistance causes type 2 diabetes. While obesity causes insulin resistance, and many people with type 2 diabetes also have obesity, not all patients do. The mechanisms causing insulin resistance are complex. Ultimately insulin resistance means that the signal from insulin binding its receptor on the cell surface doesn’t alter metabolic enzyme activity as it should.
Define gestational diabetes
Pregnancy is naturally a state of insulin resistance, which provides maternal fuels for use by the growing fetus. In a woman with gestational diabetes, the pancreas secretes insufficient insulin to overcome the resistance and blood glucose levels rise above a healthy level. Women who experience gestational diabetes are at increased risk for developing type 2 diabetes later in life.
How does gestational diabetes affect a person’s likelihood of developing Type 2 later on?
A previous diagnosis with gestational diabetes indicates that one’s pancreas is unable to secrete secret enough insulin under conditions when insulin demands increase. Recent studies suggest that a prior diagnosis of gestational diabetes increases one risk of developing type 2 diabetes by almost 10 fold.
Symptoms of hyperglycemia
Dry mouth, Blurred vision, Increased thirst, frequent urination
Symptoms of hypoglycemia
Irritability, pallor, sweating, sleepiness, lack of coordination, hunger
What are the goals of Medical Nutrition Therapy?
(1) Creation of a personal food plan and support in achieving that plan (planning meals, purchasing appropriate foods, preparing meals, proportioning foods).
(2) Ongoing weight management support and coaching
(3) Development of a food plan for managing related complications and comorbidities such as hypertension, celiac disease, gastroparesis, eating disorders/disordered eating, kidney disease, disorders of lipid metabolism, etc.
NO SUCH THING AS A DIABETIC DIET
A woman with gestational diabetes should try to follow what nutritional guidance?
Distribute carbohydrates throughout the day
Infants of diabetic mothers whose blood glucose has not been well controlled during pregnancy are often large for gestational age and at high risk for neonatal hypoglycemia. Why?
Elevated maternal glucose stimulates fetal beta cell hypertrophy and hyperplasia. This increases fetal insulin secretion and insulin is a potent anabolic, growth hormone.
An overweight 8-year-old boy was evaluated following a bicycle accident. He was found to have a ruptured spleen. Lab studies also revealed a blood glucose of 350 mg/dL. What is the most likely cause of his blood glucose value?
Normal response to trauma
Physical activity is an important part of diabetes management. Muscles working at a moderate level of exertion use which of the following macronutrients as a fuel source? Choose all that apply.
- Blood glucose
- Fatty acids released from adipocytes
- Triacylglycerol in muscle
- Fatty acids released from lipoproteins in blood
- Glycogen in muscle
