Biology • Year 12 • Module 8 • Lesson 14
Treating One Non-infectious Disease: Type 2 Diabetes
Lock in the mechanism of Type 2 diabetes and the vocabulary of treatment, management, monitoring and escalation, the foundations for investigating and evaluating the management of one non-infectious disease.
1. Complete the Type 2 diabetes mechanism and management flow
The diagram traces Type 2 diabetes from its starting mechanism through to management. Write the missing labels into boxes A–H. Every answer comes from the lesson Key Terms panel or the Learn cards. 8 marks
| Box | Your label |
|---|---|
| A | |
| B | |
| C | |
| D | |
| E | |
| F | |
| G | |
| H |
2. Term–definition match
The definitions below are shuffled. Write the matching term from this list in the right-hand column: insulin resistance, beta-cell exhaustion, chronic hyperglycaemia, management, treatment, metformin, HbA1c, escalation, remission, future direction. 10 marks
| # | Definition (shuffled) | Matching term |
|---|---|---|
| 2.1 | A blood test that estimates average blood glucose over roughly the previous two to three months, used as evidence that a plan is or is not working. | |
| 2.2 | The state in which body cells respond poorly to insulin, so more insulin is needed to move the same amount of glucose. | |
| 2.3 | An intervention that targets a disease mechanism or symptom. | |
| 2.4 | Adding another medicine, or insulin, when agreed targets are not met or beta-cell function keeps declining. | |
| 2.5 | The first-line medicine for Type 2 diabetes; it lowers glucose released by the liver and improves how tissues respond to insulin. | |
| 2.6 | The progressive decline in the ability of pancreatic beta cells to keep compensating with extra insulin output. | |
| 2.7 | Persistently raised blood glucose, which slowly damages blood vessels and nerves. | |
| 2.8 | A research path that may improve prevention, treatment or monitoring in the future. | |
| 2.9 | Ongoing actions that control the effects of a disease over the long term. | |
| 2.10 | A state in which blood glucose returns to the non-diabetic range without medication, although the underlying predisposition remains. |
3. True or false, with correction
Circle T or F. If the statement is false, write the corrected version on the line below. 8 marks (1 T/F + 1 correction where needed)
3.1 Type 2 diabetes means the pancreas makes no insulin at all. T / F
3.2 HbA1c monitoring is itself a treatment for Type 2 diabetes because it lowers average blood glucose. T / F
3.3 Metformin lowers blood glucose partly by reducing the glucose released by the liver. T / F
3.4 Remission of Type 2 diabetes removes the underlying genetic predisposition, so the disease cannot return. T / F
4. Function recall
Answer each question in 1–2 sentences using precise lesson terminology. 10 marks (2 each)
4.1 What is the function of metformin in the management of Type 2 diabetes?
4.2 What is the function of HbA1c measurement within a management plan?
4.3 What is the function of physical activity in improving blood-glucose control?
4.4 What is the function of a statin, traced from its molecular target to its clinical outcome?
4.5 What is the function of an ACE inhibitor such as ramipril in a person with diabetes?
5. Build a concept map
Draw labelled arrows between the six terms below. Each arrow must carry a linking phrase (e.g. "leads to", "improves", "measures", "targets"). Aim for at least 6 labelled arrows. 6 marks
Supplied terms: insulin resistance · beta-cell exhaustion · chronic hyperglycaemia · lifestyle change · metformin · HbA1c monitoring.
6. Cloze, fill in the blanks
Complete the paragraph using words from the word bank below. Each word is used once. 10 marks
Type 2 diabetes begins when body cells respond poorly to insulin, a state called _______________. To hold blood glucose in range the pancreatic _______________ release more insulin, but over years this compensation fails, a decline known as beta-cell _______________. Blood glucose then stays high, a state called chronic _______________, which slowly damages vessels and nerves and produces the long-term _______________ of the disease. Management therefore targets two things at once. Activity, nutrition and weight management improve insulin _______________, while metformin reduces the glucose released by the _______________. Progress is judged using _______________, and if targets are not met the plan moves to _______________. Substantial weight loss can even produce _______________, although the underlying predisposition remains.
