Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS2: Endocrine Diseases > Diabetes Management > Flashcards

Diabetes Management Flashcards

1
Q

What are the core areas of diabetes management?

A
  1. Education
    - about diabetes
    - managing diabetes
    - health care issues
    - complication avoidance
  2. Targets (blood sugar)
    - preprandial (before food) = 4-6mmol/L
    - bedtime = 6-8 mmol/L
  3. Reduce risk of associated diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When is insulin used in type 1 and type 2 diabetes?

A
  1. Type 1
    - from diagnosis
  2. Type 2
    - with inadequate control on oral meds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What Insulin regimes have better/poorer control?

A
  1. Basal-bolus more injections
    - better control
  2. Split-mixed fewer injections
    - poorer control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What healthy living advice might you give to a diabetes patient?

A
  1. Personalised diabetes management plans
  2. Dietary advice
  3. Lifestyle interventions where appropriate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What types of drugs are used as prevention to reduce risk of diabetes?

A
  1. Anti platelets
  2. Statins
  3. Anti hypertensives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What % of calories should be from saturated fat in a diabetic person?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the advantage of a glycaemic index of different foodstuffs?

A

Allows broad comparison of the glucose load of one type of foodstuffs vs another

  • this allows the patient to substitute different foods while maintaining diabetic control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why does exercise need to be planned with a diabetic patient?

A

To avoid hypoglycaemia

- extra carbohydrates must be consumed to maintain blood sugar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the ideal blood sugar level?

A

HbA_1C (glycosylated blood) = 6<10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are two different insulin monitoring options?

A
  1. Continuous glucose monitoring

2. Closed loop glucose monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does continuous glucose monitoring work?

A
  • Device attaches to skin
  • Small needle monitors tissue fluid glucose levels sub cutaneously
  • insulin levels are relayed to a monitor and the patient will be alerted of the insulin level breaches the target range
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does closed loop glucose monitoring work?

A

Monitor is attached to an insulin pump which varies the insulin dosage throughout the day based on subcutaneous sugar level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T2DM

A

T2DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is type 2 diabetes managed?

A

1.Primarily through lifestyle
- weight loss
- diet restriction
•avoid refined CHO
• encourage high fibre food
• reduce fat (especially saturated)

  1. Medication
  2. Surgery
    - gastric vertical banding - bariatric surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What 4 main groups of medications are used to help manage type 2 diabetes and what are their functions?

A
  1. Biguanides - ‘metformin’
    - first line drug for type 2 DM
    - enhance cell insulin sensitivity
    - reduced hepatic gluconeogenesis
    - preferred one obese
  2. DDP-4 inhibitors (Gliptins)
    - block the enzyme metabolising incretin
    - improves insulin response to glucose
    - reduces liver gluconeogenesis and delays stomach emptying
  3. GLP-1 mimetics
    - increase the level of incretin
    - injection daily/weekly
    - same effects as DDP-4 inhibitors
  4. Sulphonylureas
    - increase pancreatic insulin secretion
    - can cause hypoglycaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What types of patients is insulin used for in type 2 DM?

A
  1. In patients unable to maintain glycaemic control with
    - behavioural changes
    - body weight reduction
    - oral hypoglycaemic agents
17
Q

What are acute and chronic complications of diabetes?

A
  1. Acute - hypoglycaemia
    - type 1
    - type 2 on sulphonylurea or insulin
    - insulin/drug without food
  2. Chronic
    - cardiovascular risk
    - infection risk
    - neuropathy
18
Q

What type diabetes patient is at most risk of hypoglycaemia?

A
  1. Insulin treated patients with type 1 diabetes
19
Q

What symptoms are a sign of hypoglycaemia?

A
  1. Adrenaline release
  2. Sweating, tremor
    - start of brain dysfunction occurs
  3. Confusion/loss of concentration
  4. Coma/seizure
    - permanent brain damage occurs
20
Q

What blood vessel complications can occur with diabetes?

A
  1. Large vessel - atheroma
    - angina and MI, claudication, aneurysm
  2. Small vessel disease
    - poor wound healing
    - easy wound infections
    - renal disease
    - eye disease
    - neuropathy
21
Q

What specific conditions occur in diabetic eye disease?

A
  1. Cataracts
    - patient often has hazy vision
    - look for whitening of pupils
  2. Maculopathy
    - loss of high density cone section of the retina
    - results in loss of detailed vision
  3. Proliferative retinopathy
    - blood vessels grow across the back of the retina
    - these may then burst and cause haemorrhaging onto the back of the retina and gradual obliteration of the visual part of the eye
22
Q

How is diabetic retinopathy treated?

A

Laser surgery is used to destroy weak walled branches of blood vessels that have proliferated over time

23
Q

Describe consequences of diabetic neuropathy

A
  1. General sensation
    - glove and stocking
  2. Motor neuropathy
    - weakness and wasting of muscles
  3. Autonomic regulation
    - awareness of hypoglycaemia lost
    - postural reflexes
    - bladder and bowel dysfunction
24
Q

What are complications of surgery for a diabetic patient?

A
  1. Fasting is a problem in type 1
    - need insulin to prevent ketosis
    - need CHO to prevent hypoglycaemia
  2. Metabolic changes associated with surgery
    - hormone changes aggravate diabetes
    • epinephrine, cortisol, growth hormone
    - more glucose production and less muscle uptake
    - metabolic acidosis more likely
    - increased insulin requirements in T1DM
    - T2DM may require insulin cover after operation
25
Q

What are dental aspects of diabetes?

A
  1. Be aware of effect of dental treatment
    - food intake may be disrupted
  2. Be aware of acute emergencies
  3. Be aware of diabetic complication
    - IHD, dehydration, neuropathy, eyes
  4. Be aware of infection risk
  5. Be aware of poor wound healing

BDS2: Endocrine Diseases (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions