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Systems: Endocrine AB > Management of Diabetes: Lifestyle > Flashcards

Management of Diabetes: Lifestyle Flashcards

1
Q

What contributes to healthy living?

A
  • Exercise
  • Diet
  • Health
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2
Q

What do we mean by healthy living?

A
  • Eat well balanced diet
  • Don’t smoke
  • Regular physical activity
  • Moderate alcohol use (little and often?)
  • Don’t use recreational drugs
  • Good work/life balance
  • Learn to deal with stress appropriately
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3
Q

What must be considered when living with diabetes lifestyle wise?

A
  • Medication/injections
  • Blood testing
  • Diet/weight loss
  • Physical activity
  • Dealing with hypos
  • Dealing with illness
  • Travel
  • Hobbies
  • Work
  • Family/friends
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4
Q

Why is living with diabetes so hard?

A
  • Long term condition
  • Complex management
  • Lifestyle management
  • Delayed reward
  • Probabilistic reward
  • No symptoms?
  • It does not fit in with life
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5
Q

What issues may a young person with diabetes encounter?

A
  • Desire to be same as peers
  • Sport
  • Nights out
  • Alcohol/drugs
  • Learning to drive
  • Leaving home
  • Festivals
  • Travel
  • Sex/contraception
  • Tattoos and piercings
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6
Q

In what way is T2DM related to unhealthy lifestyles?

A
  • Increasing prevalence of obesity
  • Type 2 diabetes is an obesity related disease
  • Physical activity can prevent diabetes onset
  • Smoking increasing risk of diabetes
  • Alcohol excess increases risk of diabetes
  • But not everyone gets diabetes (genes can’t be changed)
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7
Q

How does diabetes affect someone’s diet?

A
  • No such thing as ‘diabetic diet’
  • Can eat simple carbohydrate in moderation
  • Poor evidence of different diets
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8
Q

What dietary considerations are there in diabetes management?

A
  • Consider need for weight loss
  • Carbohydrate is main consideration in managing glycaemic control
  • Also consider effects of diet on lipids / blood pressure
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9
Q

What is healthy eating?

A
  • Avoid missing meals too often
  • Include starchy carbohydrate at each meal (wholegrains)
  • Eat fruit and vegetables (5 servings)
  • Include more beans and lentils
  • 2 potions of oily fish per week
  • Limit sugar and sugary foods
  • 3 portions of dairy/alternative
  • Low saturated fats
  • Avoid diabetic foods
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10
Q

How is carbohydrate counting related to insulin doses?

A

-Dose to cover CHO in food = quick acting insulin dose
+
-Correction if blood glucose high

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11
Q

What eating disorder is associated with T1DM?

A

Diabulimia

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12
Q

What is diabulimia associated with?

A
  • Relatively common
  • Usually associated with poor glycaemic control
  • Recurrent DKA
  • Insulin omission
  • High morbidity and mortality
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13
Q

What alcohol guidance should diabetics stick to?

A
  • Same limit as general population
  • More than 2-3 units at one time increases hypo risk
  • Advise to eat before and snack at bedtime
  • Note other activity at time of alcohol eg dancing
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14
Q

Why is alcohol followed by a rise then fall in glucose?

A

Alcohol contains calories

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15
Q

What does alcohol reduce?

A

Glycogenolysis

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16
Q

What risks does smoking carry?

A
  • Smokers die 10 years before non-smokers
  • Smoking increases risk of diabetes 1.5 times
  • Smoking increases risk of macrovascular disease (at least doubles)
  • People with diabetes at risk of ischaemic heart disease
  • Smoking increases risk of all complications
  • Stopping smoking more beneficial than gaining a few kgs
  • Nicotine replacement and other drugs can be used in diabetes
17
Q

What risks do uppers/downers/ hallucinogenics carry, particularly in diabetes?

A
  • Risk of DKA (glucose production / hypos
  • Seizures
  • Cardiotoxic
  • Anxious
  • Sick
  • Munchies
  • Hyper / hypotension
18
Q

If someone with diabetes is going to engage in recreational drug use what advice should they follow?

A
  • Avoid
  • Avoid dehydration
  • Monitor glucose for highs and lows
  • Do not omit insulin /carbohydrate
  • Munchies and control
19
Q

What pathological burden for physical inactivity cause in the UK?

A
  • 10.5% of coronary heart disease cases
  • 18.7% of colon cancer cases
  • 17.9% of breast cancer cases
  • 13.0% of type 2 diabetes cases
  • 16.9% of premature all-cause mortality
20
Q

What are the benefits of exercise?

A
  • 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
21
Q

What are the recommended levels of exercise for the general population 16-75?

A

-Moderate exercise 2.5 - 3 hours per week translates into a 30% reduction in most major diseases.
OR
Vigorous exercise 75 mins per week

PLUS
-Strength training on 2 or more days

  • More exercise is more protective
  • Children should do 60mins / day
22
Q

How do we help people increase physical activity levels?

A 
-Talk to them about it:
What do they enjoy, Why don’t they do it, Opportunities
-Provide facilities
-Social / work place structure
-Community involvement
-Schools etc
-Councils/Government strategies
23
Q

What is the advice for diabetics when exercising?

A

Exercise (encourage all to do):

  • Reduce insulin before and after (upto 24 hours)
  • Reduction hypo risk
  • Eat more (appropriate carbohydrate)
  • Use different insulin regimen (maximise flexibility)
24
Q

What are the guidelines regarding driving with diabetes?

A
  • Risks of hypos, poor vision, neuropathy
  • Can drive with diabetes
  • Inform DVLA if on insulin
  • Since November 2011 allowed to apply for Group 2 licences if on insulin ie bus lorry - strict medical review
  • Take CHO in vehicle and test if on insulin
  • Do not drive for 45 mins after hypo
25
Q

What are the guidelines regarding driving and hypoglycaemia?

A

Patients should be advised to check their blood glucose within 2 hours of starting driving and 2 hourly during long car journeys and should always carry carbohydrate in the car.

26
Q

What are the absolute exclusions for those with diabetes and employment?

A
  • Armed forces

- Police

27
Q

When is it up to the employer if they employ someone with diabetes?

A
  • Offshore oil limited but increasing

- Blue light rapid response drivers

28
Q

Give examples of hobbies/employment to consider carefully if diabetic

A
  • Scuba diving
  • Scaffolder / window cleaner
  • Solo yachtsman / women
  • (Endurance sports)
  • Taxi- driver
  • Emergency vehicle driver
  • Bus / lorry driver
29
Q

What considerations is there for diabetics when going on holiday?

A
  • No restrictions but use common sense and insurance premium
  • Monitor glucose
  • Drink plenty of fluids
  • Avoid risks of gastroenteritis
  • Always carry insulin with you (not hold)
  • Adjust insulin to cross time zones

Systems: Endocrine AB (25 decks)

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