Q1, Labelled mechanism and management flow
A: insulin resistance (body cells respond poorly to insulin). B: beta-cell exhaustion (the pancreas can no longer keep compensating). C: chronic hyperglycaemia (blood glucose stays persistently high). D: long-term complications (cardiovascular disease, kidney disease, eye damage, nerve damage). E: lifestyle support / lifestyle management (nutrition, physical activity, sleep, weight management). F: metformin. G: HbA1c monitoring. H: escalation.
Q2, Term–definition matches
2.1 HbA1c · 2.2 insulin resistance · 2.3 treatment · 2.4 escalation · 2.5 metformin · 2.6 beta-cell exhaustion · 2.7 chronic hyperglycaemia · 2.8 future direction · 2.9 management · 2.10 remission.
Q3, True / false with correction
3.1 False. Correction: early in Type 2 diabetes the pancreas often makes plenty of insulin, sometimes more than normal. The problem is that cells respond poorly to it. Type 1 diabetes is the condition in which beta cells are destroyed and little or no insulin is made.
3.2 False. Correction: HbA1c is monitoring, not treatment. It estimates average blood glucose over the previous two to three months and supplies evidence for deciding whether to continue, adjust or escalate treatment. It does not lower glucose itself.
3.3 True.
3.4 False. Correction: remission means blood glucose has returned to the non-diabetic range without medication, but the genetic predisposition remains and weight regain brings recurrence. Remission is not a cure.
Q4, Function recall answers
4.1 Metformin: Metformin reduces the amount of glucose released by the liver and improves how muscle and fat tissue respond to insulin. This lowers blood glucose without forcing already-strained beta cells to secrete ever more insulin.
4.2 HbA1c: HbA1c estimates average blood glucose over roughly the previous two to three months. Its function is evidential: it shows whether the current plan is achieving the person's target so a clinician can continue, adjust or escalate treatment.
4.3 Physical activity: Activity improves insulin sensitivity so cells take up glucose more effectively, and contracting muscle also upregulates GLUT4 transporters, which take up glucose without needing insulin. Sustained activity also reduces excess visceral fat where relevant.
4.4 Statin: A statin such as atorvastatin inhibits HMG-CoA reductase, the rate-limiting enzyme of hepatic cholesterol synthesis. The liver responds by upregulating LDL receptors, so more LDL is cleared from the blood, less LDL infiltrates arterial walls and plaque formation slows. Statins slow progression rather than reversing existing plaque.
4.5 ACE inhibitor: Ramipril blocks angiotensin-converting enzyme, reducing production of angiotensin II. Less angiotensin II means less vasoconstriction, lower blood pressure and lower pressure inside glomerular capillaries, which protects the kidneys of a person with diabetes as well as lowering cardiovascular risk.
Q5, Sample concept map
Correct maps should include arrows such as:
- insulin resistance makes beta cells overwork, leading to → beta-cell exhaustion
- beta-cell exhaustion allows glucose to stay high, producing → chronic hyperglycaemia
- lifestyle change improves insulin sensitivity, reducing → insulin resistance
- metformin lowers liver glucose output and improves sensitivity, reducing → chronic hyperglycaemia
- HbA1c monitoring measures the average result of → chronic hyperglycaemia
- HbA1c monitoring supplies the evidence used to adjust → metformin (or lifestyle change)
Award 1 mark per biologically correct labelled arrow (maximum 6). Do not award marks for an arrow that presents HbA1c as lowering glucose.
Q6, Cloze answers (in order)
insulin resistance · beta cells · exhaustion · hyperglycaemia · complications · sensitivity · liver · HbA1c · escalation · remission