Week 4 Impact of Lifestyle on DB Prevention and Management Flashcards

1
Q

what is your increase in risk if both parents have T2DM?

A

6x

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2
Q

Define Epidemic

A

incidence of a disesase substantially exceeds what is expected based on recent experience

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3
Q

what condition is the largest risk factor for developing T2DM

A

pre-diabetes (3-5x higher risk for developing T2DM)

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4
Q

in general, what accounts for the vascular issues associated with diabetes?

A

Chronic hyperglycemia plays a major role in the initiation of diabetic vascular complications through many metabolic and structural derangements

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5
Q

what are the microvascular issues associated with DM?3

A

neuropathy, nephropathy, retinopathy….note: it makes sense that these issues could arise in T1DM as there is also chronic hyperglycemia

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6
Q

what are the macrovascular issues associated with DM?

A

cardio (CVD, HTN) and cerebrovascular disease (stroke)

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7
Q

what are some behavioral risk factors associated with T2DM? 5

A

obesity, sedentary life, smoking, Short (9hours) sleep, poor diet

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8
Q

An individual with impaired glucose tolerance or mild insulin resistance is often classified as ….

A

pre-diabetic

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9
Q

what is primary prevention of diabetes?

A

preventing the disease. reversing pre-diabetes to prevent full blown diabetes

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10
Q

what is secondary prevention of diabetes?

A

limit the complication associated with diabetes

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11
Q

what is tertiary prevention of diabetes

A

decrease disabilities or prevent death brought about by diabetes complication

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12
Q

define pre-diabetes

A

a reversible cardio metabolic risk factor in which plasma glucose levels are above normal but not high enough to diagnose T2DM

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13
Q

what is the A1C assocaited with pre-diabetes?

A

between 5.7 and 6.4%

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14
Q

is pre-diabetes a benign condition?

A

no, if your have IGT/IFG you still are at risk for other complications (CVD)

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15
Q

define IGT:

A

two-hour glucose level of 140 to 199 mg/dL after a person drinks 75 g gluocse solution following an overnight fast

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16
Q

what were the outcomes of the diabetes prevention program study? what was the set-up?

A

three groups: placebo, metformin, lifestyle change each with pre-diabetes (IFG or IGT). lifestyle had the largest reduction in risk of developing diabetes, then metformin, then placebo. 1 kg weight loss resulted in 16% reduction in incidence of T2DM

17
Q

is metformin useful across all BMIs?

A

no, metformin was shown to only significantly reduce risk in individuals with a BMI > 35

18
Q

What was the study question in the Look AHEAD study?

A

will intentional weight loss (intensive lifestyle intervention) reduce the incidence of fatal and nonfatal cardiovascular and cerebrovascular events

19
Q

what was the goal of the “intensive lifestyle intervention” in the Look AHEAD study?

A

lose 7-10% of initial body weight: physical activity, diet, weight loss pills

20
Q

What were the results of the Look AHEAD study?

A

their ABCs were better (lower A1C, lower blood pressure, lower cholesterol)

21
Q

the ABCs of T2DM are…

A

the major risk factors for CVD

22
Q

medical nutrition therapy of T2DM should accomplish (4)

A

decrease caloric intake, weight management, consistency in carb intake (avoid erratic blood sugars and hypoglycemia), nutritional content

23
Q

Independent of weight loss, what were the findings in altering macronutrient composition of a diabetic diet?

A

little evidence that altering macronutrient composition of diet has significant effect on glycemic control. there is not ideal diet. diets should be individualized

24
Q

what is the physical activity recomendation for all adults?

A

30 min PA/day ~5days/wk

25
Q

what is the “Legacy Effect”

A

early glucose control has a continued positive effects in years (10 years) to come