Week 5 - Diabetes, Obesity

Question 1

What is the main causes of diabetes?

Answer 1

Diet and exercise

Question 2

Uncontrolled diabetes leads to

Answer 2

Heart attacks
Strokes
Blindness
Deafness
Amputations
Kidney failure
Burning foot syndrome
Impotence

Question 3

5-10% Americans diagnosed with diabetes have this type:

Answer 3

Type I

Failure to produce insulin

Question 4

T/F exposure to cow’s milk protein may be important factor in development of type I diabetes

Answer 4

True

Cow’s Milk Hypothesis
1. Combines genetic vulnerabilities, exposure to cow’s milk proteins, and viral exposures

2. Under certain conditions, cow’s milk proteins pass from gut to the bloodstream, eliciting production of antibodies.
3. Antibodies then attack not only the milk proteins but also pancreatic beta-cell proteins that are structurally similar to those in cow’s milk.
4. Viral infections cause these beta-cell proteins to be exposed to the antibodies.
5. During viral infections over the next several years, intermittent antibody attacks gradually destroy the beta cells.

Question 5

Describe type II diabetes

Answer 5

Insulin resistance (body fails to properly utilize insulin) combined with insulin deficiency

Question 6

What % of diagnosed people with diabetes have Type II diabetes?

Answer 6

> 90%

Question 7

What % of pregnant women in the US get gestational diabetes?

Answer 7

4%

Question 8

Metabolic syndrome is a cluster of metabolic disorders that starts with insulin resistance at the core:

Answer 8

Insulin resistance
Dyslipidemia
Hypertension
Obesity
Glucose intolerance

Question 9

What are the 3Ps of diabetes?

Answer 9

Polydipsia - thirst
Polyuria - urination
Polyphagia - hunger

Question 10

Other signs of diabetes

Answer 10

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

Question 11

Clinical Dx of diabetes

Answer 11

Urinalysis
Fasting plasma glucose test
HbA1c

Question 12

Lifestyle signs of type II diabetes risk factors

Answer 12

Overweight
Physical inactivity
Smoking

Question 13

Laboratory signs of type II diabetes risk factors

Answer 13

Unhealthy serum cholesterol levels
High blood glucose
High BP

Question 14

Carb and fiber recommendations from the ADA (American diabetics association?)

Answer 14

Avoid carbs with added fat, sugar, sodium

No sugar sweetened beverages

Question 15

Is the glycemic index of a food linked to disease risk or health outcomes?

Answer 15

No, not according to a study in 2018

Question 16

HbA1c goal for people with diabetes

Answer 16

<7%

Question 17

7 dietary patterns identified as useful for type II diabetes mgmt

Answer 17

Mediterranean
Vegan/vegetarian
Low fat
Dash
Very low fat
Low carb
Very low carb

Paleo - mixed results

Question 18

Common threads among effective diets for diabetes:

Answer 18

Eliminate/limit processed foods

Plenty of veggies

Question 19

Differences between effective diets for diabetes

Answer 19

Meat, fish, eggs, dairy, grains, legumes, fruits

Question 20

Physiological causes for overweight and obesity

Answer 20

Hypothyroid
PCOS
Cushing’s (hyperadrenalism)
Steroids
Antidepressants
Insulin resistance

Question 21

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:

Answer 21

Stress

Tobacco

Question 22

When is weight loss needed?

Answer 22

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

Question 23

NIH guidelines how to lose weight:

Answer 23

Moderate physical activity 30 min+ on 7 days of the week

Reducing dietary fat and calories

Question 24

The initial goal of weight loss treatment according to NIH is to reduce body weight by ___% in ___months

Answer 24

10% in 6 months (1-2lb/wk)

Question 25

What is the goal?

Answer 25

Good health (not weight loss)

Question 26

Effects of bariatric surgery on diabetes and mortality rates

Answer 26

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

Question 27

Supplementation needed after bariatric surgery (4)

Answer 27

Calcium citrate
Elemental iron
Vitamin B12
Vitamin D3

Question 28

Indications for bariatric surgery

Answer 28

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