1. Blood glucose levels and obesity

2. What do you know now? From your previous knowledge in N5 or elsewhere
Brainstorm with a partner what you know about the control of blood glucose levels and obesity
Distil the information into the 5 most important points and note them on a white board for class discussion

3. What you are learning Why blood glucose control is important
How blood sugar is controlled including the hormones involved and their effects
What happens when blood sugar cannot be controlled
What is obesity
What are the consequences of being obese
How to avoid being obese

4. Number of People with diabetes
Diabetes in the UK
Country in UK
Number of People with diabetes
England
2,913,538
Northern Ireland
84,836
Scotland
271,312
Wales
183,348
Reference

5. Graph of obesity prevalence
Public Health England

6. Trends in adult prevalence in adult obesity in the UK
Public Health England

7. Blood glucose levels Why is blood glucose (sugar) important?
Why is it important to control blood glucose levels?
Chronic elevated blood glucose levels are associated with some serious problems
Blood vessels are damaged when endothelium cells take in more glucose than normal
Atherosclerosis may develop increasing risk of CVD, stroke or PVD
Damaged blood vessels may lead to haemorrhaging in the retina, cause renal failure or peripheral nerve dysfunction

8. Blood glucose level control
Part of the homeostatic systems in body
Process involves negative feedback
Look at diagram you have been given and summarise the information using bullet points

10. Blood glucose level control
Pancreatic cells detect levels of blood glucose
If blood glucose is too high insulin is secrete from β cells in the pancreas
Insulin activates conversion of glucose to glycogen in liver removing glucose from blood
More glucose taken into fat and muscle cells
If blood glucose is too low glucagon is secreted by α cells in pancreas
Glucagon activates conversion of glycogen to glucose in liver releasing glucose into blood

11. Blood glucose level control
Adrenaline (epinephrine) is released from adrenal glands
Adrenaline stimulates glucagon secretion but inhibits insulin secretion
Glucose is released into blood to cope with the situation
Adrenaline is known as the flight or fight hormone
Adrenaline is also released during exercise

12. Diabetes Type 1 and Type 2 Type 1 Usually occurs in childhood
Person cannot produce insulin
Person is treated with injections of insulin and careful diet
Type 2
Typically occurs later if life
Mainly in overweight people
Individuals produce insulin but cells are less sensitive to it
Fewer insulin receptors present in liver cells so glucose is not converted to glycogen
Exercise, weight loss, diet control to control (insulin for some)

13. Diabetes
Both types lead to chronic complications including vascular disease leading to retinal damage, renal failure, capillary damage, nerve damage.
Blood glucose levels rise rapidly after a meal.
Glucose is lost in the urine because kidneys cannot cope with the rise

14. Testing for diabetes
Urine test for diabetes is used as an indicator of diabetes
Diagnosis is done with a glucose tolerance test
Individual fasts (do not eat) for 8 hours
Blood glucose is then measured
Individuals drink 250 – 300ml of glucose solution (set conc.)
Blood glucose is monitored for next 2.5 hours (150 mins)
Results give a plot for sugar tolerance

17. Comparing diabetes types
Type 1 diabetes
Type 2 diabetes
% all cases
5 - 10
90 – 95
First occurs
Childhood/early teens
Adulthood
Typical body mass
Normal/underweight
Overweight/obese
Ability to produce insulin
absent
Present
Sensitivity to insulin (liver/skeletal muscle)
Normal insulin receptor number respond if insulin is present
Decreased receptor number glucose does not enter cells or get converted to glycogen
Treatment
Regular insulin injections and careful diet
Exercise, weight loss, diet control and insulin in some cases

18. Obesity
Accumulation of excess body fat compared to lean tissue (muscle)
Fat on outside and inside
Increases risk of health problems including CVD, kidney failure, type 2 diabetes, osteoarthritis
Variety of method used to determine ideal weight for each individual
Body mass index (BMI)
Densitometry
Skin fold thickness
Bioelectrical impedance
Waist/hip ratio

19. Body Mass Index (BMI) BMI = Body mass (Kg) height (m2)
Most often use as easy to calculate and works for most average individuals, good indicator for ideal weight for height
BMI limited exceptions athletes, body builders, rugby players have high BMI due to mass of muscle
BMI value
Expert opinion
Health risks
20 – 25
Ideal
Average
26 – 30
Overweight
Increased
31 – 40
Very overweight (obese)
Greatly increased
Over 40
Very obese (morbidly)
Very greatly increased

20. Other body measurements
Densitometry measures mass of person in air and water. Fat and muscle have set masses and can be compared
Skin fold thickness measures skin fold in a number of places to get average
Bioelectrical impedance passes current through body and calculates fat as it impedes electrical current more than muscle
Waist/hip ratio

21. Obesity causes Genetic Psychological Environmental Metabolic Dietary
For most people too much energy rich food in and not enough physical activity to use it up

22. Obesity avoidance Obesity associated with high fat level in diet and
reduced physical activity
Limit intake of fat and
free sugars (energy)
Fats are calorie rich
Free sugars require no
metabolic activity to digest
Energy in to equal energy out for balance
Exercise to increase energy expenditure and maintain
lean tissue (muscle)

23. Being Healthy – exercise and diet
Exercise can help with
Reducing cardiovascular disease
Keeping weight under control
Reducing stress
Reducing hypertension
Improving HDL levels in the blood
Controlled balanced diet will help with
Control body mass to appropriate level
Reducing risk of type 2 diabetes
Reducing risk of CVD

24. What you should be able to do
Explain how blood glucose levels are controlled
Explain why high levels of blood glucose are harmful
Explain the 2 types of diabetes – cause and effect
Explain the diagnosis of diabetes
Describe obesity and how body mass is measured
Explain why obesity is a problem
Describe how obesity can be avoided
Describe the benefits of exercise and a controlled balanced diet