Diabetes mellitus Flashcards
Define: diabetes mellitus
chronic condition in which the sufferer is unable to utilse their blood glucose regularly.
Define: insulin
hormone secreted by the pancreas to facilitate uptake of glucose from blood into cells.
in all cases of diabetes…
the process of insulin action is interrupted, causing BGL’s to be too high and cells not functioning normally
Effects of diabetes?
- 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.
WHy does type 1 diabetes occur?
pancreas not producing enough, if any, insulin to allow glucose from blood to enter cells.
Causes/risk factors of type 1 diabetes?
unknown, but presumed links between genetics and exposure to certain viruses (eg. influenza)
when does type 1 diabetes occur?
any life stage, mainly childhood//youth
how must type 1 diabetics manage their condition?
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)
WHy does type 2 diabetes occur?
due to the pancreas not producing enough insulin, or the body not using insulin effectively (insulin resistance)
Main risk factor for type 2 diabetes?
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
when does type 2 diabetes occur?
most common in older, often overweight people, but becoming more common in younger people.
how is type 2 diabetes managed?
lifestyle changes (eg. diet, exercise, weight management, sometimes medication)
type 2 diabetes is often associated with…
obesity, CVD, hypertension, high blood cholesterol
potential causes of gestational diabetes?
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.
when does gestational diabetes occur?
occurs during pregnancy (affects 3-8% of women) and goes away after pregnancy.
effect of gestational diabetes on the baby?
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.
effect of gest di on the mother?
more likely to get type 2 diabetes
why is diabetes mellitus a NHPA?
- 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
direct costs to indv?
- 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)
direct costs to comm?
- Medicare contribution to doctors and specialists consultations.
- PBS contributions for insulin
- Health promotion programs such as Life! Taking action on diabetes
indirect costs to indv?
- Paying for carers
* Lost income when unable to work
indirect costs to comm?
- Government contribution to cost of carers
- Loss of productivity
- Social security payments
- Lost taxation revenue
intangible costs to indv?
- Loss of self esteem
- Anxiety about the possibility of condition progressing – can lead to blindness and limb amputations
- Frustration over making lifestyle changes
intangible costs to comm?
- Anxiety over possibility of it progressing
* Frustration over making new lifestyle changes
biological determinants?
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.
behavioural determinants?
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
physical environment determinants?
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
social determinants?
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.
whawt is the health promotion program?
Life! taking action on diabetes
Who is life! by?
: funded by the Victorian state gov, administered by Diabetes Australia (Victoria branc), who train workforce required for implementation.
aims of Life!?
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.
life! is aimed at…
high risk Victorians - Victorians over 50 and all Aboriginal and Torres Strait Islanders.
describe the life! program
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.
other elemts of LIfe!?
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
