Lifestyle and Diabetes Flashcards
What is a healthy lifestyle?
A way of living which lowers the risk of being seriously ill or dying early
Physical, mental and social wellbeing
What are the basic 5 areas approach?
Emotion, physiology, cognition, behaviour and situation + events
What is the dietary consideration in diabetes type I and II?
Consider need for weight loss
Carbohydrate is main consideration in managing glycaemic control
Consider effects of diet on lipids and blood pressure
Describe carbohydrate counting in type I diabetes
Quick acting insulin dose - 1:10g so i unit for each 10g
1:3mmoll means 1 unit brings glucose down by 3mmoll
Describe type I diabetes and eating disorder
Reducing insulin to control weight, may involve binging behaviours and associated with poor glycaemic control
Recurrent DKA
Insulin omission
High morbidity and mortality
Explain alcohol and diabetes
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
Explain diabetes and exercise
Reduce insulin before and after
Reduction hypo risk
Eat more and use different insulin regiment
If between 7-15 then proceed to exercise
Explain smoking and diabetes
Smoking increases risk of diabetes by 1.5 times
Increases risk of macrovascular disease, ischaemic heart disease and all complications
What are the risks of recreational drugs and diabetes?
Risk of DKA, seizures, cardiotoxic, anxious, vomiting, munchies and hyper/ hypotension
Explain driving and diabetes
Risk of hypos, poor vision and neuropathy
Can drive but inform insurance
Take CHO in vehicle and do not drive 45 mins after hypo
What happens if person is hypoglycaemic and driving?
Check glucose within 2 hrs of driving and 2 hrs during long car journeys - carry CHO in car
When does risk of complications increase?
Increases with worsening glycaemic state
What are some macro and micro vascular complications?
Coronary vascular disease
CVD and PVD
Retinopathy, nephropathy and neuropathy
Describe atherosclerosis in diabetes
Dyslipidaemia is present in nearly all diabetics
HDL cholesterol is low, triglycerides higher and LDL worse
Hypercoagulation
What is the prevention of macrovascular disease?
Good diabetes control, blood pressure control, lipid control, smoking cessation, weight control and exercise
Describe retinopathy
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
What is the treatment of retinopathy?
Improve glycaemic control and watch
Laser photocoagulation
Describe nephropathy
Microalbuminuria - leak of proteins starts
Glomerular basement membrane changes, mesangial tissue proliferation, glomerular hypertension - progressive renal impairment
What is the impact of diabetic nephropathy?
75% of diabetics have renal effects and 20% will have overt kidney disease
Biggest single cause for needed dialysis
Describe the prevention and treatment of nephropathy
Screening for albumin in urine
Diabetes control
Renin angiotensin system blockage - ACE inhibition, angiotensin receptor blocker and renin inhibition
Hypertension control
What does autonomic neuropathy lead to?
GI effects and CV system
Describe Charcot foot
Effects people with diabetes
Large foot and bones are soft
Hot and swollen
What are some other conditions common in diabetes?
Erectile dysfunction and depression
What are the signs of hyperglycaemia?
Tired, nausea, hyperactivity and irritability
Blurred vision and increased breathing
Coma, delirium and seizures
