Diabetes Overview and Types
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Questions and Answers

What is the recommended weekly energy expenditure for optimal weight loss maintenance?

  • 2,500 to 2,800 kcal (correct)
  • 2,000 to 2,200 kcal
  • 3,000 to 3,200 kcal
  • 1,500 to 1,700 kcal
  • Which of the following best describes the fit fat paradox?

  • Being active does not impact health if one is overweight.
  • Only lean individuals experience longevity benefits from exercise.
  • Weight loss is essential for improving health risks.
  • Physical fitness can mitigate health risks regardless of body weight. (correct)
  • What is one effect of autonomic neuropathy on cardiovascular function?

  • Decreased resting heart rate
  • Increased HR max
  • Increased resting heart rate (correct)
  • No effect on heart rate
  • What is the correct order of lipoproteins based on size from largest to smallest?

    <p>Chylomicron, VLDL, IDL, LDL, HDL</p> Signup and view all the answers

    Which demographic factors increase the risk of developing diabetes-related complications?

    <p>First degree relative with diabetes</p> Signup and view all the answers

    How many minutes of exercise per day may be needed for effective weight loss maintenance?

    <p>60 to 90 minutes</p> Signup and view all the answers

    What role do HDL and LDL play in lipid metabolism?

    <p>HDL is anti-atherogenic while LDL is pro-atherogenic.</p> Signup and view all the answers

    What does HbA1c measure?

    <p>Average blood glucose levels over the past 2-3 months</p> Signup and view all the answers

    What is a common physical exam finding in patients with diabetes complications?

    <p>Elevated blood pressure</p> Signup and view all the answers

    Which test assesses long-term glucose control in diabetic patients?

    <p>HbA1c test</p> Signup and view all the answers

    What complication may arise due to neuropathy affecting the peripheral nervous system?

    <p>Loss of sensation in lower extremities</p> Signup and view all the answers

    Which group is considered at higher risk for developing diabetes?

    <p>African Americans and Latinos</p> Signup and view all the answers

    What physical symptom may indicate poor healing and is associated with diabetes complications?

    <p>Foot sores or ulcers</p> Signup and view all the answers

    What is the primary characteristic of android fat distribution?

    <p>Fat stored primarily in the abdomen and upper body.</p> Signup and view all the answers

    What is one of the recommended health benefits of achieving a 10% weight loss?

    <p>Decline in both systolic and diastolic blood pressure.</p> Signup and view all the answers

    Which hormone is primarily involved in signaling satiety?

    <p>Leptin</p> Signup and view all the answers

    What is the approximate caloric deficit required to lose 1 pound of fat?

    <p>3,500 kcal</p> Signup and view all the answers

    What type of dietary approach involves limiting the window of eating to 8 hours?

    <p>Time-restricted feeding</p> Signup and view all the answers

    Which of the following obesity treatment options has shown the greatest long-term efficacy?

    <p>Surgical interventions</p> Signup and view all the answers

    Which type of fat distribution is generally considered less risky for health?

    <p>Gynoid fat distribution</p> Signup and view all the answers

    What is a common challenge related to weight loss due to the set point theory?

    <p>Lower metabolic rate making weight maintenance challenging.</p> Signup and view all the answers

    Which effect from obesity can contribute to a reduction in life expectancy by approximately 7 years?

    <p>Addiction-like processes associated with body weight.</p> Signup and view all the answers

    What is a common misconception about weight loss medications?

    <p>They often reduce appetite or fat absorption.</p> Signup and view all the answers

    What fasting blood glucose level is indicative of diabetes?

    <p>130 mg/dL</p> Signup and view all the answers

    Which of the following is a role of leptin?

    <p>Controls satiety</p> Signup and view all the answers

    What is the normative value for the Oral Glucose Tolerance Test (OGTT) two hours after ingestion of glucose?

    <p>140 mg/dL</p> Signup and view all the answers

    Which of the following is a special consideration for exercise testing in individuals with diabetes?

    <p>Consider cardiac risk factors</p> Signup and view all the answers

    What body composition assessment is associated with obesity?

    <p>Excessive fat accumulation</p> Signup and view all the answers

    Which of the following is a benefit of exercise training in individuals with diabetes?

    <p>Increases fat oxidation</p> Signup and view all the answers

    Which hormone is primarily responsible for stimulating hunger?

    <p>Ghrelin</p> Signup and view all the answers

    What is the primary cell type in adipose tissue?

