Diabetes

Question 1

What is type 1 diabetes?

Answer 1

An autoimmune condition where the body attacks the cells that make insulin, which means not enough insulin is created

Question 2

Can type 1 diabetes be prevented?

Answer 2

Cannot be prevented

Question 3

How can type 1 diabetes be managed?

Answer 3

through a combination of
medication, food choice and physical activity

Question 4

What percent of diabetes cases are type 1?

Answer 4

approx. 10%

Question 5

What age is type 1 diabetes mostly diagnosed in?

Answer 5

children (7-9 y) but can occur at any age

Question 6

What is type 2 diabetes?

Answer 6

Cells either don’t produce enough insulin or don’t recognise that insulin is present

Question 7

How can type 2 diabetes be managed?

Answer 7

food choice, physical activity and medication

Question 8

Can type 2 diabetes be prevented?

Answer 8

Can be prevented in most people

Question 9

What age is type 2 diabetes mostly diagnosed in?

Answer 9

adults (30-40 y) but increasing numbers of children and teenagers are being diagnosed

Question 10

How many diabetes cases are type 2?

Answer 10

approx. 90%

Question 11

What happens after we eat glucose in a ‘normal person’?

Answer 11

• Glucose appears in the bloodstream
• Insulin is then released in response
• Insulin causes translocation of glucose transporters to the surface of the cells
• Glucose is taken into cells
• Blood glucose levels decline

Question 12

What happens after we eat glucose in someone with type 1 diabetes?

Answer 12

• No, or very little insulin is produced
• Glucose stays in the blood stream
• Not enough glucose gets into the cells and organs that need it for energy

Question 13

What happens after we eat glucose in someone with insulin resistance?

Answer 13

• Insulin receptors stop responding appropriately to insulin
• More insulin is needed to trigger translocation of glucose transporters
• Insulin continues to be produced
• Blood glucose remains high for longer after a meal

Question 14

What occurs in response to defective insulin response?

Answer 14

Hepatic gluconeogenesis occurs in response to defective insulin response

Question 15

What happens eventually due to insulin resistance?

Answer 15

• Beta-cells atrophy and insulin production shows
• Fasting glucose levels start to rise

Question 16

What happens when you have too much glucose in your blood?

Answer 16

Glucose travels to the kidney causing osmotic diuresis and polyuria

Question 17

What does osmotic diuresis and polyuria cause?

Answer 17

Dehydration

Question 18

What does osmotic diuresis and polyuria causing dehydration ultimately lead to?

Answer 18

Polydipsia (excessive thirst) and polyphagia (excessive hunger)

Question 19

Higher concentrations of blood glucose over time results in…

Answer 19

an increase in the glycation of hemoglobin molecules (addition of glucose molecule to amino acid side chain)

Question 20

How is type 2 diabetes diagnosed?

Answer 20

Glycated Hemoglobin (HbA1c)
- Measure of glycemic (blood sugar) control over previous 2-3 months

Question 21

In NZ what HbA1c indicates diabetes?

Answer 21

> 50

Question 22

In NZ what HbA1c indicates pre-diabetes?

Answer 22

41-49

Question 23

In NZ what HbA1c indicates that diabetes is unlikely?

Answer 23

<40

Question 24

What are the international HbA1c cut offs?

Answer 24

Diabetes = >48
Pre-diabetes = 42-47
Unlikely = <41

Question 25

What percent of NZ have T2D?

Answer 25

5-7%

Question 26

What percent of NZ have pre-diabetes?

Answer 26

20%

Question 27

What are the long term consequences of diabetes?

Answer 27

- Stroke - Blindness - Heart attack - Kidney failure - Amputation

Question 28

What are the risk factors for diabetes?

Answer 28

- High BMI - Family history - CVD - Gestational diabetes - Long term use of oral corticosteroids - Severe mental illness

Question 29

What is the biggest risk factor for diabetes?

Answer 29

High BMI

Question 30

What lifestyle changes will help reduce the risk of type 2 diabetes? (4)

Answer 30

- Reduce energy intake - Increase physical activity - Increase fibre intake - Reduce total and saturated fat intake

Question 31

How does weight gain contribute to diabetes risk?

Answer 31

increased fat accumulation around muscle and organs, and increased inflammation, both of which are known to decrease peripheral insulin sensitivity

Question 32

Increased triglyceride storage in the liver (due to prolonged excess energy intake) reduces...

Answer 32

Hepatic insulin sensitivity

Question 33

Exposure of beta cells to fatty acids increases the rate of cell death and...

Answer 33

Decreases insulin production

Question 34

How much do lifestyle interventions that incorporate a moderate PA component reduce diabetes incidence?

Answer 34

by 28-63% in participants with impaired glucose tolerance

Question 35

Greater reductions are seen when PA interventions also induce...

Answer 35

weight loss (but exercise alone is still effective)

Question 36

How much PA do you need to do for obesity prevention?

Answer 36

150 min a week is probably NOT ENOUGH need closer to 60 min per day

Question 37

How does exercise affect insulin?

Answer 37

- Muscle contraction can cause translocation of glut 4 without insulin - Exercise increases skeletal muscle insulin sensitivity

Question 38

How does PA reduce the risk of diabetes?

Answer 38

- Improved endothelial function and capillarization increased mitochondrial biogenesis and fibre ratios - Improved muscular respiratory capacity and fatty acid oxidation - Increased expression and activity of glut 4 and glycogen synthase

Question 39

What is the recommendation for fibres?

Answer 39

In adults, WHO recommends an intake of at least 25 g per day of naturally occurring dietary fibre as consumed in foods (strong recommendation)

Question 40

What does fibre improve?

Answer 40

Body weight, Blood pressure and Cholesterol