Management of Diabetes - Lifestyle and Exercise/Healthy Flashcards
what do we mean by 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 is so hard?
Long term condition Complex management Lifestyle management Delayed reward Probabilistic reward No symptoms ? It does not fit in with life
what is diabulimia?
Relatively common
Usually associated with poor glycaemic control
Recurrent DKA
Insulin omission (20% women omit insulin to control weight at some point)
High morbidity and mortality
what is the effects of alcohol on diabetes?
Alcohol reduces glycogenolysis
Alcohol contains calories
results in rise followed by fall in glucose
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
what is the effects of smoking on diabetes?
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
what is the effects of recreational drugs on diabetes?
Risk of DKA (glucose production / hypos Seizures Cardiotoxic Anxious Sick Munchies Hyper / hypotension
what is the effects of exercise on diabetes?
reduce insulin before and after (upto 24 hours)
Reduction hypo risk
eat more (appropriate carbohydrate)
use different insulin regimen (maximise flexibility)
what is the risk of driving with diabetes?
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
what are hobbies/work to consider carefully before doing with diabetes?
Scuba diving Scaffolder / window cleaner Solo yachtsman / women (Endurance sports) Taxi- driver Emergency vehicle driver Bus / lorry driver
