(PM3B) Diabetes Self-Care & Management Flashcards

1
Q

What support are pharmacists expected to offer for diabetic patients?

A

(1) Diet & lifestyle advice
(2) Offer locally commissioned services, e.g. weight management programmes
(3) NMS and MUR

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2
Q

What monitoring is required for diabetic patients?

A

(1) Signs + symptoms of hypo/ hyperglycaemia
(2) Signs + symptoms of chronic complications
(3) Blood glucose level - daily required for young people with type 1

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3
Q

What are the aims of treatment for diabetic patients?

A

(1) Improve QoL
(2) Regulate blood glucose
(3) Reduce risk of co-morbidities (complications)
(4) Reduce mortality

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4
Q

What is/ are the main treatment option(s) for Type 1 diabetes mellitus?

A

Insulin

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5
Q

What is/ are the main treatment option(s) for Type 2 diabetes mellitus?

A

(1) Metformin/ suphonylurea - especially if overweight
(2) Insulin
(3) Diet

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6
Q

What should diabetic patients know about their treatment?

A

(1) Types of insulin

(2) Pen/ syringes other equipment

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7
Q

What should be done with old insulin?

A

Disposed of

To make sure it is not confused with new insulin

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8
Q

Can a patient administer their own insulin in hospital?

A

Yes.

They must tell staff they wish to continue administering their own insulin

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9
Q

What is biphasic insulin?

A

A combination/ mix of insulin

  • Rapid/ short-acting
  • Intermediate
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10
Q

What types of insulin are there?

A

(1) Pre-loaded disposable pen

(2) Re-usable injection pen

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11
Q

Can IV syringes be used for insulin self-administration?

A

No. They should be avoided

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12
Q

How should a syringe be described on the box for it to be considered appropriate for insulin administration?

A

“Insulin syringe”

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13
Q

How should insulin that is IN USE be stored?

A

Below 25ºC

But NOT in the fridge

Up to 4 weeks

(2-8ºC fridge if not yet in use)

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14
Q

What does a lumpy injection site indicate?

A

Lipohypertrophy - can affect absorption

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15
Q

What can lipohypertrophy affect?

A

Absorption of the the drug

e.g. insulin

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16
Q

Name potential insulin injection sites, list them from fastest to slowest absorption.

A

(1) Abdomen
(2) Arms
(3) Thigh
(4) Buttocks

17
Q

How can lipohypertrophy be avoided?

A

Rotate injections sites

Important to use both left and right

18
Q

What is an insulin passport?

A

A record of the patient’s current insulin preparations

Also emergency information

Comes with a patient information leaflet

19
Q

What is also given with an insulin passport to the patient?

A

Patient information leaflet

Information on how to safely administer insulin

20
Q

What is the clinical diagnosis for hypoglycaemia?

A

<4mmol/L plasma glucose

21
Q

What are common symptoms of a hypoglycaemic episode?

A

(1) Shaky/ dizzy
(2) Sweaty
(3) Irritability
(4) Fatigue

22
Q

What is the first line treatment for hypoglycaemia?

A

Immediate treatment:

ø 10-20g of rapidly-acting carbohydrate (sugar)

23
Q

How can hyperglycaemia be managed?

A

(1) Increased dose of insulin
(2) Change diet to avoid sugary foods
(3) Increase exercise
(4) Monitor glucose levels regularly

24
Q

What does extreme hyperglycaemia cause?

A

Diabetic Ketoacidosis

25
How are blood glucose levels affected by illness? What is this referred to as?
(1) Usually increase | (2) Sick day rules
26
What are patients on insulin also given?
(1) Insulin passport | (2) Urine strips to test for ketones
27
When sick, how often should a Type 1 diabetic patient check their blood glucose? What else is monitored?
Every 4 hours Also urinary ketones
28
What drugs can cause kidney damage to a diabetic patient when dehydrated?
- ACE inhibitors - ARBs - NSAIDs
29
What is blood glucose level is considered hypoglycaemia?
>11mmol/L
30
What is the increased risk of stroke for a diabetes patient?
2-4x as likely
31
What would you advise a diabetic patient intending to fast, including for Ramadan?
AVOID fasting Break the fast if blood glucose <3.5mmol/L
32
What is amenorrhoea?
Absence of monthly period
33
What is cystitis?
Inflammation of the bladder Normally due to infection
34
What would be your recommendation for a diabetic patient presenting with cystitis?
Refer to GP Increased risk of nephritis
35
What should be recommended for a diabetic patient presenting with an insect bite?
Recommend insect repellant Refer if not improved in 1-2 days AVOID hydrocortisone cream
36
What are the requirements for a diabetic patient, regarding their driving licence?
(1) Inform DVLA of their condition (2) Avoid hypoglycaemia - check blood glucose before driving (3) Carry a supply of sugar in the car (4) If experiencing hypoglycaemia/ symptoms STOP and consume sugar. WAIT 45 mins before continuing
37
What effect can hot climates have on insulin?
May require more insulin
38
What does a diabetic patient require before using air travel?
A letter from the GP Explaining need for carrying syringes + needles + insulin
39
Should diabetic patients be advised to get a flu jab?
Yes. Flu vaccine is important for diabetic patients. Pneumococcal pneumonia vaccination is also recommended