Week 4 Impact of Lifestyle on DB Prevention and Management Flashcards
what is your increase in risk if both parents have T2DM?
6x
Define Epidemic
incidence of a disesase substantially exceeds what is expected based on recent experience
what condition is the largest risk factor for developing T2DM
pre-diabetes (3-5x higher risk for developing T2DM)
in general, what accounts for the vascular issues associated with diabetes?
Chronic hyperglycemia plays a major role in the initiation of diabetic vascular complications through many metabolic and structural derangements
what are the microvascular issues associated with DM?3
neuropathy, nephropathy, retinopathy….note: it makes sense that these issues could arise in T1DM as there is also chronic hyperglycemia
what are the macrovascular issues associated with DM?
cardio (CVD, HTN) and cerebrovascular disease (stroke)
what are some behavioral risk factors associated with T2DM? 5
obesity, sedentary life, smoking, Short (9hours) sleep, poor diet
An individual with impaired glucose tolerance or mild insulin resistance is often classified as ….
pre-diabetic
what is primary prevention of diabetes?
preventing the disease. reversing pre-diabetes to prevent full blown diabetes
what is secondary prevention of diabetes?
limit the complication associated with diabetes
what is tertiary prevention of diabetes
decrease disabilities or prevent death brought about by diabetes complication
define pre-diabetes
a reversible cardio metabolic risk factor in which plasma glucose levels are above normal but not high enough to diagnose T2DM
what is the A1C assocaited with pre-diabetes?
between 5.7 and 6.4%
is pre-diabetes a benign condition?
no, if your have IGT/IFG you still are at risk for other complications (CVD)
define IGT:
two-hour glucose level of 140 to 199 mg/dL after a person drinks 75 g gluocse solution following an overnight fast
what were the outcomes of the diabetes prevention program study? what was the set-up?
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
is metformin useful across all BMIs?
no, metformin was shown to only significantly reduce risk in individuals with a BMI > 35
What was the study question in the Look AHEAD study?
will intentional weight loss (intensive lifestyle intervention) reduce the incidence of fatal and nonfatal cardiovascular and cerebrovascular events
what was the goal of the “intensive lifestyle intervention” in the Look AHEAD study?
lose 7-10% of initial body weight: physical activity, diet, weight loss pills
What were the results of the Look AHEAD study?
their ABCs were better (lower A1C, lower blood pressure, lower cholesterol)
the ABCs of T2DM are…
the major risk factors for CVD
medical nutrition therapy of T2DM should accomplish (4)
decrease caloric intake, weight management, consistency in carb intake (avoid erratic blood sugars and hypoglycemia), nutritional content
Independent of weight loss, what were the findings in altering macronutrient composition of a diabetic diet?
little evidence that altering macronutrient composition of diet has significant effect on glycemic control. there is not ideal diet. diets should be individualized
what is the physical activity recomendation for all adults?
30 min PA/day ~5days/wk
what is the “Legacy Effect”
early glucose control has a continued positive effects in years (10 years) to come
