Week 7-Diabetes

Question 1

Neuronutrition

Answer 1

Essential foods for your brain
Not just what we eat, also the bacteria we have in our gut

Question 2

Neuronutrition and school neuropsychology

Answer 2

-Rapid neuronal development requires high energy rates and nutrients
-Biological factors matter
-There are neuromyths about brain food in education that need tackling
-School policies: Food habits start in childhood

Question 3

Poor eating and neurodevelopmental conditions

Answer 3

Poor eating common in neurodevelopmental conditions
Picky eaters may have specific tastes they dislike

Question 4

Functions of starches and fibres

Answer 4

Essential for functioning of microbiome
Play important role of processing foods
Make new nutrients that are important

Question 5

When glucose is low

Answer 5

Brain transforms fructose and lactose into glucose

Question 6

“Candy bar effect”

Answer 6

How glucose behaves in the body
-Fluctuates during the day
-Fluctuation levels depend on what you eat
-Foods with high GI cause blood sugar to peak very fast
-Body produces insulin to make blood sugar go down

Question 7

Glycemic Index (GI)

Answer 7

Low GI (55 or less): Fruit and veg, beans, grains, low fat dairy foods, nuts
Moderate GI (56 to 69): Potatoes, corn, white rice, couscous, wheat breakfast cereals
High GI (70 or higher): White bread, rice cakes, crackers, bagels, cakes, doughnuts, croissants, packaged breakfast cereals

Question 8

Consequences of high carb/ high GI diets

Answer 8

-Burns out the pancreas (because it constantly has to produce insulin)
-Insulin resistance
-Leads to type 2 diabetes
-Fat accumulation/obesity
-Cardiovascular diseases
-Eventually can lead to brain inflammation/dementia

Question 9

High blood glucose levels

Answer 9

-Increases risk for developing dementia
-Accelerates the aging process of the brain
-Shrinks hippocampus
-Reduces memory performance

Question 10

T1D

Answer 10

Autoimmune disease- Body attacks cells in the pancreas
Pancreas doesn’t produce insulin

Question 11

Metabolic disorders

Answer 11

-Rare genetic disorders
-Body cannot turn food into energy
-Caused by deficits in specific proteins (enzymes) that help break down parts of food
-Food product that is not broken down into energy can build up in the body and cause a wide range of symptoms
-Several inborn errors of metabolism cause developmental delays or other medical problems if they are not controlled
-700 metabolic disorders in total

Question 12

Types of metabolic disorders

Answer 12

Wilson’s disease- Defect in copper excretion
Phenylketonuria- Break down of the protein phenylalanine
Galactosemia- Break down of the simple sugar galactose
T1D- Take up of glucose into cells to produce energy

Question 13

Differences between T1D and T2D

Answer 13

T1D: Insulin is missing, glucose cannot enter cells, glucose levels rise
T2D: Insulin is present, cells are locked, glucose cannot enter cells, glucose and insulin levels rise

Question 14

Environmental triggers of T1D

Answer 14

Vitamin D deficiency
Viral infections
Early exposure to cows milk

Question 15

Hyperglycaemia

Answer 15

-High blood glucose levels (above 140mg)
-Toxicity/oxidative stress
-Can be a result of poor metabolic control (diet/ insulin injection)
-In the worst case can lead to Diabetic Ketoacidosis (DKA)

Symptoms:
-Stomach pain
-Irritability
-Very thirsty
-Need to urinate often

Question 16

Euglycaemia

Answer 16

Acceptable levels of blood glucose
70-140mg

Question 17

Dysglycaemia

Answer 17

Fluctuating levels of blood glucose

Question 18

Hypoglycaemia

Answer 18

Excessively low blood glucose levels
Below 70 mg
Due to:
-Overdoses of insulin
-Omitting food
-Strenuous physical activity
-Stress/emotions

Question 19

2 neurocognitive phenotypes in T1D

Answer 19

Majority
-Onset after age 7
-Lower intelligence and academic achievement
-Lower psychometric speed
-Intact learning and memory

Minority
-Onset before age 7
-Poor performance in all cognitive domains
-Poor learning and memory
-Significant clinical impairments
-Abnormalities visible within 1 or 2 years after onset

Question 20

Academic outcomes of T1D

Answer 20

-Lower school grades
-Poorer academic achievement
-Less years of schooling/ less employment
-Verbal IQ 3-5 points lower
-Declining IQ in young adulthood
-Relates to disease duration (Early onset= more chance of decline in intelligence)
-Early metabolic insults
-Poor metabolic control
-History of hypoglycaemia

Question 21

Grooved pegboard test

Answer 21

Predictive of long-term poor metabolic control
Test for psychomotor speed
Indicative for psychomotor slowing
Early marker of T1D related brain abnormalities
Predicts long-term poor metabolic control
Compare score to typical score for children their age

Question 22

Brain structure abnormalities in T1D

Answer 22

Subtle abnormalities in gray matter volume (MRI measures) in posterior brain regions and cerebellum
-They are stronger with hyperglycaemia and longer disease duration
Potential improvement in adolescence
Subtle microstructural abnormalities (DTI measures)

Question 23

Neurodevelopmental effects of hypers and hypos

Answer 23

Hypers:
-Default mode network
-EF’s

Hypos:
-Gating info & memory and learning
-Integration of info & language
-TOP association areas

Question 24

LT risk of hypers

Answer 24

Toxic effects on blood vessels
Risk for cardiovascular disease
Risk for hypertension
Microvascular damage

Question 25

Microvascular brain damage in adulthood

Answer 25

› The brain relies on an intricate network of small blood vessels
› Damage accelerates the ageing process
› Cognitive impairments
 Slow information processing
 Mental flexibility
› Those with retinopathy more impaired (proxy for microvascular damage in brain)

Question 26

Hormonal changes in puberty

Answer 26

New balance
Increased insulin resistance