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NUT 116A > Midterm 2 pt. 2 > Flashcards

Midterm 2 pt. 2 Flashcards

(69 cards)

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1
Q

if pancreatic beta cells have decreased sensitivity to incretins,

A

decreased insulin secretion

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2
Q

if pancreatic alpha cells remain sensitive to GIP,

A

increased glucagon secretion

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3
Q

in type II DM, there are

A

altered levels of GLP-1 and GIP and response at tissues

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4
Q

in type II DM, the liver

A

still takes up glucose in high capacity (because it has GLUT2, insulin independent)

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5
Q

in the type II DM, insulin is a _________________

A

relative deficiency (not enough to compensate for high levels of blood glucoss

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6
Q

synonym for pre-diabetes is

A

impaired glucose tolerance

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7
Q

for pre-diabetics, progression of type II DM

A

is NOT inevitable (can be delayed w/ body wt loss)

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8
Q

healthy fasting blood glucose number/range

A

below 100 mg/dL

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9
Q

diabetes fasting blood glucose number/range

A

126 mg/dL

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10
Q

healthy A1C number/range

A

<5.5%

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11
Q

diabetic A1C number/range

A

> 6.5%

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12
Q

healthy result from 2 hr oral glucose

A

below 140 mg/dL

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13
Q

diabetes result from 2 hr oral glucose

A

200 mg/dL

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14
Q

type II DM is associated

A

with obesity, but can also occur in lean people

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15
Q

type 1 DM etiology

A

autoimmune destruction of beta cells

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16
Q

three signs and symptoms of uncontrolled DM

A

polyuria
polydipsia
polyphagia

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17
Q

polyuria is characterized by

A

presence of glucose in urine

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18
Q

polydipsia is characterized by

A

increased thirst

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19
Q

polyphagia is characterized by

A

hunger

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20
Q

signs and symptoms of type I DM

A

wt loss, nausea/vomiting, diabetic ketoacidosis

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21
Q

decreased intracellular glucose results

A

polyphagia

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22
Q

when the threshold of renal glucose is exceeded

A

polyuria, leads to polydipsia

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23
Q

how is fat metabolism affected by insulin deficiency for type I DM

A

decreased TG synthesis, increased lipolysis

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24
Q

in type I diabetes, we use _______________ as an energy source

A

fatty acids, increased risk of ketoacidosis

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25
what is the GLUT4 pathway?
PI3K - AKT
26
long term consequences of insulin deficiency and hyperglycemia
macrovascular and microvascular
27
macrovascular complications include
CVD, atherosclerosis, HTN
28
microvascular complications include
nephropathy, retinopathy, neuropathy
29
nephropathy refers to
the end stage renal disease
30
retinopathy refers to
blindness
31
neuropathy refers to
peripheral neuropathy/foot problems
32
HbA1C reflects
average blood glucose over the past 3 mo
33
diabetes control and complications trial
study of type 1 DM, intensive treatment vs conventional treatment, intensive treatment lowered blood glycemia more, better glucose control = fewer complications
34
10 yrs after the diabetes control and complications trial,
there were still decreases in CVD risk
35
A1C treatment goal
below 7%, but should be individualized
36
ABCs and of DM management
A (average blood glucose/HbA1C) B (blood pressure) C (cholesterol)
37
diabetes prevention program
compared lifestyle with metformin, lifestyle decreased much more
38
nutritional requirements of people with DM are
similar to those of a general healthy population
39
no insulin or hypoglycemic meds leads to
CHO is spread throughout the day
40
how does diabetes affect protein metabolism
increased blood amino acids + muscle wasting
41
what pathway is responsible for bringing GLUT4 to membrane?
PI3K-AKT
42
what are long-term complications of hyperglycemia?
macrovascular (CVD, atherosclerosis, HTN) and microvascular (retino-, neuro-, nephropathy)
43
advanced glycosylation end products
accumulation of intermediate products of glycolysis
44
glycated hemoglobin is an example of
hemoglobin is an example of an advanced glycosylation end product
45
risk of diabetes concentrations increases with
average blood glucose concentrations
46
primary prevention goal in diabetes prevention is to
prevent diabetes
47
secondary prevention in diabetes prevention is to
prevent complications from diabetes
48
tertiary prevention in diabetes prevention is to
prevent death from diabetes
49
for diabetes, is MNT clinically and cost effective?
yes
50
the american diabetes assocation
does not have an "ADA" diet, no 1 diet for diabetics
51
basic CHO counting is
adding up total CHO regardless of source
52
advanced CHO counting
matches insulin to CHO
53
advanced CHO counting uses
insulin to CHO ratio (ICR) and corrective factor (CF)
54
advanced CHO counting is useful for
patients with an insulin pump or who take multiple shots a day
55
taking oral hypoglycemic meds leads to
daily CHO is spread throughout the day, monitor blood sugar closely because some meds cause hypoglycemia
56
when on a fixed/daily dose of insulin,
need consistent timing and CHO content of meals
57
kcal for normal wt
30 kcal/kg body wt
58
kcal for overwt/obese
20-24 kcal/kg body wt
59
CHO kcal
40-50%
60
protein kcal
15-20%
61
fat kcal
30-40%
62
limit CHO at breakfast to
30-45 g
63
what eating pattern has robust evidence for type 1 DM?
none, low-carb has preliminary evidence of benefit
64
what eating pattern has robust evidence for type 2 DM?
low-carb and mediterranean have highest evidence
65
mediterranean diet vs. low fat in type 2 DM development
mediterranean has lower risk
66
what has the most overall evidence for improving glycemia?
low carb
67
glycemic index refers to the
quantity and rate which different CHO foods influence blood glucose response
68
in individuals with pre-DM, 7-10% wt loss
is shown to prevent/delay type 2 DM
69
in individuals with type 2 DM, 5% wt loss
achieves clinical benefits

NUT 116A (2 decks)

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