Diabetes practical

Question 1

type 1 diabetes is managed through

Answer 1

medication mostly, but also food choice and physical activity

Question 2

type 1 diabetes makes up what % of diabetes cases

Answer 2

10%

Question 3

type 1 diabetes is an

Answer 3

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

Question 4

type 1 diabetes is mostly diagnosed when

Answer 4

in children

Question 5

type 2 diabetes makes up what proportion of diabetes cases

Answer 5

90%

Question 6

what happens in type 2 diabetes

Answer 6

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

Question 7

when is type 2 diabetes usually diagnosed

Answer 7

mostly diagnosed in adults, but increasing numbers of children and teenagers are being diagnosed

Question 8

after we eat glucose appears in

Answer 8

the bloodstream

Question 9

when glucose appears in the bloodstream what is released in response

Answer 9

insulin

Question 10

when insulin receptors detect insulin what happens

Answer 10

insulin causes translocation of glucose transporters to the surface of the cells

Question 11

what happens when glucose transporters are translocated to the surface of cells

Answer 11

glucose is taken into cells and blood glucose declines

Question 12

what are the issues that occur in the glucose / insulin relationship in 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 in a state of insulin resistance

Answer 13

insulin receptors stop responding appropriately to insulin

more insulin is needed to trigger translocation of glucose transporters

Question 14

insulin is continued to be produced in insulin resistance because why

Answer 14

blood glucose remains high after a meal because glucose transporters are unable to transport it into the cells so the body continues to produce insulin to try and help

Question 15

what occurs in response to defective insulin response, and after a while what starts to rise (also eventually or simultaneously what occurs)

Answer 15

hepatic gluconeogenesis

fasting glucose levels begin to rise

beta cells atrophy and insulin production slows

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

polyuria leads to

Question 18

what is HbA1c

Answer 18

Higher concentrations of blood glucose over time

Question 19

higher concentrations of blood glucose overtime results in an

Answer 19

Higher concentrations of blood glucose over time results in an
increase in the glycation of hemoglobin molecules (addition of
glucose molecule to amino acid side chain)

Question 20

HbA1c is a measure of

Answer 20

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

Question 21

what are the HbA1c cut offs for diagnosing type 2 diabetes in NZ

Answer 21

> 50 = indicative of diabetes
41-49 = pre diabetes
<40 = diabetes unlikely

Question 22

what are the HbA1c cut offs for diagnosing type 2 diabetes internationally

Answer 22

> 48 = indicative of diabetes
42-47 = pre diabetes
<41 = diabetes unlikely

Question 23

what proportion of NZ had type 2 diabetes

Answer 23

Somewhere between 5 and
7% of the population

Question 24

what proportion of NZ population have prediabetes

Answer 24

~20% of the population

Question 25

what are the long term health consequences that can be a result of diabetes

Answer 25

-stroke -Blindness -Heart attack -Kidney failure -Amputation

Question 26

what are the risk factors for diabetes

Answer 26

-High BMI -PCOS -CVD -family history -Gestational diabetes -severe mental illness -Long term use of oral corticosteroids

Question 27

risk of diabetes increases with what

Answer 27

BMI

Question 28

what lifestyle changes will help reduce the risk of type 2 diabetes

Answer 28

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

Question 29

how does weight gain contribute to diabetes risk (positive energy balance)

Answer 29

Being in a state of prolonged positive energy balance is associated with increased fat accumulation around muscle and organs, and increased inflammation, both of which are known to decrease peripheral insulin sensitivity

Question 30

how does weight gain contribute to diabetes risk (increased triglyceride storage)

Answer 30

Increased triglyceride storage in the liver (due to prolonged excess energy intake) reduces hepatic insulin sensitivity

Question 31

how does weight gain contribute to diabetes risk (exposure of beta cells)

Answer 31

Exposure of beta cells to fatty acids increases the rate of cell death and decreases insulin production

Question 32

lifestyle interventions that incorporate a moderate physical activity component reduce incidence diabetes by

Answer 32

Lifestyle interventions that incorporate a moderate physical activity component reduce incidence diabetes by 28-63% in participants with impaired glucose tolerance Greater reductions are seen when the intervention also induces weight loss (but exercise alone is still effective)

Question 33

in obese prevention the goal of 150 min a week is probably …..

Answer 33

NOT ENOUGH needs be be closer to 60 mins per day

Question 34

most common suggestion of physical activity to reduce the risk of diabetes

Question 34

what is the effect of exercise

Answer 34

Being physically active helps to prevent obesity

Question 35

how does physical activity reduce the risk of diabetes

Answer 35

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 36

what is the types of carbohydrates and their associated outcomes

Answer 36

Sugar starches Fibre

Question 37

what is the recommended intake of sugar

Answer 37

Recommended intake <10%TE

Question 38

what is the outcomes associated with sugar

Answer 38

Increased body weight Increased rates of dental caries

Question 39

fibre lowers the risk of

Answer 39

⬇️ Mortality ⬇️ CVD ⬇️ CHD ⬇️ T2 ⬇️ colorectal cancer

Question 40

fibre improves

Answer 40

Improved Body weight, Blood pressure and Cholesterol

Question 41

WHO recommends what for fibre intake

Answer 41

25 g per day

Question 42

“Important messages

Answer 42

“Important messages are to consume minimally processed plant foods, such as whole grains, vegetables, whole fruit, legumes, nuts, seeds and nonhydrogenated non-tropical vegetable oils, while minimising the consumption of red and processed meats, sodium, sugarsweetened beverages and refined grains.