Diabetes Management

Question 1

what do you educate diabetics about?

Answer 1

about diabetes, managing diabetes, healthcare issues, complication avoidance

Question 2

what is the prepandial target for diabetics?

Answer 2

4-6mmol/L

Question 3

what is the bedtime target for diabetics?

Answer 3

6-8mmol/L

Question 4

when is insulin used for type 1 and type 2?

Answer 4

1 - from diagnosis

2 - with inadequate control on oral meds

Question 5

what are the 2 types of insulin regimes?

Answer 5

basal-bolus (more injections), split-mixed (fewer injections e.g., administered by nurse)

Question 6

what are the key areas for diabetes management?

Answer 6

structured education, healthy living advice, blood glucose management, consider prevention to reduce risk

Question 7

how do you manage type 1?

Answer 7

nutrition, exercise, monitoring, insulin injections

Question 8

how do you manage type 2?

Answer 8

lifestyle, medication, surgery

Question 9

what medication is used for type 2?

Answer 9

biguanides, DDP-4 inhibitors, GLP-1 mimetics, sulphonylureas

Question 10

what biguanide is used and what does it do?

Answer 10

metformin, it enhances insulin sensitivity, reduces hepatic gluconeogenesis

Question 11

what are DDP-4 inhibitors and what do they do?

Answer 11

gliptins, block enzyme metabolising incretin so it improves insulin response to glucose

Question 12

what do GLP-1 mimetics do?

Answer 12

increase the level of incretin

Question 13

what do sulphonylureas do?

Answer 13

increase pancreatic insulin secretion but can cause hypoglycaemia

Question 14

when is the need for insulin in type 2 diabetics suggested?

Answer 14

when patients are unable to maintain glycaemic control with behavioural changes, body weight reduction, oral hypoglycaemia agents

Question 15

what is the acute complication for diabetes and who experiences this?

Answer 15

hypoglycaemia, mainly type 1 but type 2 on sulphonylurea/insulin also experience

Question 16

what are the chronic complications from diabetes?

Answer 16

cardiovascular risk, infection risk, neuropathy

Question 17

what happens over time with hypoglycaemia ?

Answer 17

the time between signs of hypoglycaemia and actual hypoglycaemia decreases

Question 18

what are the large vessel complications?

Answer 18

atheroma = angina and MI

Question 19

what are the small vessel complications?

Answer 19

poor wound healing, easy wound infections, renal disease, eye disease, neuropathy

Question 20

what are the different diabetic eye diseases?

Answer 20

cataracts, maculopathy, proliferative retinopathy

Question 21

what do cataracts look like and how do you fix it?

Answer 21

cloudy eyes and fixed by replacing the lense

Question 22

what happens with diabetic retinopathy?

Answer 22

the blood vessels in the back of the eye burst. only fixed if spotted early but once blood vessels burst the vision is lost

Question 23

what is affected with diabetic neuropathy?

Answer 23

general sensation, motor neuropathy and autonomic regulation

Question 24

how do you overcome the issue with diabetics and surgery?

Answer 24

admit to hospital early to keep on insulin and glucose drip before surgery over fasting period

Question 25

what are the main dental aspects to be aware of with diabetes?

Answer 25

infection risk and poor wound healing