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 6

What are some myths about diabetes?

Answer 6

Should eat a “diabetic diet”

Can not eat simple carbohydrates

Question 7

What are some dietary considerations in diabetes?

Answer 7

Consider need for weight loss

Carbohydrate is main consideration in managing glycaemic control

Also consider effects of diet on lipids/blood pressure

Question 8

What is the purpose of carbohydrate counting?

Answer 8

To work out how much insulin to give yourself

Question 9

What is a quick acting insulin dose composed of?

Answer 9

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

Question 10

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

Answer 10

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

Question 11

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

Answer 11

Diabulimia

Question 12

What is diabulimia?

Answer 12

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 13

What does diabulimia lead to?

Answer 13

Recurrent DKA

High morbidity and mortality

Question 14

Why does alcohol consumption impact diabetes?

Answer 14

Alcohol reduces glycogenolysis

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

Question 15

What is glycogenolysis?

Answer 15

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

Question 16

What is the advice to diabetics who are going drinking?

Answer 16

Eat before and snack at bedtime

Note other activites when drinking such as dancing

Question 17

By how much does smoking increase the risk of diabetes?

Answer 17

1.5x

Question 18

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

Answer 18

2x

Question 19

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

Answer 19

Nicotine replacement therapy and other drugs

Question 20

How do recreational drugs impact diabetes?

Answer 20

Risk of DKA

Seizures

Cardiotoxic

Anxious

Sick

Munchies

Hyper/hypotension

Question 21

What is the advice for recreational drugs and diabetes?

Answer 21

Avoid

Avoid dehydration

Monitor glucose for highs and lows

Do not omit insulin/carbohydrates

Munchies and control

Question 22

What are the advantages of exercise?

Answer 22

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 23

How does exercise impact diabetes?

Answer 23

Reduce insulin before nad after

Reduction hypo risk

Eat more (appropriate carbohydrates)

Use different insulin regimen

Question 24

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

Answer 24

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 25

Why does diabetes impact driving?

Answer 25

Risk of hypos, poor vision, neuropathy

Can drive with diabetes, but must inform the DVLA

Question 26

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

Answer 26

Yes, but need strict medical review

Question 27

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

Answer 27

At least 45 minutes

Question 28

What is the advice for diabetics driving?

Answer 28

No 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 29

Are people with diabetes less likely to get a job?

Answer 29

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

Question 30

What jobs are people with diabetes excluded from?

Answer 30

Armed forces

Police

Question 31

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

Answer 31

Offshore oil limited but increases

Blue light rapid response driver

Question 32

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

Answer 32

Scuba diving

Scaffolder/window cleaner

Solo yachtsman

Endurance sports

Taxi driver

Emergency vehicle driver

Bus/lorry driver

Question 33

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

Answer 33

Monitor glucose and drink plenty fluids

Always carry insulin with you

Adjust insulin to cross timezones