    <p>Adipocyte</p> Signup and view all the answers

    What characterizes the pathophysiology of Type 1 diabetes?

    <p>Insulin deficiency due to beta cell destruction</p> Signup and view all the answers

    Which of the following best describes Type 2 diabetes?

    <p>Insulin secretion defect with eventual insulin resistance</p> Signup and view all the answers

    What is the role of alpha cells in glucose regulation?

    <p>They produce glucagon to increase blood sugar when it's low</p> Signup and view all the answers

    Which condition is characterized by glucose intolerance during pregnancy?

    <p>Gestational Diabetes</p> Signup and view all the answers

    What distinguishes hyperglycemia from hypoglycemia?

    <p>Hyperglycemia leads to high blood sugar, hypoglycemia leads to low blood sugar</p> Signup and view all the answers

    What increases the future risk of Type 2 diabetes after pregnancy?

    <p>Gestational diabetes</p> Signup and view all the answers

    What type of vessel disease is associated with coronary arteries and major blood vessels?

    <p>Macrovascular disease</p> Signup and view all the answers

    Which is a common characteristic of microvascular complications in diabetes?

    <p>Retinopathy and nephropathy</p> Signup and view all the answers

    How does insulin signaling typically function in Type 2 diabetes?

    <p>Cells become resistant to insulin over time</p> Signup and view all the answers

    What is often the first step in diagnosing diabetes?

    <p>Testing blood glucose levels</p> Signup and view all the answers

    Study Notes

    Diabetes Definition

    • A group of metabolic diseases characterized by the inability to produce sufficient amounts of insulin or the inability to respond to insulin properly.

    Alpha vs Beta Cell Function

    • Alpha Cells: When blood sugar is low, alpha cells release glucagon, signaling the liver to release stored glucose, raising blood sugar.
    • Beta Cells: When blood sugar is high, beta cells release insulin, helping body cells absorb glucose, lowering blood sugar. Beta cells are often found in clusters called islets of Langerhans.

    Type 1 vs Type 2 vs Gestational Diabetes

    Type 1

    • Pathophysiology: Immune attack on beta cells, preventing insulin production.
    • Prevalence: "Juvenile onset"
    • Characteristics: Insulin-dependent, beta cell destruction, autoimmune disease (or idiopathic).

    Type 2

    • Pathophysiology: Increased blood glucose and insulin, eventually leading to insulin resistance.
    • Prevalence: 90-95 percent of diabetics, adult onset.
    • Characteristics: Insulin resistance, insulin secretion defect, strong genetic influence.

    Gestational Diabetes

    • Pathophysiology: Glucose intolerance during pregnancy.
    • Characteristics: Occurs in 2-10% of pregnancies, increases future risk of type 2 diabetes for the mother, and possibly the child.

    Criteria for Testing Diabetes

    • Fasting Plasma Glucose: ADA/CDC: 5.6-6.9 mmol/L (100-125 mg/dL); WHO: 6.1-6.9 mmol/L (110-125 mg/dL); Diabetes: 7.0 mmol/L (≥126 mg/dL)
    • 2-Hour Plasma Glucose: 2.2-11.1 mmol/L (140-200 mg/dL); ≥ 11.1 mmol/L (≥200 mg/dL)
    • HbA1c: 5.7-6.4% (39-47 mmol/mol); ≥6.5% (≥48 mmol/mol)

    Hyperglycemia vs Hypoglycemia

    • Hyperglycemia: Fasting blood glucose >130 mg/dL. Kidneys excrete glucose and water. Can lead to Diabetic Ketoacidosis (body metabolizes fat, producing ketones). Leads to organ damage.
    • Hypoglycemia: Fasting blood glucose <70 mg/dL. Too much insulin or too little carbohydrates. Can lead to coma and death.

    Macrovascular vs Microvascular vs Neuropathy (Diabetes)

    • Macrovascular: large vessel disease (coronary arteries, cerebrum, and periphery)
    • Microvascular: small vessel disease (retinopathy, nephropathy)
    • Neuropathy: effects peripheral and autonomic nervous systems. Includes peripheral nerve damage in lower extremities (loss of sensation, reflexes, and increased risk of infections) and autonomic neuropathy.

