Diabetes mellitus

Question 1

Define: diabetes mellitus

Answer 1

chronic condition in which the sufferer is unable to utilse their blood glucose regularly.

Question 2

Define: insulin

Answer 2

hormone secreted by the pancreas to facilitate uptake of glucose from blood into cells.

Question 3

in all cases of diabetes…

Answer 3

the process of insulin action is interrupted, causing BGL’s to be too high and cells not functioning normally

Question 4

Effects of diabetes?

Answer 4

• Poor circulation and CVD: excess glucose in bloodstream can result in blood vessels being damaged and poor circulation. Can cause tingling, cell death, amputation of limbs and increased risk of CVD
• Vision problems and blindness: excess blood glucose can damage blood vessels supplying the eye
• Kidney disease: kidneys must work harder to fulter excess glucose in blood which can lead to kidney damage/disease.

Question 5

WHy does type 1 diabetes occur?

Answer 5

pancreas not producing enough, if any, insulin to allow glucose from blood to enter cells.

Question 6

Causes/risk factors of type 1 diabetes?

Answer 6

unknown, but presumed links between genetics and exposure to certain viruses (eg. influenza)

Question 7

when does type 1 diabetes occur?

Answer 7

any life stage, mainly childhood//youth

Question 8

how must type 1 diabetics manage their condition?

Answer 8

need to deliver insulin (olden days used needle and syringe, now use pumps)
Need to monitor BGL’s - fluctuations can cause tiredness, confusion and headaches
SPecial attention to diet, exercise abd BW (can affect BGL’s)

Question 9

WHy does type 2 diabetes occur?

Answer 9

due to the pancreas not producing enough insulin, or the body not using insulin effectively (insulin resistance)

Question 10

Main risk factor for type 2 diabetes?

Answer 10

being overweight - but relationship unclear. potentially:
cells are more resistant to insulin (and hence fat people are more insulin resistant)
 High levels of fat could destroy insulin producing cells, lowering level of insulin available
 Being overweight puts strain on the pancreas, as it has tried to produce enough insulin. After time

Question 11

when does type 2 diabetes occur?

Answer 11

most common in older, often overweight people, but becoming more common in younger people.

Question 12

how is type 2 diabetes managed?

Answer 12

lifestyle changes (eg. diet, exercise, weight management, sometimes medication)

Question 13

type 2 diabetes is often associated with…

Answer 13

obesity, CVD, hypertension, high blood cholesterol

Question 14

potential causes of gestational diabetes?

Answer 14

 Occurs as hormones released to assist baby’s growth and development can reduce the
 Energy requirements increase over the course of pregnancy – as does insulin needs – so there might not be enough insulin to metabolise glucose.

Question 15

when does gestational diabetes occur?

Answer 15

occurs during pregnancy (affects 3-8% of women) and goes away after pregnancy.

Question 16

effect of gestational diabetes on the baby?

Answer 16

more glucose is passed onto the baby, resulting in increased gestational growth, resulting in higher birthweight and lower blood glucose, but not diabetes, in the baby.

Question 17

effect of gest di on the mother?

Answer 17

more likely to get type 2 diabetes

Question 18

why is diabetes mellitus a NHPA?

Answer 18

• Major contributor of BOD, both YLD (esp. type one can cause long term disability) and YLL (risk factor for conditions which often result in death).
• Risk for type 2 diabetes can be reduced through lifestyle factors

Question 19

direct costs to indv?

Answer 19

• Ambulance transport if a person has a diabetic coma (due to diabetes being uncontrolled)
• Patient co-payments for insulin
• Patient co-payments for doctor/dspecialist services (often require ongoing treatment from them)

Question 20

direct costs to comm?

Answer 20

• Medicare contribution to doctors and specialists consultations.
• PBS contributions for insulin
• Health promotion programs such as Life! Taking action on diabetes

Question 21

indirect costs to indv?

Answer 21

• Paying for carers

* Lost income when unable to work

Question 22

indirect costs to comm?

Answer 22

• Government contribution to cost of carers
• Loss of productivity
• Social security payments
• Lost taxation revenue

Question 23

intangible costs to indv?

Answer 23

• Loss of self esteem
• Anxiety about the possibility of condition progressing – can lead to blindness and limb amputations
• Frustration over making lifestyle changes

Question 24

intangible costs to comm?

Answer 24

• Anxiety over possibility of it progressing

* Frustration over making new lifestyle changes

Question 25

biological determinants?

Answer 25

Age
• T2 Increases with age – highest risk over 55
• T2 Rates in young people increasing – due to increased obesity rates
Hypertension and high blood cholesterol
• unsure whether they cause obesity and hence type 2 diabetes, or whether diabetes causes them.
Impaired glucose regulation
• Precursor to type 2
• IF not managed, can lead to it.
Genetic predisposition:
• more likely if another family member has
Body weight
• Overweight/obesity a risk factor for T2, unsure why.

Question 26

behavioural determinants?

Answer 26

obacco smoking
• Leads to higher BGL  insulin resistance  type 2
• More likely to be sedentary/overweight
Excessive alcohol consumption
• Energy dense  obesity  TD and gest
Physical activity
• Inactive  weight gain  obesity  T2 and gest diabetes
Dietary behaviour
• Energy dense/high fat foods  obesity - type 2 and gest

Question 27

physical environment determinants?

Answer 27

Work environment
• If doesn’t promote incidental physical activity, more type 2
Transport
• Passive transport  obesity  T2
Access to recreational facilities
• If not  not enough exercise  obesity  t2

Question 28

social determinants?

Answer 28

Socioeconomic status
• Lower  higher rates of obesity  higher rates of T2/gest
Occupation
• If managerial/sedentary  obesity  t2
Food security
• None  might eat energy dense, processed foods  obesity  T2 and gest
Early life experiences
• Low birth weight  increased risk of T2
• Malnutrition could damage insulin producing cells in pancreas.

Question 29

whawt is the health promotion program?

Answer 29

Life! taking action on diabetes

Question 30

Who is life! by?

Answer 30

: funded by the Victorian state gov, administered by Diabetes Australia (Victoria branc), who train workforce required for implementation.

Question 31

aims of Life!?

Answer 31

 Prevent people from developing type 2 diabetes – specifically to prevent its onset in 25,000 high risk Victorians over a four year period.
 To contribute to early diagnosis in those who have type 2 diabetes but don’t know they do.

Question 32

life! is aimed at…

Answer 32

high risk Victorians - Victorians over 50 and all Aboriginal and Torres Strait Islanders.

Question 33

describe the life! program

Answer 33

 Delivers a program to the 25,000 high risk Victorians
• These participents identified through online/phone diabetes risk test. Note – only people with RISK of diabetes, not already with diabetes, are chosen.
• Conducted in metropolitan, rural and remote areas.
• 6 group sessions over 8 months – educates individuals about type 2 diabetes and the lifestyle changes (diet and exercise) to reduce risk.
o They analyse their own lifestyle, set goals for behaviour change and aim to lose atleast 5kg over the program.

Question 34

other elemts of LIfe!?

Answer 34

 Website: contains resource/education to individuals and health professionals about the prevention of type 2 diabetes. Including recipes and success stories
 Mass media campaigns: eg. Don’t be the type to leave it too late: woman saying healthy eating and exercise is vital, but wasn’t always healthy. She is swimming and gets out of pool and reveals amputated leg