Identify, among young people aged 10–19 years, which ethnic group showed the highest rate of new cases of type I diabetes and type II diabetes.

Type I diabetes:

Type II diabetes:

Determine the rate of new cases of type II diabetes among children of African ethnicity aged 10–19 years.

Compare rates of diabetes between the two age groups studied.

(i) Compare the relative proportions of type I and type II diabetes between the different ethnic groups. 

(ii) Suggest a reason for the different rates of type II diabetes among the ethnic groups.  

State the relationship between plasma fatty acid level and enzyme activity.

Calculate the percentage change of enzyme activity after 5 hours exposure to lipids.

Discuss, using the data, whether the effect of lipids on this enzyme is reversible.

Comment on the effect of increased insulin concentration on glucose absorption in the muscle bathed in lipid.

Some investigators suggest that there is a strong relationship between high lipid diet and the body’s response to insulin. Using the data provided, evaluate this hypothesis.

type I: European / E
type II: Native American / NA

Both needed

(accept range) 18–20 (cases per 100 000)

type I shows same/similar pattern of rate in both age groups;
rates of type II were (much) greater among those aged 10–19 years than <10 years

(i) Europeans/E have lowest rate of type II / only Europeans/E (10+) have a higher rate for type I (than type II);
API/NA 10+ rate higher for type II (than type I);
LA/A rates for both similar at 10+;
NA(10+) has the lowest cases of type I but highest number of type II / NA under 10 have lowest rates for both types;

(ii) different genetic factors (affect fat metabolism);
(rise) due to increase in fat/carbohydrate intake/junk food/low in fibre;
“western” diet (in US) very different from traditional diets;

negative/inverse relationship/negative correlation / as one variable increases the other decreases / as plasma fatty acid increases, enzyme activity decreases / vice versa

(a decrease of) 45 (%) (accept answers in the range of 44 (%) to 47 (%))

yes, effect is reversible as activity returns to (approximately) original level (when lipids/fatty acids decrease);

when lipid/fatty acids washed out enzyme is more active/activity increases;

difference between starting and final levels of enzyme activity is insignificant because of error bars;

three hours/experimental time may be insufficient to reverse the effect;

increased insulin concentration causes more glucose absorption (up to 10³ μU ml^–1);

glucose absorption in muscle bathed in lipid always less than control;

no further increase/slight decrease in glucose absorption beyond 103 (μU ml^–1) insulin;

Referring to first graph:
plasma lipids lower activity of enzyme (needed for glucose absorption);

Referring to second graph:
more/higher glucose uptake with higher insulin levels in muscles without lipids
(compared to muscles bathed in lipids);
lipids reduce glucose absorption (even at raised insulin concentrations);
isolated muscle used in experiments so results may differ in whole organisms;

This was a data analysis question based around diabetes. Most gained the mark for the correct ethnic groups in (a), however, part (b) proved surprisingly difficult, with less than half of the candidates correctly calculating 19 cases (per 100, 000). In (c) most gained the mark for the (much) greater incidence of Type II amongst 10-19 year olds, but only the better candidates spotted the similarity between the incidences of Type I in both age groups. In the first part of (d) the better candidates could find at least one good comparison between the ethnic groups. The answer ‘due to different diets’ was a common vague answer in (d)(ii). More precision was expected, e.g. greater fat/carbohydrate intake.

Most were able to state that the relationship was negative/inverse in (e), with weaker candidates trying to describe it using numbers from the graph. Stronger candidates correctly calculated the 45% decrease in part (f). There was no mark for the workings, but the numbers should have been taken from the right hand axis. Most were able to gain at least one mark for the discussion of reversibility in (g). Similarly in (h) most were able to link increased insulin concentration with more glucose absorption and in (i) most gained a mark, although the fact that the plasma lipids lowered the activity of the enzyme was not well spotted.

This was a data analysis question based around diabetes. Most gained the mark for the correct ethnic groups in (a), however, part (b) proved surprisingly difficult, with less than half of the candidates correctly calculating 19 cases (per 100, 000). In (c) most gained the mark for the (much) greater incidence of Type II amongst 10-19 year olds, but only the better candidates spotted the similarity between the incidences of Type I in both age groups. In the first part of (d) the better candidates could find at least one good comparison between the ethnic groups. The answer ‘due to different diets’ was a common vague answer in (d)(ii). More precision was expected, e.g. greater fat/carbohydrate intake.

Most were able to state that the relationship was negative/inverse in (e), with weaker candidates trying to describe it using numbers from the graph. Stronger candidates correctly calculated the 45% decrease in part (f). There was no mark for the workings, but the numbers should have been taken from the right hand axis. Most were able to gain at least one mark for the discussion of reversibility in (g). Similarly in (h) most were able to link increased insulin concentration with more glucose absorption and in (i) most gained a mark, although the fact that the plasma lipids lowered the activity of the enzyme was not well spotted.

This was a data analysis question based around diabetes. Most gained the mark for the correct ethnic groups in (a), however, part (b) proved surprisingly difficult, with less than half of the candidates correctly calculating 19 cases (per 100, 000). In (c) most gained the mark for the (much) greater incidence of Type II amongst 10-19 year olds, but only the better candidates spotted the similarity between the incidences of Type I in both age groups. In the first part of (d) the better candidates could find at least one good comparison between the ethnic groups. The answer ‘due to different diets’ was a common vague answer in (d)(ii). More precision was expected, e.g. greater fat/carbohydrate intake.

