Diabetes Management

Question 1

what is the target blood glucose levels fore before eating that Diabetics should aim for?

Answer 1

4-6mmol/L

Question 2

what is the target blood glucose level that Diabetics should aim for before bedtime?

Answer 2

6-8mmol/L

Question 3

when providing diabetes management advice to patients, what are the main points that should be covered?

Answer 3

• structured diabetes education (appropriate to the patients needs)
• healthy living advice
• blood glucose management
• consider prevention to reduce risk from other complications

Question 4

when providing healthy living advice to patients suffering from diabetes, what should be discussed?

Answer 4

• personalised diabetes management plan
• dietary advice
• lifestyles interventions where appropriate

Question 5

what preventative measures may be taken in diabetic patients to reduce risk of adverse side effects?

Answer 5

• antiplatelet drugs
• statins
• antihypertensives

Question 6

what are the main features of Type One diabetes management?

Answer 6

• good nutrition
• exercise
• monitoring
• subcutaneous insulin

Question 7

what are the main features of Type Two diabetes management?

Answer 7

• lifestyles changes
• medication
• surgery

Question 8

what lifestyle changes should a patient suffering from type two diabetes make?

Answer 8

• weight loss
• diet restrictions
• smoking cessation

Question 9

what specific diet rules should a person suffering from type two diabetes aim to stick to?

Answer 9

• avoid refined CHO (carbs)
• encourage high fibre foods
• reduce fat (especially saturated)

Question 10

what surgery may be undertook in a patient with type two diabetes?

Answer 10

gastric vertical banding

Question 11

what type two medications are commonly used?

Answer 11

• Biguanides
• DDP-4 inhibitors
• GLP-1 mimetics
• Sulphonylureas

Question 12

what are Biguanides?

Answer 12

• first line drug for T2DM
• they enhance cell insulin sensitivity
• reduce hepatic gluconeogenesis

Question 13

what is the function of DDP-4 inhibitors?

Answer 13

block the enzyme metabolising incretin which;

• improves insulin response to glucose
• reduces liver gluconeogenesis & delays stomach emptying

Question 14

what is incretin?

Answer 14

• metabolising hormone

- released from stomach in response to sugar absorbent & stimulate insulin release

Question 15

what is the function of GLP-1 mimetics?

Answer 15

increase the level of incretin

- injections daily/weekly

Question 16

what is the function of sulphonylureas?

Answer 16

increase pancreatic insulin secretin

Question 17

what is an acute complication of diabetes?

Answer 17

hypoglycaemia

Question 18

what do chronic diabetes complications result in?

Answer 18

• increased cardiovascular risk
• increased infection risk
• neuropathy

Question 19

what circulatory complications are diabetic patients more at risk of?

Answer 19

• large vessel atheromas

- small vessel disease

Question 20

what can atheromas of large vessels cause?

Answer 20

• angina
• myocardial infarction
• claudication
• anneurysm

Question 21

what are the clinical features of small vessel disease?

Answer 21

• poor wound healing
• easy wound infections
• RENAL DISEASE
• EYE disease
• neuropathy

Question 22

what diabetic eye diseases are commonly seen?

Answer 22

• cataracts
• maculopathy
• proliferation retinopathy

Question 23

what occurs in patients with proliferative retinopathy?

Answer 23

blood vessels grow across back of the retina

Question 24

what may occur as a result of diabetic neuropathy?

Answer 24

• loss of general sensation (glove & stocking)
• motor neuropathy
• loss of autonomic regulation

Question 25

what can motor neuropathy lead to?

Answer 25

weakness and wasting of muscles

Question 26

if a patient is going into the hospital for surgery, why might Type One diabetes be an issue?

Answer 26

• typically need to fast before a surgery that requires GA

- fasting may cause hypoglycaemia

Question 27

what aspects of Diabetes may affect dentistry?

Answer 27

• dental treatment may disrupt a patients food intake
• awareness of acute emergencies is vital
• be aware of INFECTION RISK
• be aware of POOR WOUND HEALING