Impact of diabetes Flashcards
Why does a patient with diabetes need to take insulin, even if they have not eaten
insulin required for:
- glucose uptake into peripheral tissues (GLUT4)
- suppress glyconeolysis, lipolysis and gluconeogenesis
even if not eaten!
What is the effect of an illness on diabetes patients?
illness can raise blood glucose levels as cotrisol stimulates gluconeogenesis as a stress response
Insulin dose may need to be increased during illness
how might diabetes have a physical impact on a patient?
- serious complications of illness
- pregnancy impact
- surgical impact
What are the serious complications that can occur from diabetes?
- kidney dialysis
- blindness
- amputations
- increased CVD risk
- lifespan reduced (~10y - T2DM, ~20y T1DM)
What less serious impacts can diabetes have?
- impotence
- neuropathy pain
- recurrent UTIs
- recurrent skin infections
- daily BMs
What is the impact of diabetes on pregnancy?
risk of complications for mother and infant increased (T1DM or gestational diabetes)
- e.g. drop in neonate’s blood sugar after birth because their insulin levels are based on their mother’s higher blood sugar levels.
What is the effect of diabetes in the family environment?
Relationships may be affected by sexual problems
Family cohesion is necessary to follow meals/insulin regime for child with diabetes, as is good communication with
school/childcare.
Carers often experience emotional difficulties; other children in family may be affected.
Young children with diabetes: diet can be challenging (e.g. child being offered sweets, picky eating); many children afraid of (insulin) injections.
What is the effect of diabetes on adolescence?
adjustment and diabetes management may be harder due to concurrent physical, cognitive, emotional, sexual and social
changes (e.g. leaving parental home, increased risk-taking, peer influence)
What is the impact of diabetes on psychological wellbeing?
requires adjustment
- anger, anxiety, depression, frustration, feeling overwhelmed.
- Constant awareness can lead to ‘diabetes burnout’.
- Depression more common in people with diabetes; eating disorders sometimes arise.
- anxiety about future
- discrimination
- Guilt on management issues
What is the financial impact of diabetes?
- insurance can be expensive
- absences from work
- complications can lead to long term disability
What is the impact of diabetes on driving?
Patient must inform DVLA if insulin-dependent; impaired hypoglycaemia awareness; >1
severe hypo/12 months; vision below legal limit; foot problems that impair pedal use
What are the impacts on employment for diabetes patients?
- careers in armed forces not possible
- medical assessment for emergency services, pilots
To what extent to patients with diabetes self-manage condition?
- regular BMs for glucose-dependent
- may test glucose/ketones in urine
- diet awareness
- adjust insulin to menstrual cycle
- fixed dose regime = restrictive diet
What is the importance of a diabetes patient self managing their condition
- minimise complications (T1DM & T2DM)
- slow progression (T2DM)
What is the role of an endocrine clinic in diabetes management?
- initial assessment
- information about diabetes
- education on BMs/injecting/hypo
- 4xyr check up to assess
