Intervention for Diabetes Flashcards
List some lifestyle intervention strategies.
Dietary management and exercise for weight loss
Smoking cessation
Reduced alcohol intake
What is the aim of lifestyle interventions?
Optimize glycaemic control, BP and lipid levels
Manage CVD risk and prevent/delay microvascular complications
What is the NZ recommendation for weight loss?
5-10% of initial weight if patient is overweight or obese
What to note when confronting weight issue and telling patients:
Non-judgmental
Avoid stigma - current weight is not just person’s responsibility
Weight loss should be coupled with exercise and diet
Talk about food or food pattern, not nutrients
Need ongoing support
GI/Glycaemic Index
Ratio expressed as % of iAUC of the test vs reference (glucose) food
Ranking 0-100 (where glucose = 100)
What are the limitations of the GI index?
Ranking system has no rationale
GI changes depending on how the food is cooked & how long its cooked for
Glucose response of individuals vary
Wholefoods are low GI anyway
How to assess someones diet:
Step 1 - separate into food groups
Step 2 - quantify food groups
Step 3 - assess your analysis with recommended services
Step 4 - provide nutrition intervention - give good points (at least 3) vs things to improve to lose weight and improve diet
List some dietary tips for glycaemic management in T1 and T2 diabetes.
Have regular meals (3/day) at regular times
Have a healthy diet
Choose CHOs from healthy food groups
Spread CHO containing foods throughout the day
Have only one piece of fruit at a time
In each meal, try to have similar amount of carbohydrate
What is ataxia?
Coordination of muscles is impaired = unsteady gait
Describe ataxic gait and the causes.
Widely placed feet for a broader base of support
Patient may lose balance, lean or lurch to one side or veer off course
Lots of movement in arms/trunk to maintain balance
Caused by alcohol intoxication (affecting cerebellum) or mid-line cerebellar lesions
What is meningism and its causes?
Meningeal irritation - neck stiffness, photophobia, headache
Caused by meningitis, encephalitis and SAH
What is delirium and what causes it?
Rapid onset of disturbance of mental abilities causing confused thinking and decreased awareness of environment
Seen with infection and metabolic disturbance
May occur due to effects of toxins and drugs
What is dementia and what causes it?
Deterioration in memory, thinking, behaviour and ability to perform everyday activities. Consciousness is preserved. NOT a normal part of ageing.
AD = most common cause
Vascular dementia = second common
