Diabetes Management Flashcards
what is the target blood glucose levels fore before eating that Diabetics should aim for?
4-6mmol/L
what is the target blood glucose level that Diabetics should aim for before bedtime?
6-8mmol/L
when providing diabetes management advice to patients, what are the main points that should be covered?
- structured diabetes education (appropriate to the patients needs)
- healthy living advice
- blood glucose management
- consider prevention to reduce risk from other complications
when providing healthy living advice to patients suffering from diabetes, what should be discussed?
- personalised diabetes management plan
- dietary advice
- lifestyles interventions where appropriate
what preventative measures may be taken in diabetic patients to reduce risk of adverse side effects?
- antiplatelet drugs
- statins
- antihypertensives
what are the main features of Type One diabetes management?
- good nutrition
- exercise
- monitoring
- subcutaneous insulin
what are the main features of Type Two diabetes management?
- lifestyles changes
- medication
- surgery
what lifestyle changes should a patient suffering from type two diabetes make?
- weight loss
- diet restrictions
- smoking cessation
what specific diet rules should a person suffering from type two diabetes aim to stick to?
- avoid refined CHO (carbs)
- encourage high fibre foods
- reduce fat (especially saturated)
what surgery may be undertook in a patient with type two diabetes?
gastric vertical banding
what type two medications are commonly used?
- Biguanides
- DDP-4 inhibitors
- GLP-1 mimetics
- Sulphonylureas
what are Biguanides?
- first line drug for T2DM
- they enhance cell insulin sensitivity
- reduce hepatic gluconeogenesis
what is the function of DDP-4 inhibitors?
block the enzyme metabolising incretin which;
- improves insulin response to glucose
- reduces liver gluconeogenesis & delays stomach emptying
what is incretin?
- metabolising hormone
- released from stomach in response to sugar absorbent & stimulate insulin release
what is the function of GLP-1 mimetics?
increase the level of incretin
- injections daily/weekly
what is the function of sulphonylureas?
increase pancreatic insulin secretin
what is an acute complication of diabetes?
hypoglycaemia
what do chronic diabetes complications result in?
- increased cardiovascular risk
- increased infection risk
- neuropathy
what circulatory complications are diabetic patients more at risk of?
- large vessel atheromas
- small vessel disease
what can atheromas of large vessels cause?
- angina
- myocardial infarction
- claudication
- anneurysm
what are the clinical features of small vessel disease?
- poor wound healing
- easy wound infections
- RENAL DISEASE
- EYE disease
- neuropathy
what diabetic eye diseases are commonly seen?
- cataracts
- maculopathy
- proliferation retinopathy
what occurs in patients with proliferative retinopathy?
blood vessels grow across back of the retina
what may occur as a result of diabetic neuropathy?
- loss of general sensation (glove & stocking)
- motor neuropathy
- loss of autonomic regulation
what can motor neuropathy lead to?
weakness and wasting of muscles
if a patient is going into the hospital for surgery, why might Type One diabetes be an issue?
- typically need to fast before a surgery that requires GA
- fasting may cause hypoglycaemia
what aspects of Diabetes may affect dentistry?
- 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
