Lifestyle and Diabetes

Question 1

What is a healthy lifestyle?

Answer 1

A way of living which lowers the risk of being seriously ill or dying early
Physical, mental and social wellbeing

Question 2

What are the basic 5 areas approach?

Answer 2

Emotion, physiology, cognition, behaviour and situation + events

Question 3

What is the dietary consideration in diabetes type I and II?

Answer 3

Consider need for weight loss
Carbohydrate is main consideration in managing glycaemic control
Consider effects of diet on lipids and blood pressure

Question 4

Describe carbohydrate counting in type I diabetes

Answer 4

Quick acting insulin dose - 1:10g so i unit for each 10g
1:3mmoll means 1 unit brings glucose down by 3mmoll

Question 5

Describe type I diabetes and eating disorder

Answer 5

Reducing insulin to control weight, may involve binging behaviours and associated with poor glycaemic control
Recurrent DKA
Insulin omission
High morbidity and mortality

Question 6

Explain alcohol and diabetes

Answer 6

Reduces glycogenolysis, alcohol contains calories so causes fall in glucose
Same limit as everyone but more than 2-3 units at one time increases risk of hypo
Eat before and snack at bedtime

Question 7

Explain diabetes and exercise

Answer 7

Reduce insulin before and after
Reduction hypo risk
Eat more and use different insulin regiment
If between 7-15 then proceed to exercise

Question 8

Explain smoking and diabetes

Answer 8

Smoking increases risk of diabetes by 1.5 times
Increases risk of macrovascular disease, ischaemic heart disease and all complications

Question 9

What are the risks of recreational drugs and diabetes?

Answer 9

Risk of DKA, seizures, cardiotoxic, anxious, vomiting, munchies and hyper/ hypotension

Question 10

Explain driving and diabetes

Answer 10

Risk of hypos, poor vision and neuropathy
Can drive but inform insurance
Take CHO in vehicle and do not drive 45 mins after hypo

Question 11

What happens if person is hypoglycaemic and driving?

Answer 11

Check glucose within 2 hrs of driving and 2 hrs during long car journeys - carry CHO in car

Question 12

When does risk of complications increase?

Answer 12

Increases with worsening glycaemic state

Question 12

What are some macro and micro vascular complications?

Answer 12

Coronary vascular disease
CVD and PVD
Retinopathy, nephropathy and neuropathy

Question 13

Describe atherosclerosis in diabetes

Answer 13

Dyslipidaemia is present in nearly all diabetics
HDL cholesterol is low, triglycerides higher and LDL worse
Hypercoagulation

Question 14

What is the prevention of macrovascular disease?

Answer 14

Good diabetes control, blood pressure control, lipid control, smoking cessation, weight control and exercise

Question 15

Describe retinopathy

Answer 15

Non proliferative - retinal capillary dysfunction, platelet dysfunction and blood viscosity abnormal
Proliferative - retinal ischaemia, new blood vessel formation, vitreous haemorrhage and retinal tears - laser photocoagulation

Question 16

What is the treatment of retinopathy?

Answer 16

Improve glycaemic control and watch
Laser photocoagulation

Question 17

Describe nephropathy

Answer 17

Microalbuminuria - leak of proteins starts
Glomerular basement membrane changes, mesangial tissue proliferation, glomerular hypertension - progressive renal impairment

Question 18

What is the impact of diabetic nephropathy?

Answer 18

75% of diabetics have renal effects and 20% will have overt kidney disease
Biggest single cause for needed dialysis

Question 19

Describe the prevention and treatment of nephropathy

Answer 19

Screening for albumin in urine
Diabetes control
Renin angiotensin system blockage - ACE inhibition, angiotensin receptor blocker and renin inhibition
Hypertension control

Question 20

What does autonomic neuropathy lead to?

Answer 20

GI effects and CV system

Question 21

Describe Charcot foot

Answer 21

Effects people with diabetes
Large foot and bones are soft
Hot and swollen

Question 22

What are some other conditions common in diabetes?

Answer 22

Erectile dysfunction and depression

Question 23

What are the signs of hyperglycaemia?

Answer 23

Tired, nausea, hyperactivity and irritability
Blurred vision and increased breathing
Coma, delirium and seizures

Question 24

What are the signs of hypoglycaemia?

Answer 24

Headache, hunger, sweating and confusion
Shakes, irritability and anxiety
Blurred vision and drowsiness
Can lead to DKA as fat burning - ketones

Question 25

How common is mental health problems with diabetes?

Answer 25

Twice as likely to experience anxiety and depression
Impact on glycaemic control

Question 26

How does anxiety and stress affect blood glucose levels?

Answer 26

Increases BG levels