    Diabetes- Medical History and Physical Exam

    • Medical History: Focus on acute and chronic complications, laboratory values (HbA1c, plasma glucose), lipids, proteinuria, blood pressure, body weight, and body mass index.
    • Physical Exam: Elevated resting heart rate; loss of sensation (especially lower extremities); loss of reflexes (especially lower extremities); foot sores/ulcers; excessive bruising; retinal vascular abnormalities

    Diabetes Exercise Testing

    • Special Considerations: Exercise testing needs to consider cardiovascular risk, neuropathy, blood glucose control.
    • ECG Stress Testing: May be indicated in those with additional risk factors.
    • Types of Exercise: Cardio-respiratory, Resistance, Range of Motion.

    Obesity (Chapter 8)

    • Definition: Abnormal or excessive fat accumulation that risks health.
    • Calculation: BMI= weight (kg)/ height^2 (m^2) or weight (lb) x 703 / height^2 (in^2).
    • Classification: Body weight-related categories (underweight, normal, overweight, and various obesity classes). Table 8.1 (in the text) provides specific criteria.
    • Adipocytes: Primary cell type in adipose tissue, stores triglycerides.
    • Adipokines: Adipose-derived hormones.
    • Leptin: Hormone suppressing appetite, affecting metabolism.
    • Adiponectin: Increases metabolism and energy expenditure.
    • Ghrelin: Hormone stimulating hunger, released from gastrointestinal tract.

    Obesity- Pathophysiology

    • Risks: Diabetes, hypertension, dyslipidemia, breathlessness, sleep apnea, gall bladder disease, heart disease, osteoarthritis, hyperuricemia, complications during pregnancy, and cancer.
    • Fat Distribution: Android fat (abdomen, upper body) often more associated with health risks than gynoid fat(hips, thighs, and buttocks).

    Obesity - Exercise Testing

    • Types of Diets: High-protein, low-carb, hypocaloric, time-restricted feeding.
    • Pharmacological: Appetite suppressants, fat absorption reducers.
    • Surgical: Significant weight loss, but carries risk of complications, potentially permanent weight gain.
    • Exercise is important for maintaining and improving health at any body weight.

    Hyperlipidemia and Dyslipidemia

    • Lipids: Chylomicron, VLDL, IDL, LDL, HDL (in order of size and density), with different roles in transporting lipids & cholesterol.
    • LDL receptor: Pathway that removes cholesterol from bloodstream.
    • Reverse Cholesterol Pathway: Pathway that transports cholesterol back to the liver.

    Metabolic Syndrome

    • Definition: Collection of interrelated cardiometabolic risk factors (more common when in the presence of overweight/obesity).. Leading to greater risk of atherosclerotic cardiovascular disease.
    • Exercise Recommendation: Moderate intensity cardio exercise 150-250 min per week. Resistance exercise can supplement cardio exercise.

    Peripheral Artery Disease

    • Definition: Blockage of leg arteries leading to decreased blood flow to the muscles.
    • Classifications: Fontaine (asymptomatic, mild-severe claudication, rest pain, ulceration, gangrene); Rutherford (based on tissue loss).
    • Clinical Considerations: Inclaudication is the most common symptom.
    • Exercise Considerations: Exercise testing and special considerations for PAD will need to consider the presence, severity, and stage of claudication.
    • Important Considerations Duration, intensity, use of Borg 15 category scale or similar scales.

    Asthma

    • Pathophysiology: Airway inflammation and airflow limitation.
    • Diagnosis: Spirometry measurement such as FEV1/FVC, flow volume loop.
    • Special Considerations: Exercise testing needs to use and monitor BP, ECG, arterial oxygen saturation, dyspnea (Borg scale).
    • Exercise Prescription: Walking, running, swimming, or other aerobic exercise (at intensity just below the anaerobic threshold). Exercise precautions.

    Cancer (Chapter 21)

    • Definition: Uncontrolled cell growth.
    • Types of cancer: Carcinoma, sarcoma, leukemia, lymphoma.
    • Differentiation: Benign (slow-growing, isolated) and malignant (faster-growing, invasive).
    • Pathophysiology: Tumor growth, angiogenesis, metastasis.
    • Treatment Options: Surgery, radiation, chemotherapy, biotherapy
    • Exercise Testing: Special considerations for both cancer types and related conditions.

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    KIN492 Test 3 Study Guide PDF

    Description

    This quiz covers the definitions, cell functions, and differences between Type 1, Type 2, and Gestational diabetes. It examines the underlying pathophysiology and characteristics of each type, providing a comprehensive overview of diabetes. Test your understanding of these metabolic diseases and their clinical implications.

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