Diabetes Management Flashcards
what do you educate diabetics about?
about diabetes, managing diabetes, healthcare issues, complication avoidance
what is the prepandial target for diabetics?
4-6mmol/L
what is the bedtime target for diabetics?
6-8mmol/L
when is insulin used for type 1 and type 2?
1 - from diagnosis
2 - with inadequate control on oral meds
what are the 2 types of insulin regimes?
basal-bolus (more injections), split-mixed (fewer injections e.g., administered by nurse)
what are the key areas for diabetes management?
structured education, healthy living advice, blood glucose management, consider prevention to reduce risk
how do you manage type 1?
nutrition, exercise, monitoring, insulin injections
how do you manage type 2?
lifestyle, medication, surgery
what medication is used for type 2?
biguanides, DDP-4 inhibitors, GLP-1 mimetics, sulphonylureas
what biguanide is used and what does it do?
metformin, it enhances insulin sensitivity, reduces hepatic gluconeogenesis
what are DDP-4 inhibitors and what do they do?
gliptins, block enzyme metabolising incretin so it improves insulin response to glucose
what do GLP-1 mimetics do?
increase the level of incretin
what do sulphonylureas do?
increase pancreatic insulin secretion but can cause hypoglycaemia
when is the need for insulin in type 2 diabetics suggested?
when patients are unable to maintain glycaemic control with behavioural changes, body weight reduction, oral hypoglycaemia agents
what is the acute complication for diabetes and who experiences this?
hypoglycaemia, mainly type 1 but type 2 on sulphonylurea/insulin also experience
what are the chronic complications from diabetes?
cardiovascular risk, infection risk, neuropathy
what happens over time with hypoglycaemia ?
the time between signs of hypoglycaemia and actual hypoglycaemia decreases
what are the large vessel complications?
atheroma = angina and MI
what are the small vessel complications?
poor wound healing, easy wound infections, renal disease, eye disease, neuropathy
what are the different diabetic eye diseases?
cataracts, maculopathy, proliferative retinopathy
what do cataracts look like and how do you fix it?
cloudy eyes and fixed by replacing the lense
what happens with diabetic retinopathy?
the blood vessels in the back of the eye burst. only fixed if spotted early but once blood vessels burst the vision is lost
what is affected with diabetic neuropathy?
general sensation, motor neuropathy and autonomic regulation
how do you overcome the issue with diabetics and surgery?
admit to hospital early to keep on insulin and glucose drip before surgery over fasting period
