Diabetes Flashcards
Diabetic foot examination
look at feets, ask if any problems, look at footwear
look at all areas for any ulcers, callouses, deformities and signs of PVD
feel pulses
use 10g neurofilament (big toe, third toe and 3 points on ball of foot)
What might you want to cover in a diabetes review consultation
background-
what is their understanding of this consultation, how have they been since the last consultation, what changes were made in the last consultation, how long have they had diabetes for, have they had any complications
current issues-
any current concerns or symptoms (thirst, fatigue)
PMH and medications (inc allergies), how is their compliance
SH- how do they keep, smoking, drinking, exercise, how does their diabetes affect you
Anticipated issues-
eye and foot screening
blood pressure, renal function
shared management plan-
what changes could we make
signpost to useful resources
future follow up
what are the diet guidelines for people with diabetes
low glycaemic index foods (which release sugar slowly), oily fish, lots of frit and vegetables, low-fat dairy products
if overweight or obese, lose 5-10% of body weight
diabetes UK have good dietary education and weight loss advice resources
what are the exercise guidelines for people with diabetes
diabetes UK and NHs inform websites have excellent resources
recommended physical activity is 2/12 hours moderate activity such as brisk walking OR 1 1/4 hours vigorous such as run
What medications should people with T2DM be on to reduce cardiovascular risk
statin
aspirin
ace
annual diabetic screening
eye (high risk)
foot
bloods- renal (and dipstick)
how often is HbA1c checked
3 monthly until stabilised
6 monthly once stable
at what HbA1c do you add in a second drug
58mmol/L
