13 GLUCOSE & INSULIN METAB_SW-1.ppt

13 GLUCOSE & INSULIN METAB_SW-1.ppt -...

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    Effects of Physical Activity on  Glucose and Insulin  Metabolism
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Report of the Expert Committee on the  Diagnosis and Classification of Diabetes  Mellitus “Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.” The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care , 26 (supplement 1):S5-S20, 2003.
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Diabetes Facts ~21 million people in the US with diabetes Prevalence ~7.0% in US 1.5 million new cases diagnosed in people aged 20 years or older in 2005 Estimated diabetes costs = over $132 billion CDC, National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2005. Atlanta, GA: US Dept of Health and Human Services, CDC, 2005.
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Criteria for the Diagnosis of Diabetes  Mellitus 1. Symptoms of diabetes + casual blood glucose ≥ 200 mg/dL OR 2. Fasting plasma glucose ≥ 126 mg/dL OR 3. 2-hour plasma glucose ≥ 200 mg/dL during an oral glucose tolerance test (OGTT) The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care , 26 (supplement 1):S5-S20, 2003.
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Diagnosis of Diabetes: Fasting Glucose Fasting glucose If normal, not necessarily proof that non-diabetic Typically have to have advanced diabetes for fasting glucose to be elevated
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Diagnosis of Diabetes: OGTT OGTT Fasted blood sample, glucose drink, blood samples drawn over time Also like to see insulin over time during OGTT but not often done (not conventional measure) GTT F0 male 0 50 100 150 200 250 300 350 400 450 500 0 30 60 90 120 Time (min) Delta Plasma Glucose (mg/dl) SED EX
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Type 2 Diabetes and Obesity Very important to remember that many to most type 2 diabetes (T2D) patients are also obese!!!
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Type 2 Diabetes Progression Healthy – normal glucose, normal insulin Some insulin resistance – normal glucose, elevated insulin More insulin resistance – normal fasting glucose, high glucose during OGTT, elevated insulin Even more insulin resistance – high fasting and OGTT glucose, insulin starts to decrease Full blown T2D – high fasting and OGTT glucose, low insulin
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Summary of T2D and Exercise Studies:  Gudat et al. “In summary, caution is warranted against overinterpreting the few (mostly uncontrolled) intervention studies. One often faces difficulties separating dietary influences from exercise effects.” Reading #32
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Summary of T2D and Exercise Studies:  NIH 1987 Consensus Conference “Exercise itself may have a small but transient effect in lowering blood glucose and insulin resistance.” “Normal weight maintenance continues as the
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This note was uploaded on 10/18/2011 for the course KNES 260 taught by Professor Hagberg during the Spring '08 term at Maryland.

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13 GLUCOSE & INSULIN METAB_SW-1.ppt -...

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