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HSCI 2211 - Final Exam > 5 - Diabetes Control Programs > Flashcards

5 - Diabetes Control Programs Flashcards

1
Q

Can type 1 diabetes be prevented?

A

No

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2
Q

Can type 2 diabetes be prevented?

A

Yes

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3
Q

Can long-term complications of type 1 diabetes be delayed or prevented?

A

Yes

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4
Q

How can long-term complications of type 1 diabetes be delayed or prevented?

A

Through strict control of blood glucose.

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5
Q

What lifestyle interventions can be used to prevent or delay type 2 diabetes?

A

Weight loss, diet, exercise.

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6
Q

How can long-term complications of type 2 diabetes be delayed or prevented?

A

Through strict control of blood glucose and blood pressure.

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7
Q

What is diabetes primary prevention?

A

Preventing the development of diabetes through reduction of modifiable risk factors in the general population and in individuals at high-risk.

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8
Q

What is the population strategy of diabetes primary prevention?

A

Reduce modifiable risk factors in the general population.

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9
Q

What is the high risk strategy of diabetes primary prevention?

A

Reduce modifiable risk factors in individuals at risk.

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10
Q

What is diabetes secondary prevention?

A

Early detection and screening those at high-risk of diabetes.

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11
Q

What is diabetes tertiary prevention?

A

Upon diagnosis of diabetes, prevention of complications, morbidity, and mortality, through adequate treatment.

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12
Q

What is the goal of diabetes primary prevention?

A

To prevent diabetes.

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13
Q

Who are the targets of diabetes primary prevention?

A

The general population and high risk groups.

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14
Q

What is the message of diabetes primary prevention?

A

Make healthy lifestyle choices.

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15
Q

What are the two current delivery models of primary prevention?

A

Population health and primary care.

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16
Q

Who does the high risk approach to diabetes primary prevention focus on?

A

Individuals who have other risk factors (obesity, physical inactivity, smoking, high BP, family history and genetic factors).

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17
Q

What are the interventions found in the high risk approach to diabetes primary prevention?

A

Dietary changes, weight reduction and increased physical activity.

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18
Q

What dietary recommendations are made in the high risk approach to diabetes primary prevention?

A

Monitor carbohydrates, limit foods with a high glycemic index, limit sweetened beverages, and monitor total daily calories consumed.

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19
Q

Sugar should made up what percent of total daily calories according to the high risk approach to diabetes primary prevention?

A

Less than 10%, approximately 12 teaspoons

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20
Q

What are barriers to effective clinical-system based lifestyle intervention programs?

A

Waiting until someone has elevated glucose is already too late, and diabetes is a common-source epidemic rooted in culture and society.

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21
Q

What does the population-based approach of diabetes primary prevention focus on?

A

Prevention strategies for the whole population.

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22
Q

Where can prevention strategies for the whole population take place?

A

Communities, workplaces, schools, social and healthcare settings.

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23
Q

Two types of market regulation and restrictions for diabetes primary prevention….

A

Access-restriction and strategic pricing.

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24
Q

What are examples of strategic pricing (used in market regulation and restriction for diabetes primary prevention)?

A

Taxation, food and menu labelling, and affordable foods.

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25
Q

Who is a patients first contact in the healthcare system?

A

Their family doctor/general practitioner.

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26
Q

What is the role of the primary care physician in terms of diabetes primary prevention?

A

To promote a healthy-lifestyle, included: a healthy diet, physical activity and a healthy bodyweight.

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27
Q

What are examples of effective education and public information that contributes to a change in individual behaviour?

A

Instituting education campaigns that enable people to read and understand food labels. And, providing training staff and volunteers for the skills required to promote population health

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28
Q

What is a school prevention strategy that is known to be effective for children?

A

Increasing time for physical activity.

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29
Q

What are examples of community-wise approaches to promoting health?

A

Community recreational facilities, networks of community-based organizations and services committed to improving nutrition and physical activity, and mandating a local health service such as a diabetes education centre.

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30
Q

What are examples of socio-environmental and workplace primary prevention strategy?

A

Public and social policy interventions. And, programs and polices that encourage behaviour change and create safer and healthier work environments.

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31
Q

What are some examples of programs and policies that encourage behavioural change and create safer and healthier work environments?

A

Smoke-free workplaces and public places. Physical activity programs at work.

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32
Q

What are seven areas involved in diabetes primary prevention?

A

Market regulation and restriction, intervention by primary health providers, public information, school-based interventions, community support, socio-environmental interventions, and workplace interventions.

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33
Q

What is the goal of diabetes secondary screening?

A

Early identification of those with dysglycemia.

34
Q

Who is the target population for diabetes secondary screening?

A

Asymptomatic individuals who have diabetes or who are at a high risk of developing diabetes.

35
Q

Examples of high risk populations for diabetes…

A

Overweight/obese, 45+ years, physically inactive, high blood pressure, low HDL cholesterol, high triglycerides, belonging to an ethnic or minority group at high risk for diabetes, a family history of diabetes, or a history of gestational diabetes.

36
Q

Briefly describe the fasting blood glucose test (fasting plasma glucose test).

A

Blood is collected after an overnight fast, and glucose level is measured.

37
Q

Briefly describe a random blood glucose test.

A

Blood is collected at a random, non-fasting, time, and glucose level is measured.

38
Q

Briefly describe an oral glucose tolerance test.

A

Blood is collected after fasting and agains 2 hours after drinking a glucose-rich drink, and glucose level is measured.

39
Q

Briefly describe a glycated hemoglobin A1C test.

A

This test measures the percentage of hemoglobin molecules that have glucose attached. This test indicates an average blood glucose level for the past 3 months.

40
Q

Hemoglobin

A

A protein that makes red blood cells red-coloured.

