Diabetes

Question 1

Uk prevelance

Answer 1

2019- 3.8 milion people

Question 2

% of type I

Answer 2

10%

Question 3

% of Type II

Answer 3

90%

Question 4

blood glucose levels fasted and OGTT for normal

Answer 4

fasting - <5.6mmol.l

2 hour plasma OGTT - <7.8

Question 5

blood glucose levels fasted and OGTT for pre-diabetes

Answer 5

fasted - 5.6-6.9

2hr post OGTT - 7.8-11

Question 6

blood glucose levels fasted and OGTT for diabetes

Answer 6

fasted- >7

2hr post >11.1

Question 7

how is type I managed

Answer 7

diet
exercise
self adminsted insulin

Question 8

effect of type I on stroke and heart attack

Answer 8

3.5 times more liekly to have a stroke

4 times more liekly to have a heart attack

Question 9

how is type II managed

Answer 9

lifestyle

Question 10

effect of type II on stroke and heart attack

Answer 10

2 time more likley to have storke

2.5 times more likely to have a heart attack

Question 11

describe type I

Answer 11

juvenile onset 
abrupt onset 
genetic predipostion 
reduced or absent insulin 
10% of cases

Question 12

describe type II

Answer 12

usually mature onset, now younger 
gradual onset 
genetic predisposition 
hyperinsulinaemia 
90% of cases

Question 13

how many people die from complications and comorbidites associated with diabetes and what are they

Answer 13

more then 500 people die prematurely due to complications from diabetes every week
stroke
heart attack
heart failure

Question 14

glycogenesis

Answer 14

glucose -> glycogen

insulin promotes this

Question 15

glycogenlysis

Answer 15

glycogen -> glucose

insulin inhibits this

Question 16

gluconeogensis

Answer 16

lactacte/AA -> glucose

insulin inhibts this

Question 17

lipolysis

Answer 17

TAG -> FA + Glycerol

insulin inhibits this

Question 18

ketogenesis

Answer 18

FA -> ketones

insulin inhibits this

Question 19

Lipogenesis

Answer 19

Glucose/AA -> TAG

insulin promotes this

Question 20

periperhal neuropathy

Answer 20

limited sensation in peripheries
may promote damage, abrasion or ulcers
hyperglycaemia reduces immune function and blood flow

Question 21

how many patients who develop foot ulcers willl require amputation

Answer 21

20%

Question 22

exercise impliactions of diabetes

Answer 22

– Vision may be impaired
– Joints may hurt (so consider low impact activities)
– Consider peripheral sensation (tripping + avoidance of cuts)
– Appropriate footwear (avoid blisters)

Question 23

risk factors of diabetes

Answer 23

overweigth/obesity 
physical inactivty 
diet 
metabolic syndrome 
ethnicity 
family history 
age 
sex
history of gestational diabetes

Question 24

benefical effects of exercsie for type I

Answer 24

fitness 
insulin requirements 
lipids 
endotheial function 
mortaility 
insulin resistance 
CVD 
well being

Question 25

benefical effects of exercsie for Type II

Answer 25

``` fitness insulin requirements lipids endotheial function mortaility insulin resistance CVD blood pressure beta cell function glycaemic control ```

Question 26

effect of exercise on mechanisms

Answer 26

increased GLUT 4 protein load and translocation | increased GLUT4 Gene actiavtion

Question 27

recommendations aerobic

Answer 27

mod to vig at least 150 mins MVPA 3-7 days a week HIIT and continous

Question 28

resistance training

Answer 28

8-10 exercises 1-3 sets 10-15 reps

Question 29

overall benefits of exercise

Answer 29

``` social improved QoL decreased fear of disease improved self esteem improved metabolic health increased muscel mass improved body composition improved insulin sensivity increased GLUT4 protein load + translocation lower CVD risk ```

Question 30

non/pre-proliferative retinopathy

Answer 30

widespread death of periocytes leaky blood flow due to endothelial growth - micro-aneurism - LDL bulid up on back of eye - hard exudates deteced during eye exam

Question 31

diabetes without retinopathy

Answer 31

pericytes exposed to excessive amounts of glucose unable to process results in increased blood flow and endothelial cell growth - no symptons, unable to detect

Question 32

what is role of pericytes

Answer 32

pericytes found on capillaries in the eye help control blood flow and vasotone prevents endothlial cell proliferation

Question 33

proliferative retionpathy

Answer 33

``` angiogensis - formation of new blood vessels retina is hypoxic due to leaks vasodilation VEGF released - encourages angiogensis increased blood vessels can causes detached retina ```

Question 34

neuropathy = kidney

Answer 34

1/5 with diabetes will need kidney treatment hyperglycemia causes vasoconctriction of efferent increases pressure in bowmans damages mesangial inflammation and oxidatiive stress capilaries become more leaky = loss of proteins