Diet and Chronic Disease: Diabetes Mellitus Flashcards

1
Q

what are characteristics of diabetes mellitus?

A

relative or absolute insulin deficiency; hyperglycemia; glucosuria; polyuria

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2
Q

what are associated risks of diabetes mellitus?

A

retinopathy; nephropathy; neuropathy; atherosclerotic coronary and peripheral vascular disease

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3
Q

what are other names for type I diabetes?

A

insulin dependent diabetes mellitus (IDDM) and juvenile onset (old)

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4
Q

what are other names for type II diabetes?

A

non-insulin dependent diabetes mellitus (NIDDM) and adult onset (old)

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5
Q

what age of onset is most commonly associated with type I?

A

less than 30 years old

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6
Q

what age of onset is most commonly associated with type II?

A

greater than 30 years old

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7
Q

which type of diabetes is associated with obesity?

A

type II

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8
Q

which type of diabetes has propensity to ketoacidosis and requires insulin to control?

A

type I

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9
Q

whats the level of endogenous insulin secreted in type I?

A

extremely low

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10
Q

whats the level of endogenous insulin secreted in type II?

A

significant but variable

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11
Q

what is the cell response to insulin in type I?

A

normal

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12
Q

what is the cell response to insulin in type II?

A

resistant

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13
Q

what does hyperglycemia result in?

A

glucose being bound to hemoglobin

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14
Q

what is glycosylated hemoglobin (A!C) an indicator of?

A

average blood glucose levels over the last 3 months (lifespan of RBC)

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15
Q

what is a normal level of an A1C?

A

<7%

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16
Q

what is the best way to assess and manage blood glucose control?

A

fasting blood glucose; glucose tolerance test; A1C; but we really want to know how well glucose is metabolized and that means lipids and proteins would be involved; Metabolomics

17
Q

what is metabolomics?

A

simultaneously measure the impact of changes in metabolism of “everything” to get at the impact of changes of diet on glucose metabolism… or metabolism of everything

18
Q

what are signs of diabetic ketoacidosis?

A

acetone breath, ketonemia, ketonuria

19
Q

how can you control type I with diet?

A

carbohydrate counting, low glycemic index foods/high dietary fiber, attention to lipid levels

20
Q

how can you control type II with diet?

A

weight loss/ exercise

21
Q

what drugs are used to treat DM?

A

insulin injection; reduce glucose absorption (alpha-glucosidase inhibitors); suppress glucose synthesis by the liver (biguanides); help pancreas continue to make insulin (DPP-4 inhibitors); increase beta-cell growth/reduce appetite (glucagon-like peptides); stimulate insulin secretion (sulfonylureas or meglitinide); increase insulin sensitivity of peripheral tissues (thiazolidinediones); reduce glucose reabsorption by kidney (SGLT2 inhibitor)

22
Q

What are dietary treatment of IDDM?

A

energy (maintain healthy body weight); carbohydrate (need carbs to maintain blood glucose levels; constant amount at regular intervals; complex carbs); protein (adequate but not excessive protein help in preventing kidney disease); fat (follow dietary guidelines; elevated LDL may need additional restrictions); alcohol (moderate amounts with attention to calories, simple sugars, etc.)

23
Q

what is the dietary treatment of NIDDM?

A

timing and distribution of meals (consistent carbohydrates spaced throughout the day); weight control (weight loss helps to reverse insulin resistance); alcohol (similar to IDDM but may interact with some oral hypoglycemic drugs); physical activity (improves blood glucose; contributes to weight loss; improves blood pressure)

24
Q

what is glycemic index?

A

ratio of blood glucose response to a given food in comparison to a standard

25
Q

what is glycemic load?

A

glycemic index multiplied times the grams of carbohydrate in 1 serving

26
Q

what is gestational diabetes?

A

blood insulin levels increase during pregnancy to cause storage of energy nutrients; later in pregnancy cells become more insulin resistant to shift from storage to utilization by fetus; this stress on glucose regulation causes anyone with impaired systems to have problems

27
Q

what is diet therapy for gestational diabetes?

A

support demands of pregnancy while maintaining normal glucose levels; lower levels of carbohydrates in meals to prevent higher levels of glucose after meals; this means smaller, more frequent meals

28
Q

what happens after gestational diabetes pregnancy?

A

usually glucose tolerance returns to normal; greater risk of developing NIDDM with much greater impact of overweight; therefore, maintain healthy body weight and monitor glucose levels regularly

29
Q

what are the types of hypoglycemia?

A

reactive (postprandial) and fasting

30
Q

what are symptoms of hypoglycemia?

A

shaky/jittery/dizzy; sweaty; hungry; headache; weakness; slow thought processes

31
Q

what is the diagnosis for hypoglycemia?

A

hypoglycemia + symptoms

32
Q

what is hypoglycemia most often associated with?

A

diabetes (error in insulin injection; insufficient CHO consumption; skipping or delaying meals; increased physical activity; alcohol without food; being ill)