41
Q

What happens when hemoglobin picks up a glucose molecule?

A

It becomes glycosylated.

42
Q

What does HbA1c stand for?

A

Glycosylated hemoglobin

43
Q

A1C score for diagnosis of diabetes

A

6.5% or higher.

44
Q

A1C score for diagnosis of prediabetes

A

6% - 6.4% (according to Canadian guidelines)

45
Q

A1C score of a healthy adult without diabetes

A

less than 5.7%

46
Q

Are patients with pre-diabetes usually symptomatic or asymptomatic?

A

Asymptomatic

47
Q

What is the result of intervening early if someone has pre-diabetes?

A

Plasma glucose levels will return to the normal range.

48
Q

How often should someone with pre-diabetes be screened for diabetes?

A

Ever 1.2 years.

49
Q

Compared to someone without pre-diabetes, what is the risk of cardiovascular disease for someone with pre-diabetes?

A

Someone with pre-diabetes has a 1.5-fold higher risk of cardiovascular disease.

50
Q

Compared to someone without diabetes, what is the risk of cardiovascular disease for someone with diabetes?

A

Someone with diabetes has a 2-fold to 4-fold increased risk of cardiovascular disease.

51
Q

In people with pre-diabetes, what other factors can influence risk of cardiovascular disease?

A

Tobacco use, high blood pressure, and high cholesterol.

52
Q

Who is tertiary prevention geared toward?

A

People who already have diabetes.

53
Q

What are the main interventions involved in diabetes tertiary prevention?

A

Physical activity, nutrition, weight management, and medication.

54
Q

Give examples of areas of concern for diabetics in managing their condition…

A

blood glucose levels, blood glucose control, cholesterol, kidneys, eyes, feet, nerve damage, blood pressure, nutrition, diet, weight, and exercise.

55
Q

People with diabetes require continuing medical care and ongoing patient management, education and support to prevent ___ complications.

A

acute

56
Q

People with diabetes require continuing medical care and ongoing patient management, education and support to reduce the rest of ___ microvascular and macrovascular complications.

A

longterm

57
Q

Examples of longterm microvascular and macrovascular complications of diabetes…

A

retinopathy, neuropathy, nephropathy, atherogenesis, blindness, limb amputation, kidney failture, coronary heart disease, myocardial infarction, and stroke.

58
Q

The cornerstone of diabetes tertiary prevention is…

A

maintenance of blood glucose levels within normal limits.

59
Q

How are blood glucose levels controlled in diabetes tertiary prevention?

A

A combination of insulin replacement, medication, diet and exercise.

60
Q

Why are regular eye exams an important part of diabetes tertiary prevention?

A

To prevent vision loss due to retinopathy.

61
Q

Why are regular foot exams and proper foot care an important part of diabetes tertiary prevention?

A

Vascular and neurological damage to the extremities can lead to amputation.

62
Q

4 types of exams/tests important in diabetes tertiary prevention.

A

Blood tests (A1C, microalbumin and lipid tests). Blood pressure tests. Eye exams. Feet exams.

63
Q

Microalbumin test

A

This test measures the amount of a protein called microalbumin in the urine. This test can indicate kidney disease if large amounts of the protein are found.

64
Q

Examples of lifestyle changes needed upon diagnosis of diabetes

A

Self-monitoring blood glucose, exercise, eat healthy meals, stop smoking, limit alcohol, and lower stress.

65
Q

Glucagon

A

A pancreatic hormone that raises blood glucose levels

66
Q

4 key pieces to diabetes self-management.

A

Regular blood sugar testing, following a healthy meal plan, take medication, and get regular exercise.

67
Q

Aim of nutrition self-management?

A

Prevent or delay the onset of complications.

68
Q

What types of foods are encouraged for diabetic patients?

A

Whole grains, vegetables, fruits, low fat meats, non-fatty dairy products, and fish.

69
Q

What types of foods should people with diabetes avoid.

A

Sugary foods, such as pastries, candy bars, and pies.

70
Q

What is the aim of exercise in diabetes self-management?

A

To improve blood glucose control and insulin sensitivity, and to reduce cardiovascular risk, independently of weight loss, by reducing the risk of type 2 diabetes.

71
Q

How much exercise is recommended for diabetic patients?

A

30 minutes a day, at least 3 days a week.

72
Q

How does exercise improve blood sugar levels?

A

It lowers blood sugar levels by improving cell uptake of glucose, causing the body to process glucose faster.

73
Q

What type of medication doe everyone with type 1 diabetes require?

A

Insulin.

74
Q

What is the goal of taking antidiabetic medications?

A

To prevent long-term complications, such as cardiovascular disease.

75
Q

Why might insulin treatment be started in a patient with type 2 diabetes?

A

It might be started if a relative deficiency of insulin secretion develops over time, due to the progressive nature of diabetes.

76
Q

How does insulin work?

A

It promotes glucose uptake by the tissues to facilitate normal body metabolism.

77
Q

How does Metformin work?

A

It lowers the amount of sugar released by the liver, it increases the cells’ sensitivity to insulin, and it slows absorption of sugars from the intestines.

78
Q

What current screening methods are effective, as they are being carried out now?

A

Screening for blood pressure and lipids.

79
Q

What current screening methods are deficient, as they are being carried out now?

A

Screening for microvascular disease complications: retinopathy, nephropathy, neuropathy and foot exams.

80
Q

What does a multi-tiered public health response to diabetes include?

A

Efficient identification and referral of high risk people to structured lifestyle programs using clinical-community partnerships. And, broad population-targeted approaches aimed at food, social, and economic environment to ultimately change trends in the epidemic.

HSCI 2211 - Final Exam (11 decks)

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