Obesity, Diabetes, and the Metabolic Syndrome Flashcards

(46 cards)

1
Q

Components of the metabolic syndrome

A
  • Obesity
  • Hyperlipidemia
  • Coronary artery disease
  • Fatty heart (also liver)
  • Hypertension (high blood pressure)
  • Insulin resistance
  • Diabetes type II
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2
Q

Diabetes = High blood glucose levels

> ?

A

126 mg/dl or greater with fasting
glucose test

  • supposed to be 24 hours
    (guidelines) , but most go by 12 hours*
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3
Q

What is metabolic syndrome?

A

Insulin resistant syndrome linked to obesity

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4
Q

What is BMI?

A

Body weight in KG divided by height in meters squared

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5
Q

Formulas used in determining risk (?)

A
  1. BMI
  2. WHR (waist hip ratio)
  3. abdominal circumference only
  4. liver fat content
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6
Q

WHR

how to measure

A
  • Waist measured at the most narrow part of torso above umbilicus and below xiphoid
  • Hip measured at the max circumference of hips or buttocks
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7
Q

BMI

underweight

A

< 18.5

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8
Q

BMI

normal

A

18.5-24.9

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9
Q

BMI

overweight

A

25-29.9

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10
Q

BMI

obese (Class I)

A

30-34.9

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11
Q

BMI

obese (Class II)

A

35-39.9

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12
Q

BMI

obese (Class III)

A

>40

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13
Q

unused energy →

A

fat deposition

doesn’t matter what type of intake

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14
Q

How many calories in a pound?

A

3500

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15
Q

Cals per gram

fat

A

9

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16
Q

Cals per gram

carbs

A

4

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17
Q

Cals per gram

protein

A

4

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18
Q

Cals per gram

alcohol

A

7

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19
Q

diabetes

Casual plasma glucose

A

above 200 mg/dl

casual, not fasted

20
Q

diabetes diagnosis

Fasting plasma glucose

A

above 126 mg/dl

21
Q

75g glucose load test

A

2 hour test

measure at the end of an hour and then after 2 hours

measure above 200 mg/dl

22
Q

Pre-diabetic numbers

A

above 100 mg/dl

23
Q

Hb1ac is a measure of:

A

measure of average blood glucose over 2-3 months (6% = 126 mg/dl)

better to see the big picture

24
Q

Hb1ac

normal value

25
Hb1ac pre-diabetic value
5.7 to 6.4%
26
Hb1ac diabetic
6.5% or higher
27
What is type I used to be called juvenile diabetes
**IDDM: insulin dependent diabetes mellitus** Autoimmune destruction of β cells
28
Type II diabetes
* NIDDM * Relationship with obesity * Decreased number of insulin receptors * Mobilization of fat in the body * Protein depletion for energy
29
Diabetes: kidney effects
* increased kidney filtration of glucose (***DAMAGES KIDNEYS,** large molecules going through*) ↓↓↓↓↓ * increased thirst * increased urination
30
acidosis
increase acidity in the blood Fat metabolism replacing carbohydrate- increases acidity from 1 to 10 mEq/liter
31
acidosis S/S
* Rapid and deep breathing * fruity breath * ketone formation * coma * death
32
pancreas functions
1. endocrine (glands) 2. digestive (fat storage)
33
pancreas digestion
* acinar cells * secrete digestive enzymes
34
pancreas hormone secretion
* Islets of Langerhans * Insulin and glucagon
35
Islets of Langerhaans 3 major types of cells
* Alpha- secrete glucagon * Beta- secrete insulin * Delta- secrete somatostatin
36
Effects of Insulin binding to cell (glucose, membrane, transcription, metabolic activity)
* Glucose permeable to 80% of cells within seconds * Membrane permeable to amino acids, potassium, phosphate * DNA and RNA transcription of new proteins * Slower process * Intracellular metabolic activity * Slower process
37
normal blood glucose fasting
* 80-90 mg/dl * Minimal insulin secretion-25 ng/min/kg weight
38
blood glucose Increased glucose- 2 to 3 X normal
* Results in 10 fold increase in insulin in 3 to 5 minutes, returns to resting after 5 to 10 minutes * Negative feedback loop- triggered at 100 mg/dl * 15 minutes after initial secretion second increase which will plateau in 2 to 3 hours
39
insulin resistance due to obesity glucose absorption
* Cells that normally use insulin to allow entrance of glucose do not function properly- insulin resistance
40
insulin resistance due to obesity lipid synthesis
However, insulin stimulated lipid synthesis (another role of insulin) occurs at increased rate due to an increase in lipid producing enzymes
41
treatment goals BMI
below 25%
42
treatment goals BP
below 125/75
43
treatment goals LDL
below 100 mg/dl
44
treatment goals triglycerides
below 150 mg/dl
45
treatment goals HDL
* HDL above (men) 40 mg/dl (women) 50 mg/dl * HDL above 60 mg/dl for all
46
treatment goals blood glucose
below 100 mg/dl