Lecture 17 Flashcards
(26 cards)
What is the NOVA classification system?
Categorizes food on the extent to which they are processed
What is the fraction of adult population with prediabetes?
1/3 of adult pop
What is the approx. fraction of prediabetics who go on to full diabetes?
Up to 70% of prediabetics-> diabetes
What is prediabetes associated with?
early forms of kidney disease, retinopathy, and vascular disease
How are the worldwide trends similar to US?
Worldwide trends are reflected in US stats
What are the major risk factors for diabetes?
- Age
- Excess weight
- Excess added sugar consumption
- Excess saturated fat and meat consumption
What is the effect of sugar availability on diabetes risk? (economic analysis)
- Study found that every 150 kcal/person/day increase in sugar availability was associated with increased diabetes prevalence by 1.1%
What are the basic features of a glucose tolerance test (GTT)?
blood glucose in diabetic and non-diabetic persons after consuming 75 g test load of glucose
What is the nature of glycation that produces HbA-1C?
- a non enzymatic modification of HbA with glucose; through an Amadori rearrangement (amine->ketone) produces HbA-1C
How does measuring HbA-1C helpful for detection of long term glucose?
- The more glucose in the body-> the more HbA-1C (a monotonic relationship)
- More useful for long term bc more accurate for long term measurement
what are the normal values of fasting glucose? 2hr post GTT? levels? HbA-1C levels?
Fasting glucose: <100 mg/dL
2hr GTT: <140 mg/dL
HbA-1C: <5.7 %
what are the diabetes values of fasting glucose? 2hr post GTT? levels? HbA-1C levels?
Fasting glucose: >126 mg/dL
2hr GTT: >200 mg/dL
HbA-1C: >6.4%
What is the difference between visceral fat obesity and subcutaneous fat obesity?
- subcutaneous obesity- healthy adipose tissue
- visceral obesity- dysfunctional adipose tissue
Why are both sumo wrestlers and people with lipodystrophy useful about obesity and pathology?
Sumo: high adipose, low metabolic problems
Lipodystrophy: no adipose, high metabolic problems
Results: these studies tells us where the fat is and what it’s doing to our biochemistry
What is the role of genetics in T1D and T1D from twin studies?
No one “gene” for diabetes, but there are genetic components to both syndromes
What are clinical interventions and options for T1D and T2D?
T1D: glucose monitors, insulin injection, and insulin pumps
T2D: meds, insulin, lifestyle therapies, and bariatric surgery (for weight loss)
What is the value of CGM (Continuous Glucose Monitor) in diabetes management?
CGMs can distinguish between dropping and increasing blood glucose levels (critical for managing blood glucose levels)
What drug treatment for T2D reduce liver glucose over-production
Metformin
What drug treatments for T2D reduces insulin resistance?
Avandia and Metformin
What drug treatments for T2D stimulates insulin production?
Sulfonylureas
Incretins
What do Incretins (GLP-1, GIP) do?
- Stimulate insulin release
- Inhibit glucagon release
result: Lowering of blood glucose
What is Avandia?
an insulin sensitizer
What class of drug is Avandia a member of?
Thiazolidinedione
How does Avandia act as an insulin sensitizer? What do they bind to?
They reduce glucose, fatty acid, and insulin blood concentrations; they work by binding to the peroxisome proliferator-activated receptors (PPARs)
