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Diabetes > Non-pharmacologic Treatment > Flashcards

Non-pharmacologic Treatment Flashcards

1
Q

The cornerstone of diabetes care that can effectively lower BG is…

A

Diet

Can be 1st line treatment for T2DM

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2
Q

Nutritional education is vital to understand the relationship between…

A

Carbohydrates, insulin, and blood glucose,
Also consider effects of weight, BP, and lipids

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3
Q

Diet should be individualized, based on…

A

Patient goals and preferences

Be mindful of cultural importance of food

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4
Q

If weight loss is a goal, this amount of weight loss may provide health benefits…

A

5-10%

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5
Q

Carbohydrates are available as the following…

A

Starches, sugars, and fibre

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6
Q

Carb counting can be used to allow for insulin doses to be…

A

Adjusted according to meal content

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7
Q

Generally, people should consume ____ of their total energy from carbohydrates

A

45-60%

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8
Q

Glycemic index is used to assess the quality of carbohydrate foods, based on…

A

Their ability to increase BG

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9
Q

Glycemic index can be used to distinguish foods based on…

A

Foods to choose more often (low GI) and foods to choose less often (high GI)

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10
Q

1 serving of carbohydrates is usually classified as…

A

15g

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11
Q

Soluble fibre works in the body by…

A

Slowing gastric emptying and delaying sugar absorption in the small intestine

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12
Q

When carb counting, fiber should be ____ since it cannot be ____

A

Subtracted from total carbs, since it cannot be digested

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13
Q

When a patient is considering fasting (Ramadan), it is important to encourage consultation with…

A

Dietitians +/- diabetes educators, 2 months before

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14
Q

For fasting, T1DM patients should be…

A

Advised against fasting

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15
Q

For fasting, medications should be chosen and adjusted based on…

A

Lowest risk of hypoglycemia, adjusted to try and minimize risk of low BG

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16
Q

Alcohol use in PWD can decrease ____ which can result in ____

A

Hepatic production of glucose, which can result in masking symptoms of hypoglycemia

17
Q

In people with T1DM, or those with T2DM on insulin/sulfonylureas, alcohol can cause delayed hypoglycemia which means that…

A

Hypoglycemia can occur at blood alcohol levels of mild intoxication + persist for up to 24 hours following the last drink

18
Q

New alcohol recommendations state that…

A

No amount of alcohol is safe, and it is a continuum of risk

19
Q

Health benefits of physical activity, beyond weight loss + glycemic control include…

A

Increased cardio/respiratory fitness
Decreased insulin resistance
Improved lipids + BP (reduced risk of CVD, stroke, onset of mcirovascular issues)

Psychological aspect important

20
Q

Physical activity has been correlated with A1C with…

A

Improvements in T2DM patients and kids with T1

Less clear evidence for A1C of adults with T1

21
Q

Exercise recommendations for people with diabetes are…

A

> 150 minutes of moderate to vigorous intensity aerobic exercise/week

Spread over 3+ days, no more than 2 consecutive days of no activity

IT IS OK TO START SLOW

22
Q

Before starting exercise, it is important to assess for conditions that can predispose to injury such as…

A

Neuropathy, CAD, previous MI/TIA… etc.

23
Q

Low-moderate intensity exercise (aerobic) affects BG by…

A

Decreasing BG during + after exercise due to increased insulin sensitivity

Using glucose as fuel

30 minutes of exercise can improve insulin sensitivity for the next 48 hours

24
Q

Very intense exercise (anaerobic) affects BG by…

A

Increasing BG during + after exercise due to increased glucose production (increased secretion of stress hormones)

25
Q

It is important for PWD to monitor for signs of low/high BG and continue to self monitor glucose levels, because…

Particular for those on insulin

A

Rapid changes in BG can occur during and after exercise

26
Q

Exercising for T1DM has a special focus on…

A

Minimizing risk of hypoglycemia

27
Q

Some non-insulin strategies to minimize risk of hypoglycemia during exercise includes…

A

Consuming extra carbs before/during/after exercise, carry a fast acting glucose source
Perform max intensity exercise before aerobic exercise

28
Q

Ways that insulin can be adjusted during exercise to minimize hypoglycemia risk includes…

A

Injecting insulin at a non-exercise site
Reducing dose of bolus insulin that is most active at time of exercise (25-75%)
Reducing basal insulin overnight by 20%

Careful with exercise late in the evening - overnight lows

29
Q

Exercise should be avoided if BG is below…

A

4 mmol/L

30
Q

In T2DM, exercise is okay to initiate if BG is high, as long as…

A

There are no signs of dehydration and the patient feels fine

31
Q

In T1DM, exercise is okay to initiate if BG is high, as long as…

A

No ketones are present, patient feels fine
BG is below 16.7 mmol/L

Diabetes (5 decks)

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