Management of Diabetes, Lifestyle and Exercise

Question 1

What are some examples of things that composes a healthy lifestyle?

Answer 1

Eat well balanced diet

Do not smoke

Regular physical activity

Moderate alcohol use

Do not use recreational drugs

Good work/life balance

Learn to deal with stress appropriately

Question 2

What are examples of lifestyle things that will change after being diagnosed with diabetes?

Answer 2

Medication/injections

Blood testing

Diet/weight loss

Physical activity

Dealing with hypos

Dealing with illness

Travel

Hobbies

Work

Family/friends

Question 3

What are some things that makes diabetes really hard to live with?

Answer 3

Long term condition

Complex management

Lifestyle manageent

Delayed reward

Probaibilistic reward

Does not fit in with life

Question 4

What are some lifestyle problems with young people and diabetes?

Answer 4

Desire to be same as peers

Sports

Nights out

Alcohol/drugs

Learning to drive

Leaving home

Festivals

Travel

Sex/contraception

Tattoos and piercings

Question 5

Is the prevalence of obesity increasing or decreasing?

Answer 5

Increasing

Question 7

What are some myths about diabetes?

Answer 7

Should eat a “diabetic diet”

Can not eat simple carbohydrates

Question 8

What are some dietary considerations in diabetes?

Answer 8

Consider need for weight loss

Carbohydrate is main consideration in managing glycaemic control

Also consider effects of diet on lipids/blood pressure

Question 9

What is the purpose of carbohydrate counting?

Answer 9

To work out how much insulin to give yourself

Question 10

What is a quick acting insulin dose composed of?

Answer 10

• dose to cover total carbohydrate in food
• correction dose if blood glucose is high

Question 11

Why might adjustment of timing of insulin be required for higher GI foods?

Answer 11

Composition of foods alters how quickly carbohydrate is absorbed from the gut

Question 12

What is an example of an eating disorder of someone with type 1 diabetes?

Answer 12

Diabulimia

Question 13

What is diabulimia?

Answer 13

Eating disorder in which people with type 1 diabetes deliberately give themselves less insulin that they need or stop taking insulin altogether for the purpose of weight loss

Question 14

What does diabulimia lead to?

Answer 14

Recurrent DKA

High morbidity and mortality

Question 15

Why does alcohol consumption impact diabetes?

Answer 15

Alcohol reduces glycogenolysis

Alcohol contains calories, resulting in rise followed by fall in glucose

Question 16

What is glycogenolysis?

Answer 16

Breakdown of glycogen (n) to glucose-1-phosphate and glycogen (n-1)

Question 17

What is the advice to diabetics who are going drinking?

Answer 17

Eat before and snack at bedtime

Note other activites when drinking such as dancing

Question 18

By how much does smoking increase the risk of diabetes?

Answer 18

1.5x

Question 19

By how much does smoking increase is the risk of macrovascular disease?

Answer 19

2x

Question 20

What drugs can be used in diabetes to help people stop smoking?

Answer 20

Nicotine replacement therapy and other drugs

Question 21

How do recreational drugs impact diabetes?

Answer 21

Risk of DKA

Seizures

Cardiotoxic

Anxious

Sick

Munchies

Hyper/hypotension

Question 22

What is the advice for recreational drugs and diabetes?

Answer 22

Avoid

Avoid dehydration

Monitor glucose for highs and lows

Do not omit insulin/carbohydrates

Munchies and control

Question 23

What are the advantages of exercise?

Answer 23

• 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

Question 24

How does exercise impact diabetes?

Answer 24

• reduce insulin before and after
• reduce hypo risk
• eat more (appropriate carbohydrates)
• use different insulin regimen

Question 25

What are some ways to get people to increase physical activity levels?

Answer 25

• talk to them about it
• address diabetic specific barriers (such as fear of hypos, insulin adjustment, lack of knowledge, nutrition)
• provide facilities
• community involvement
• government strategies

Question 26

Why does diabetes impact driving?

Answer 26

Risk of hypos, poor vision, neuropathy

Can drive with diabetes, but must inform the DVLA

Question 27

Are people with diabetes allowed to apply for group 2 licences if on insulin (for bus or lorry)?

Answer 27

Yes, but need strict medical review

Question 28

How much time should there be between having a hypo and driving?

Answer 28

At least 45 minutes

Question 29

What is the advice for diabetics driving?

Answer 29

• do not drive for 45 minutes after a hypo
• check glucose within 2 hours of starting driving and 2 hourly during long car journeys
• always carry carbohydrates in car

Question 30

Are people with diabetes less likely to get a job?

Answer 30

No because cannot be discriminated against due to the Disability Discrimination Act of 2010

Question 31

What jobs are people with diabetes excluded from?

Answer 31

Armed forces

Police

Question 32

What jobs can people with diabetes get but it is under the review of the employer?

Answer 32

Offshore oil limited but increases

Blue light rapid response driver

Question 33

What are examples of some hobbies/types of work that needs to be carefully considered before doing with diabetes?

Answer 33

Scuba diving

Scaffolder/window cleaner

Solo yachtsman

Endurance sports

Taxi driver

Emergency vehicle driver

Bus/lorry driver

Question 34

What is the advice for people with diabetes going away on holiday?

Answer 34

Monitor glucose and drink plenty fluids

Always carry insulin with you

Adjust insulin to cross timezones