Type 1 and Type 2 Diabetes

1. 1 State [1 mark]

   State what is meant by type 1 diabetes.

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   Model answer

   A condition in which the pancreas does not produce enough insulin.

   Mark scheme

   • Pancreas does not produce enough insulin — 1 mark
2. 2 Describe [2 marks]

   Describe how a person with type 1 diabetes controls their blood glucose concentration.

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   Model answer

   They inject insulin, and they control their diet, including the carbohydrate that they eat, and take exercise.

   Mark scheme

   • Inject insulin — 1 mark
   • Diet and exercise — 1 mark
3. 3 Explain [3 marks]

   Explain why a person with type 1 diabetes has to inject insulin rather than swallow it.

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   Model answer

   Insulin is a protein. If it was swallowed, it would be digested by protease enzymes in the stomach and the small intestine, so it would not reach the blood. Injection puts it straight into the blood.

   Mark scheme

   • Insulin is a protein — 1 mark
   • Would be digested — 1 mark
   • Injection puts it into the blood — 1 mark
4. 4 Explain [3 marks]

   Explain why a person with type 2 diabetes may have a high blood glucose concentration even though the pancreas makes insulin.

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   Model answer

   The body cells no longer respond properly to insulin. So the cells do not take up glucose from the blood, and the liver does not store it, so the blood glucose concentration stays high.

   Mark scheme

   • Cells do not respond to insulin — 1 mark
   • Glucose not taken up — 1 mark
   • Concentration stays high — 1 mark
5. 5 Interpret [3 marks]

   The graph shows the blood glucose concentration after a meal. Describe two differences between the curve for a person with type 1 diabetes and the curve for a person with no diabetes.

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   Model answer

   The person with type 1 diabetes has a higher starting concentration, about 10 compared with 5 mmol per dm³, and a higher peak, about 17 compared with 8. After 4 hours, the person with type 1 diabetes is still about 15, while the person with no diabetes has returned to 5.

   Mark scheme

   • Higher starting concentration — 1 mark
   • Higher peak — 1 mark
   • Does not return to normal — 1 mark
6. 6 Evaluate [6 marks]

   Compare the causes of type 1 and type 2 diabetes, and evaluate how each is controlled.

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   Model answer

   In type 1 diabetes, the immune system destroys the cells in the pancreas that make insulin, so the pancreas does not produce enough insulin. In type 2 diabetes, the body cells no longer respond to insulin, and this is linked to obesity and a lack of exercise. Type 1 is controlled by injections of insulin, because insulin is a protein that would be digested if swallowed, together with a controlled diet and exercise. This works well, but the person has to monitor their glucose and inject for life. Type 2 is controlled by a healthy diet, exercise and weight loss, which can reduce the risk and may reverse the condition, and tablets or insulin are used if these are not enough. Type 2 can often be prevented, but type 1 cannot be, because it is not caused by lifestyle.

   Mark scheme

   • Type 1: insulin-making cells destroyed — 1 mark
   • Type 2: cells do not respond, linked to obesity — 1 mark
   • Type 1 controlled by insulin, diet, exercise — 1 mark
   • Why injection — 1 mark
   • Type 2 controlled by diet, exercise and weight loss — 1 mark
   • Type 2 can be prevented, type 1 cannot — 1 mark

Quick check

1. 1

   What is the cause of type 1 diabetes?

   1. AEating too much sugar
   2. BThe pancreas does not produce enough insulin
   3. CThe cells make too much insulin
   4. DA virus in the liver
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   B: The pancreas does not produce enough insulin

   The pancreas does not produce enough insulin.

2. 2

   What is the cause of type 2 diabetes?

   1. ANo pancreas
   2. BToo little water
   3. CToo much insulin
   4. DThe body cells no longer respond to insulin
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   D: The body cells no longer respond to insulin

   The body cells no longer respond to insulin.

3. 3

   How is type 1 diabetes controlled?

   1. ABy injections of insulin, diet and exercise
   2. BBy drinking more water
   3. CBy taking antibiotics
   4. DBy removing the pancreas
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   A: By injections of insulin, diet and exercise

   By injections of insulin, a healthy diet and exercise.

4. 4

   Why is insulin not taken by mouth?

   1. AIt tastes bad
   2. BIt is too small
   3. CIt would be digested
   4. DIt is a lipid
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   C: It would be digested

   It is a protein, and would be digested.

5. 5

   What is the main risk factor for type 2 diabetes?

   1. ABeing underweight
   2. BObesity
   3. CDrinking water
   4. DBeing tall
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   B: Obesity

   Obesity.

6. 6

   Which type of diabetes often starts in childhood?

   1. AType 1
   2. BType 2
   3. CBoth start at birth
   4. DNeither
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   A: Type 1

   Type 1.

7. 7

   How can type 2 diabetes often be prevented?

   1. AAntibiotics
   2. BInsulin injections
   3. CVaccination
   4. DA healthy diet and exercise
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   D: A healthy diet and exercise

   A healthy diet and exercise.

8. 8

   What happens to the blood glucose in a person with diabetes after a meal?

   1. AIt falls to zero
   2. BIt does not change
   3. CIt rises higher and stays high for longer
   4. DIt is converted to protein
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   C: It rises higher and stays high for longer

   It rises higher, and stays high for longer.

9. 9

   What is an insulin pump?

   1. AA device that measures the pulse
   2. BA device that delivers insulin
   3. CA type of tablet
   4. DA part of the pancreas
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   B: A device that delivers insulin

   A device that delivers insulin under the skin.