Most were able to state that the relationship was negative/inverse in (e), with weaker candidates trying to describe it using numbers from the graph. Stronger candidates correctly calculated the 45% decrease in part (f). There was no mark for the workings, but the numbers should have been taken from the right hand axis. Most were able to gain at least one mark for the discussion of reversibility in (g). Similarly in (h) most were able to link increased insulin concentration with more glucose absorption and in (i) most gained a mark, although the fact that the plasma lipids lowered the activity of the enzyme was not well spotted.

This was a data analysis question based around diabetes. Most gained the mark for the correct ethnic groups in (a), however, part (b) proved surprisingly difficult, with less than half of the candidates correctly calculating 19 cases (per 100, 000). In (c) most gained the mark for the (much) greater incidence of Type II amongst 10-19 year olds, but only the better candidates spotted the similarity between the incidences of Type I in both age groups. In the first part of (d) the better candidates could find at least one good comparison between the ethnic groups. The answer ‘due to different diets’ was a common vague answer in (d)(ii). More precision was expected, e.g. greater fat/carbohydrate intake.

Most were able to state that the relationship was negative/inverse in (e), with weaker candidates trying to describe it using numbers from the graph. Stronger candidates correctly calculated the 45% decrease in part (f). There was no mark for the workings, but the numbers should have been taken from the right hand axis. Most were able to gain at least one mark for the discussion of reversibility in (g). Similarly in (h) most were able to link increased insulin concentration with more glucose absorption and in (i) most gained a mark, although the fact that the plasma lipids lowered the activity of the enzyme was not well spotted.

This was a data analysis question based around diabetes. Most gained the mark for the correct ethnic groups in (a), however, part (b) proved surprisingly difficult, with less than half of the candidates correctly calculating 19 cases (per 100, 000). In (c) most gained the mark for the (much) greater incidence of Type II amongst 10-19 year olds, but only the better candidates spotted the similarity between the incidences of Type I in both age groups. In the first part of (d) the better candidates could find at least one good comparison between the ethnic groups. The answer ‘due to different diets’ was a common vague answer in (d)(ii). More precision was expected, e.g. greater fat/carbohydrate intake.

Most were able to state that the relationship was negative/inverse in (e), with weaker candidates trying to describe it using numbers from the graph. Stronger candidates correctly calculated the 45% decrease in part (f). There was no mark for the workings, but the numbers should have been taken from the right hand axis. Most were able to gain at least one mark for the discussion of reversibility in (g). Similarly in (h) most were able to link increased insulin concentration with more glucose absorption and in (i) most gained a mark, although the fact that the plasma lipids lowered the activity of the enzyme was not well spotted.

This was a data analysis question based around diabetes. Most gained the mark for the correct ethnic groups in (a), however, part (b) proved surprisingly difficult, with less than half of the candidates correctly calculating 19 cases (per 100, 000). In (c) most gained the mark for the (much) greater incidence of Type II amongst 10-19 year olds, but only the better candidates spotted the similarity between the incidences of Type I in both age groups. In the first part of (d) the better candidates could find at least one good comparison between the ethnic groups. The answer ‘due to different diets’ was a common vague answer in (d)(ii). More precision was expected, e.g. greater fat/carbohydrate intake.

Most were able to state that the relationship was negative/inverse in (e), with weaker candidates trying to describe it using numbers from the graph. Stronger candidates correctly calculated the 45% decrease in part (f). There was no mark for the workings, but the numbers should have been taken from the right hand axis. Most were able to gain at least one mark for the discussion of reversibility in (g). Similarly in (h) most were able to link increased insulin concentration with more glucose absorption and in (i) most gained a mark, although the fact that the plasma lipids lowered the activity of the enzyme was not well spotted.

This was a data analysis question based around diabetes. Most gained the mark for the correct ethnic groups in (a), however, part (b) proved surprisingly difficult, with less than half of the candidates correctly calculating 19 cases (per 100, 000). In (c) most gained the mark for the (much) greater incidence of Type II amongst 10-19 year olds, but only the better candidates spotted the similarity between the incidences of Type I in both age groups. In the first part of (d) the better candidates could find at least one good comparison between the ethnic groups. The answer ‘due to different diets’ was a common vague answer in (d)(ii). More precision was expected, e.g. greater fat/carbohydrate intake.

Most were able to state that the relationship was negative/inverse in (e), with weaker candidates trying to describe it using numbers from the graph. Stronger candidates correctly calculated the 45% decrease in part (f). There was no mark for the workings, but the numbers should have been taken from the right hand axis. Most were able to gain at least one mark for the discussion of reversibility in (g). Similarly in (h) most were able to link increased insulin concentration with more glucose absorption and in (i) most gained a mark, although the fact that the plasma lipids lowered the activity of the enzyme was not well spotted.

This was a data analysis question based around diabetes. Most gained the mark for the correct ethnic groups in (a), however, part (b) proved surprisingly difficult, with less than half of the candidates correctly calculating 19 cases (per 100, 000). In (c) most gained the mark for the (much) greater incidence of Type II amongst 10-19 year olds, but only the better candidates spotted the similarity between the incidences of Type I in both age groups. In the first part of (d) the better candidates could find at least one good comparison between the ethnic groups. The answer ‘due to different diets’ was a common vague answer in (d)(ii). More precision was expected, e.g. greater fat/carbohydrate intake.

Most were able to state that the relationship was negative/inverse in (e), with weaker candidates trying to describe it using numbers from the graph. Stronger candidates correctly calculated the 45% decrease in part (f). There was no mark for the workings, but the numbers should have been taken from the right hand axis. Most were able to gain at least one mark for the discussion of reversibility in (g). Similarly in (h) most were able to link increased insulin concentration with more glucose absorption and in (i) most gained a mark, although the fact that the plasma lipids lowered the activity of the enzyme was not well spotted.