Management of Diabetes - Lifestyle and Exercise/Healthy Living Flashcards
What do we mean by a healthy lifestyle?
- Eat well balanced diet
- Don’t smoke
- Regular physical activity
etc etc
For those people who live with diabetes, what changes did they have to make after getting diagnosed?
Diagnosis of diabetes requires change:
Type 1 and Type 2
- Medication / Injections
- Blood testing
- Diet / weight loss
- Physical activity
- Dealing with hypos
- Dealing with illness…
- Travel
- Hobbies
- Work
- Family / friends…
Why is diabetes so hard to deal with/manage?
- It is a long term condition
- It has complex management
- Lifestyle management
- Delayed reward
- Probabilistic reward
- No symptoms ?
- It does not fit in with life
What problems do young people with diabetes face?
- Desire to be same as peers
- Sport
- Nights out
- Alcohol / Drugs
- Learning to drive
- Leaving home
- Festivals
- Travel
- Sex / Contraception
- Tattoos and piercings ….
How do unhealthy lifestyles relate to Type II Diabetes?
- Increasing prevalence of obesity
- Type 2 Diabetes is an obesity related disease
- Physical activity can prevent diabetes onset
- Smoking increases risk of diabetes
- Alcohol excess increases risk of diabetes
What dietary considerations need to be made in the management of Type I and Type II diabetes
- Carbohydrate is main consideration in managing glycaemic control
- Consider need for weight loss (calorie defecit??)
- Consider the effects of the diet on lipids/ blood pressure
What is the glycaemic index?
- A figure representing the relative ability of a carbohydrate food to increase the level of glucose in the blood.
(description NOT in lecture)
When carbohydrate counting in Type I Diabetes, how do we calculate the quick acting insulin dose?
Quick acting insulin dose
= Dose to cover total carbs in food + correction dose if blood glucose is high
How does the glycaemic index of foods relate to how insulin is taken?
- Adjustment to the timing of insulin injection may be required
What is diabulimia? (defintion not in the lecture)
- An eating disorder in which 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 is diabulimia associated with and what can it lead to?
Associated with: Poor glycaemic control
Can lead to: Recurrent DKA
How does alcohol affect diabetes?
- Alcohol reduces glycogenolysis (this decreases BG)
- Alcohol contains calories (this increases BG)
What should diabetics who decide to drink alcohol do?
- Eat before drinking alcohol
- Snack at bedtime
(note: they have the same limit as the general population)
State the problems with diabetes and smoking
- In diabetics, smokers die 10 years before non-smokers
- Smoking increases risk of diabetes by 1.5x
- Smoking increases risk of macrovascular disease by at least 2x
- Increased risk of ischaemic heart disease
- Smoking increases risk of all diabetes complications
(nicotine replacement therapy may be used)
Recreational drugs and diabetes:
What is the benefit of exercise for those with diabetes?
- Cardiovascular benefit
- Reduces cancer risk
- Consumes energy
- Builds lean tissue and consumes fat
- Improves strength, endurance etc
What are the risks of driving for those with diabetes?
- Hypoglycaemia (due to taking insulin - coma, death)
- Poor vision
- Neuropathy
What are the driving regulations for those with diabetes?
- You can still drive if you have diabetes!
- But you need to inform the DVLA if you’re on insulin (allowed to apply to Group 2 licences if on insulin)
- Take CHO in vehicle and test if on insulin
- DO NOT drive for 45 mins after hypo
To reduce the risk of hypoglycaemia, what should patients with diabetets who drive do?
- Check glucose levels within 2 hours of starting driving
- Check glucose levels every 2 hours of the journey (i.e long car journeys)
- Always carry CARBOHYDRATE in the car (increases BG)
Diabetes and work:
Holidays and diabetes:
