Management of Diabetes, Lifestyle and Exercise Flashcards
What are some examples of things that composes a healthy lifestyle?
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
What are examples of lifestyle things that will change after being diagnosed with diabetes?
Medication/injections
Blood testing
Diet/weight loss
Physical activity
Dealing with hypos
Dealing with illness
Travel
Hobbies
Work
Family/friends
What are some things that makes diabetes really hard to live with?
Long term condition
Complex management
Lifestyle manageent
Delayed reward
Probabilistic reward
Does not fit in with life
What are some lifestyle problems with young people and diabetes?
Desire to be same as peers
Sports
Nights out
Alcohol/drugs
Learning to drive
Leaving home
Festivals
Travel
Sex/contraception
Tattoos and piercings
Is the prevalence of obesity increasing or decreasing?
Increasing
What are some myths about diabetes?
Should eat a “diabetic diet”
Can not eat simple carbohydrates
What are some dietary considerations in diabetes?
Consider need for weight loss
Carbohydrate is main consideration in managing glycaemic control
Also consider effects of diet on lipids/blood pressure
What is the purpose of carbohydrate counting?
To work out how much insulin to give yourself
What is a quick acting insulin dose composed of?
Dose to cover total carbohydrate in food and correction dose if blood glucose is high
Why might adjustment of timing of insulin be required for higher GI foods?
Composition of foods alters how quickly carbohydrate is absorbed from the gut
What is an example of an eating disorder of someone with type 1 diabetes?
Diabulimia
What is diabulimia?
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
What does diabulimia lead to?
Recurrent DKA
High morbidity and mortality
Why does alcohol consumption impact diabetes?
Alcohol reduces glycogenolysis
Alcohol contains calories, resulting in rise followed by fall in glucose
What is glycogenolysis?
Breakdown of glycogen (n) to glucose-1-phosphate and glycogen (n-1)
What is the advice to diabetics who are going drinking?
Eat before and snack at bedtime
Note other activites when drinking such as dancing
By how much does smoking increase the risk of diabetes?
1.5x
By how much does smoking increase is the risk of macrovascular disease?
2x
What drugs can be used in diabetes to help people stop smoking?
Nicotine replacement therapy and other drugs
How do recreational drugs impact diabetes?
Risk of DKA
Seizures
Cardiotoxic
Anxious
Sick
Munchies
Hyper/hypotension
What is the advice for recreational drugs and diabetes?
Avoid
Avoid dehydration
Monitor glucose for highs and lows
Do not omit insulin/carbohydrates
Munchies and control
What are the advantages of exercise?
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
How does exercise impact diabetes?
Reduce insulin before nad after
Reduction hypo risk
Eat more (appropriate carbohydrates)
Use different insulin regimen
What are some ways to get people to increase physical activity levels?
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
Why does diabetes impact driving?
Risk of hypos, poor vision, neuropathy
Can drive with diabetes, but must inform the DVLA
Are people with diabetes allowed to apply for group 2 licences if on insulin (for bus or lorry)?
Yes, but need strict medical review
How much time should there be between having a hypo and driving?
At least 45 minutes
What is the advice for diabetics driving?
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
Are people with diabetes less likely to get a job?
No because cannot be discriminated against due to the Disability Discrimination Act of 2010
What jobs are people with diabetes excluded from?
Armed forces
Police
What jobs can people with diabetes get but it is under the review of the employer?
Offshore oil limited but increases
Blue light rapid response driver
What are examples of some hobbies/types of work that needs to be carefully considered before doing with diabetes?
Scuba diving
Scaffolder/window cleaner
Solo yachtsman
Endurance sports
Taxi driver
Emergency vehicle driver
Bus/lorry driver
What is the advice for people with diabetes going away on holiday?
Monitor glucose and drink plenty fluids
Always carry insulin with you
Adjust insulin to cross timezones
