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Insulin resistance syndrome

distinguishes Syndrome X form other diagnoses that are also called Syndrome X

Metabolic Syndrome

a cluster of metabolic abnormalities defined as any combination of three of the following: abdominal obesity, glucose intolerance, hypertension, and abnormal blood lipid levels

Insulin resistance

the body cells resist the action of insulin; the usual consequence is an increased production of insulin to override the resistance at the cell level


excess insulin in the blood is felt to play a large part int eh health issues of insulin resistance

Diagnosis based on health correlates/conditions

1. central obesity- men above 40 in, women above 35 in
2. hypertension
3. dyslipidemia- above 150
4. prediabetes- 110-126 mg/dl

Polycystic ovary syndrome (PCOS)

growth of multiple cysts, causes irregular menstrual cycle. common cause of infertility.


uric acid levels increase in bloodstream and form crystals in feet. must avoid high purine foods

Associations with Metabolic syndrome (markers)

-nonalcoholic fatty liver
-elevated CRP
-elevated ferritin levels
-acanthosis nigricans and cutaneous papillomas

Metabolic syndrome prevention

-emphasize regular physical activity
-high fiber
-avoid excess refined carbohydrates
-emphasize unsaturated fats; avoid excess saturated fat and trans fat
-maintain ideal body weight
-adequate sleep

Management of Metabolic syndrome

-fat intake; emphasis on monounsaturated fats
-CHO intake (fiber)
-several small meals (low gylcemic)
-incrase exercise and low kilocalorie intake
-decrease inflammation
-limit alcohol

Diabetes Mellitus

-fasting blood glucose levels equal to or over 126 mg/dL
-Type 1: Juvenile onset, usually of normal or underweight, pancreatic beta cells destroyed, daily insulin injections required
-Type 2: overweight, insulin resistance related to obesity, most common

Short term effects of diabetes

-excessive hunger and thirst (polyphasia)
-increase urination
-increase or decrease weight
-blurred vision
-increase infections
-decrease wound healing

Long term effects of diabetes

-heart disease
-kidney failure
-poor circulation
-loss of limbs

Risk factors for diabetes and pre diabetes

genetics, family, racial/ethnic background, sedentary lifestyle, HTN, low HDL, high Trig, CVD

Type 1 diabetes risk factors

-uncontrolled celiac disease- must avoid gluten
-vitamin d deficiency

Type 2 risk factors

-excess weight
-physical inactivity
-low fiber intake, processed foods
-high levels of saturated and trans fats, red meat

Type 1 diabetes

-autoummine disease
-onset peak during adolescence
-betal cells destroyed leading to destruction of insulin production
-usually thin and ketone-prone
-always requires insulin to avoid ketoacidosis (DKA)- occurs when glucose can't be used for energy b/c f insuff. insulin -emergency situation
-timing is important

Type 2 diabetes

-related to insulin resistance
-genetic predisposition requires environ. factors to result in this
-body is producing insulin but cells aren't accepting them

Gestational Diabetes

-occurs during pregnancy after placenta is formed, no increased risk in north defects.
-similar to type 2
-possible role of zinc and selenium def.

Potential Consequences of GDM

-elevated glucose form mother = risk of adverse outcomes: spontaneous abortion, stillbirth, neonatal death, congenital anomalies, increase insulin and glucose uptake and trig formation in fetus.
-fetal changes increase likelihood later in life in obesity, HTN and type 2 diabetes

Hormones control blood glucose

-insuline lowers BG by allowing cell uptake
-counterregulatory stress hormone raise BG levels by allowing stored glycogen to be released as BG

Counterregulatory stress hormones

-growth hormone

A1C, the 3month test

sugar attaches to protein throughout the bod and lives for 3 months. BG should be under 7%

The Diet plan

heart healthy diet.
-whole-grain breads and cereals, vegetables, fruits, high fiber foods
-limited intake of simple sugars
-low GI foods
-monounsaturated fats
-three regular meals and snacks

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