Lifestyle/Healthy Living and Diabetes Flashcards
Give basic rules of a healthy lifestyle
- Eat well balanced diet
- Don’t smoke
- Regular physical activity
- Moderate alcohol use
- Don’t use recreational drugs
- Good work / life balance
- Learn to deal with stress appropriately
Why is diabetes hard to cope with?
- Long term condition
- Complex management
- Lifestyle management
- Delayed reward
- Probabilistic reward
- No symptoms ?
- It does not fit in with life
In what other ways does diabetes affect young people?
- Desire to be same as peers
- Sport
- Nights out
- Alcohol / Drugs
- Learning to drive
- Leaving home
- Festivals
- Travel
- Sex / Contraception
- Tattoos and piercings
What is the relationship between Type 2 Diabetes and an unhealthy lifestyles?
- Increasing prevalence of obesity
- Type 2 Diabetes is an obesity related disease
- Physical activity can prevent diabetes onset
- Smoking and alcohol excess increases risk of diabetes
What are the dietary considerations that should be made to manage diabetes?
- Weight loss
- CHO main consideration in managing glycaemic control
- Effects of diet on lipids/blood pressure
Describe the glycaemic index graph
Composition of food alters how quickly CHO is absorbed from gut
If food has a high GI, BG levels peak high with less time after food.
If low GI, BG levels gradual peak and not as high.
\_\_\_\_\_
/ \
/ \
/ \
/ \ HIGH GI
\_\_\_\_\_\_\_\_\_\_\_\_\_\_
/ \
/ \ LOW GI
What is glycaemic index?
The ability of a carbohydrate food to increase the level of glucose in the blood
How do you carbohydrate count in Type 1 Diabetes?
Quick acting insulin does =
Dose to cover total CHO in food
+
Correction dose if BG high
How does the glycaemic index of food affect insulin dose required?
Adjustment of timing of insulin may be required for higher GI foods
Name an eating disorders of type 1 diabetes
Diabulima
What is diabulima?
People with type 1 diabetes deliberately give themselves less insulin than they need or stop taking it altogether for the purpose of weight loss.
What are the features of diabulima?
- Usually associated with poor glycaemic control
- Recurrent DKA
- Insulin omission
- High morbidity and mortality
How does alcohol impact diabetes?
- Reduces glyconenolysis
- Contains calories - results in rise followed by fall in Glc
- > 2-3units at one time increases hypo risk
- Advise to eat before and snack at bedtime
- Note other activity at time of alcohol i.e. dancing
How does smoking impact diabetes?
- Increases risk of diabetes x1.5
- Increases risk of macrovascular disease
- Increases risk of all complications
- Diabetes are at risk of ischaemic heart disease
- Stopping smoking more beneficial than gaining a few kgs
- Nicotine replacement used in diabetes
How do recreational drugs impact diabetes?
Uppers/Downers/Hallucinogenics • Risk of DKA • Seizures • Cardiotoxic • Anxious • Sick • Munchies • Hyper/hypotension
What is the advice given for use of recreational drugs in diabetes?
- Avoid
- Avoid dehydration
- Monitor Glc for high and lows
- Do not omit insulin/CHO
- Munchies and control
What are the benefits of exercise?
- Cardiovascular benefit
- Reduces cancer risk
- Consumes energy
- Builds lean tissue and consumes fat
- Improves strength, endurance, balance and flexibility
- Improves mood and self esteem
- Can be sociable
How do healthcare professionals help people increase physical activity levels?
Address diabetes specific barriers:
• Fear of hypos / insulin adjustment / lack of knowledge / nutrition
How does exercise reduce diabetes risk?
• Reduce insulin before and after (upto 24 hours)
• Reduction hypo risk
eat more (appropriate carbohydrate)
• Use different insulin regimen (maximise flexibility)
How does diabetes impact driving?
- Risks of hypos, poor vision, neuropathy
- Can drive with diabetes but need to inform DVLA if on insulin
- Take CHO in vehicle and test if on insulin
- Do not drive for 45mins after hypo
What are hypoglycaemics advised to do before driving?
Check BG within 2 hours of starting to drive and 2 hourly during long car journeys and should always carry CHO in the car
How does insulin impact work/employment?
- Comes under Disability Discrimination Act 2010
- Absolute exclusions: armed forces, police
- Up to employer (I.e. offshore)
- Driving restrictions
What should diabetics consider when going on holiday?
- Drink plenty fluids
- Avoid risks of gastroenteritis
- Always carry insulin with you
- Adjust insulin to cross time zones
