Self Care Diabetes

Question 1

What are some key self-management activities? (7)

Answer 1

1. managing relatonship between food, meds and activity
2. Self monitoring, glucose etc
3. Individual target goals
4. Applying sick day rules when ill
5. Understanding diabetes
6. Managing acute complications
7. Understanding legislative issues such as driving and employment

Question 2

What is DESMOND?

Answer 2

Diabetes Education and Self Management for Ongoing and Diagnosed

the collaborative name for a family of group self management education modules, toolkits and care pathways for people with, or at risk of, Type 2 diabetes

Question 3

What is DAFNE?

Answer 3

dose adjustment for normal eating regimen

way of managing Type 1 diabetes and provides people with the skillsnecessary to estimate the carbohydrate in each meal and to inject the right dose of insulin

Question 4

What are the Plasma glucose levels for diagnosis of diabetes?

Answer 4

Fasting plasma glucose > 7.0mmol/L

Plasma glucose 2 hours after ingestion of 75g glucose > 11.1mmol/L (Glucose tolerance test)

Question 5

What sort monitoring should be done?

Answer 5

Hba1c (target level of 48mmol/mol (6.5%) or less)
Cardiovascular monitoring – BP, cholesterol
Urine proteins

Question 6

How long is the onset, peak and duration of Rapid/short insulins?

Answer 6

onset: 5-15min
peak: 60min
duration: 3-5hours

Question 7

How long is the onset, peak and duration of Intermediate insulins?

Answer 7

onset: 1-2 hrs
peak: 6-10hrs
duration: 12-18 hrs

Question 8

How long is the onset, peak and duration of Long insulins?

Answer 8

onset: 1-2 hrs
peak: flat profile
duration: 18-36 hrs

Question 9

How long is the onset, peak and duration of Mix insulins?

Answer 9

onset: 15-60min
peak: 1-10 hrs
duration: 12-18hrs

Question 10

What is Lipohypertrophy?

Answer 10

(“lumpy” injection site) can affect absorption

Question 11

How long can be insulin be kept once opened?

Answer 11

4 weeks below the temps of 25-28 degrees

Question 12

Where should insulin be stored when not in use?

Answer 12

Fridge 2-8 degrees

Question 13

What is an Insulin passport?

Answer 13

record of the patient’s current insulin preparations and a section for emergency information

Question 14

What are some acute complications of diabetes?

Answer 14

Hypoglycaemia (<4mmol/L glucose)
excessive dose of insulin or antidiabetic tablets, excessive exercise, missed meals, infection, illness

Hyperglycaemia: infection, illness, stress, missed doses

Question 15

What are some chronic complications?

Answer 15

Eye disease
Nephropathy
Neuropathy
Cerebrovascular and Coronary artery disease

Question 16

What are the sick day rules?

Answer 16

Should Never stop taking their insulin
Type 1 - more monitoring of blood glucose (every 4 hours) and urinary ketones
Type 2 – blood glucose

provided with urine strips to test for ketones (e.g., Ketostix)

Continue to take tablets and/or insulin as normal even if they are not eating much