Week 7-Diabetes Flashcards
Neuronutrition
Essential foods for your brain
Not just what we eat, also the bacteria we have in our gut
Neuronutrition and school neuropsychology
-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
Poor eating and neurodevelopmental conditions
Poor eating common in neurodevelopmental conditions
Picky eaters may have specific tastes they dislike
Functions of starches and fibres
Essential for functioning of microbiome
Play important role of processing foods
Make new nutrients that are important
When glucose is low
Brain transforms fructose and lactose into glucose
“Candy bar effect”
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
Glycemic Index (GI)
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
Consequences of high carb/ high GI diets
-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
High blood glucose levels
-Increases risk for developing dementia
-Accelerates the aging process of the brain
-Shrinks hippocampus
-Reduces memory performance
T1D
Autoimmune disease- Body attacks cells in the pancreas
Pancreas doesn’t produce insulin
Metabolic disorders
-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
Types of metabolic disorders
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
Differences between T1D and T2D
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
Environmental triggers of T1D
Vitamin D deficiency
Viral infections
Early exposure to cows milk
Hyperglycaemia
-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
Euglycaemia
Acceptable levels of blood glucose
70-140mg
Dysglycaemia
Fluctuating levels of blood glucose
Hypoglycaemia
Excessively low blood glucose levels
Below 70 mg
Due to:
-Overdoses of insulin
-Omitting food
-Strenuous physical activity
-Stress/emotions
2 neurocognitive phenotypes in T1D
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
Academic outcomes of T1D
-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
Grooved pegboard test
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
Brain structure abnormalities in T1D
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)
Neurodevelopmental effects of hypers and hypos
Hypers:
-Default mode network
-EF’s
Hypos:
-Gating info & memory and learning
-Integration of info & language
-TOP association areas
LT risk of hypers
Toxic effects on blood vessels
Risk for cardiovascular disease
Risk for hypertension
Microvascular damage
