Week 5 - Diabetes, Obesity Flashcards
What is the main causes of diabetes?
Diet and exercise
Uncontrolled diabetes leads to
Heart attacks Strokes Blindness Deafness Amputations Kidney failure Burning foot syndrome Impotence
5-10% Americans diagnosed with diabetes have this type:
Type I
Failure to produce insulin
T/F exposure to cow’s milk protein may be important factor in development of type I diabetes
True
Cow’s Milk Hypothesis
1. Combines genetic vulnerabilities, exposure to cow’s milk proteins, and viral exposures
- Under certain conditions, cow’s milk proteins pass from gut to the bloodstream, eliciting production of antibodies.
- Antibodies then attack not only the milk proteins but also pancreatic beta-cell proteins that are structurally similar to those in cow’s milk.
- Viral infections cause these beta-cell proteins to be exposed to the antibodies.
- During viral infections over the next several years, intermittent antibody attacks gradually destroy the beta cells.
Describe type II diabetes
Insulin resistance (body fails to properly utilize insulin) combined with insulin deficiency
What % of diagnosed people with diabetes have Type II diabetes?
> 90%
What % of pregnant women in the US get gestational diabetes?
4%
Metabolic syndrome is a cluster of metabolic disorders that starts with insulin resistance at the core:
Insulin resistance Dyslipidemia Hypertension Obesity Glucose intolerance
What are the 3Ps of diabetes?
Polydipsia - thirst
Polyuria - urination
Polyphagia - hunger
Other signs of diabetes
Slow-healing sores/cuts Itching skin around vagina or groin Frequent yeast infections Recent weight gain Velvety dark skin changes of neck, armpit, groin Diabetic neuropathy Decreased vision
Clinical Dx of diabetes
Urinalysis
Fasting plasma glucose test
HbA1c
Lifestyle signs of type II diabetes risk factors
Overweight
Physical inactivity
Smoking
Laboratory signs of type II diabetes risk factors
Unhealthy serum cholesterol levels
High blood glucose
High BP
Carb and fiber recommendations from the ADA (American diabetics association?)
Avoid carbs with added fat, sugar, sodium
No sugar sweetened beverages
Is the glycemic index of a food linked to disease risk or health outcomes?
No, not according to a study in 2018
HbA1c goal for people with diabetes
<7%
7 dietary patterns identified as useful for type II diabetes mgmt
Mediterranean Vegan/vegetarian Low fat Dash Very low fat Low carb Very low carb
Paleo - mixed results
Common threads among effective diets for diabetes:
Eliminate/limit processed foods
Plenty of veggies
Differences between effective diets for diabetes
Meat, fish, eggs, dairy, grains, legumes, fruits
Physiological causes for overweight and obesity
Hypothyroid PCOS Cushing’s (hyperadrenalism) Steroids Antidepressants Insulin resistance
Poor people tend to be obese, and they do die sooner. What kills them is a combo of factors with (2) being at the top of the list:
Stress
Tobacco
When is weight loss needed?
BMI greater or equal to 30
BMI 25-29.9 OR waist circumference >35” F or >40” M PLUS 2 or more:
- high BP
- high total cholesterol
- low HDL
NIH guidelines how to lose weight:
Moderate physical activity 30 min+ on 7 days of the week
Reducing dietary fat and calories
The initial goal of weight loss treatment according to NIH is to reduce body weight by ___% in ___months
10% in 6 months (1-2lb/wk)
What is the goal?
Good health (not weight loss)
Effects of bariatric surgery on diabetes and mortality rates
Remission of DM occurs in 60-80% of patients 1-2 years later
Retained in 30% of patients at 15 years
Reduction in all-cause mortality of 30-50% after 7-15 years
Supplementation needed after bariatric surgery (4)
Calcium citrate
Elemental iron
Vitamin B12
Vitamin D3
Indications for bariatric surgery
BMI >40 (~100 lb overweight men; ~80 lb overweight women)
OR
BMI 35-40 AND serious health problem such as DM, heart disease, sleep apnea
AND
An understanding of the operation and lifestyle changes required
