Chapter 14: Diabetes

What is the prevalence of pre-diabetes in the United States?

84 million Americans have pre-diabetes but only 11% of those people know that they have prediabetes.

hypoglycemia is a blood glucose of what value?

<70 mg/dL

What is the cost of treating diabetes in the United States each year?

245 billion dollars a year. 176 billion from direct healthcare costs and 69 billion from indirect causes such as lost work disability and premature death.

What percentage of people with diabetes have increased depressive symptoms?

25%

How many deaths are caused by type 2 diabetes worldwide each year?

3.2 million deaths or six deaths per minute.

What is the prevalence of diabetes in the United States?

30 million Americans have diabetes which is 9.4% of the population.

moving every _________ minutes can have a significant effect on metabolism and people with type 2 diabetes?

30 minutes

The diabetes prevention program found that metformin can decrease the progression of prediabetes to diabetes by what percent?

33%

What is the prevalence of type 1 diabetes in the United States?

5 to 10% of Americans or 1.25 million people

In people with overweight or obesity what percentage of weight loss is necessary to reverse insulin resistance?

5 to 7% of starting body weight.

What fasting plasma glucose is indicative of diabetes?

>126 mg/dL on two separate occasions

What is the value on an oral glucose tolerance test that is indicative of diabetes?

>200

What hemoglobin a1c is indicative of diabetes

A1C greater than or equal to 6.5%

The diabetes prevention program found that lifestyle medicine could decrease the progression from prediabetes to type two diabetes by what percent?

58%

What percentage of type 1 diabetes cases are diagnosed before the age of 18?

75%

type 2 diabetes is the _______ leading cause of death in the United States

7th

during exercise aim to keep blood glucose levels between these values

80 & 180

What is the most common complication of type 2 diabetes?

peripheral neuropathy which is a loss of sensation in the feet which can lead to undetected ulcers and lower limb amputation.

What percentage of Americans with diabetes mellitus have type 2 diabetes?

More than 90%

What are the five counter-regulatory hormones that cause increases in blood glucose?

- glucagon -epinephrine (adrenaline) -norepinephrine -growth hormone -cortisol

What are the important exercise considerations for people with type 2 diabetes?

1 - crescent layers because they have trouble regulating heat. 2 - Have good shoes and socks to avoid damage to feet which may go undetected due to peripheral neuropathy. 3 - beyond the lookout for hypoglycemia 4- medications especially those causing insulin release may need to be decreased prior to starting a physical activity program.

When is blood glucose at its highest after eating?

1 hour after eating. But it can remain elevated for 2 hours after eating

What three different tests can be used to diagnose diabetes or pre-diabetes?

1- hemoglobin a1c 2- fasting plasma glucose 3- oral glucose tolerance test

What fasting plasma glucose is indicative of prediabetes?

100-125

What is the value on an oral glucose tolerance test that is indicative of pre-diabetes?

140-199

In order for a client with pre-diabetes to see improvement in blood lipids inflammation levels and insulin action They need to lose approximately how much weight?

19 pounds

What are the exercise recommendations for resistance training for people with type 2 diabetes?

2 to 3 resistance training sessions per week including 8 to 10 exercises using 1 to 3 sets of 10 to 15 repetitions. It's important to go close to fatigue on each set.

What are the recommendations for aerobic exercise for people with type 2 diabetes?

At least 150 minutes of moderate intensity aerobic exercise per week with no more than two consecutive days without exercise

How long must you fast for a fasting plasma glucose test?

At least 8 hours.

When does gestational diabetes mellitus usually occur?

In the second or third trimester of pregnancy

What are the health consequences of an insulin resistant liver?

Increase blood fats and cholesterol levels which lead to an increase risk of cardiovascular disease

What are the symptoms of hyperglycemia?

Increased thirst, urination, or fatigue, blurred vision, unexplained hunger, rapid weight loss, and slow healing cuts or infections.

What is the function of metformin?

It targets the liver to decrease glucose release into the bloodstream effectively decreasing blood glucose.

What are the risks associated to the mother and the baby with gestational diabetes?

The baby could be born over 9 lb and have other complications. The mother is much more likely to develop type 2 diabetes later on in life.

describe the procedure for an oral glucose tolerance test

The patient has their blood glucose level tested at baseline then drinks 75 g of a glucose solution and blood glucose is measured 2 hours afterwards.

How does the risk of developing type 2 diabetes differ between ethnic and racial minorities as compared to the whole US population?

The whole population has a 1 in 3 chance of developing type two diabetes over their lifetime. for racial and ethnic minorities This is a 1 in 2 chance

People with type 2 diabetes have trouble maintaining normal blood glucose especially when?

after eating, when stressed or ill, and sometimes during physical activity.

Who needs to be tested for gestational diabetes mellitus and when?

all pregnant women between 24 to 28 weeks along in their pregnancy

What type of diabetics are required to take insulin?

all type 1 diabetics and many type 2 diabetics

What hemoglobin a1c is indicative of prediabetes?

and A1C between 5.7 and 6.4%

What type of cells are responsible for producing insulin?

beta cells in the pancreas

What is the normal fasting plasma glucose?

between 70 and 99 mg/dL

The majority of insulin resistance occurs in what type of tissue?

muscle.

What are the 2 main risk factors that can lead the liver to become insulin resistant?

eating too many processed foods and refined carbohydrates.

What is the short-term effect of exercise on type 2 diabetes?

exercise helps muscles uptake glucose independent of insulin for up to 24 to 48 hours following exercise therefore decreasing circulating blood glucose

When choosing which of the three diagnostic tests to use for diabetes what should doctors consider?

family history.

What is the purpose of glucagon and from where is it released?

glucagon is released by the alpha cells in the pancreas and function to signal the liver to release glucose into the bloodstream for use during fasting and exercise or when blood sugar is too low.

What is the storage form of glucose and where is it stored in the body?

glycogen is the stored form of glucose and it can be stored in the muscle, fat cells, or liver.

How much higher are medical costs for a person with type 2 diabetes as compared to someone without type 2 diabetes?

healthcare costs are 2.3 times higher in people with type 2 diabetes

Which type of diabetes test measures the average blood glucose levels over the past 2 to 3 months?

hemoglobin a1c

If present in the urine or blood what chemical is an indication that diabetes is not well controlled?

ketones

What are the symptoms of hypoglycemia?

shakiness, fatigue, elevated pulse, visual changes, & mental confusion