T2DM - Initial Managment

Question 1

? care plan: for each patient.
Structured ? ? programme: for every newly diagnosed diabetic.
Screen for ?.

Answer 1

individual
group education
complx

Question 2

At ? and then repeat ? per year;
• ?.
• ? screen.
——> • First pass morning ? for ?:?, plus
serum creatinine for ?.
• ? Check.
—–>• Check for neuropathy, ischaemia (?-? ? ?), ?, deformity.
—–>• Frequent ‘? clinic’ appointments if necessary

Answer 2

Dx
once
fundoscopy
nephropathy
urine
ACR
eGFR
ABPI
ulcers
foot

Question 3

Monitor cardiovascular risk.

o Control blood pressure to /?
—• <130/80 if ?, ? or ? damage.
o Assess ? score.
—• Offer ? ?mg for those with 10-year risk >?%.

Answer 3

140/80
renal, eye, cerebrovascular
QRisk2
atorva 20
10

Question 4

Lifestyle

o Diet: no different to that considered healthy for everyone.

• —• ? in ?-? carbohydrates.
• —• Limit foods high in ? and ? ?.
• —• Diabetic specific foods are ? required.
• —• Can see ? to help with meal plans.

Answer 4

high in low-GI carbs
sugar
sat fat
not
nutrionist

Question 5

Lifestyle

Weight loss.
—• If ?, set a body weight loss target of ?-?%.
o Increase physical activity.
—• Aim for ? minutes exercise per ?, e.g. brisk walking.
o Stop ?: worsens CV risk.

Answer 5

overweight
5-10
30
day
smoking

Question 6

Lifestyle

o Alcohol advice.

• –• Alcohol may exacerbate/ prolong effect of ? drugs, and may make the signs of a ? less clear.
• –• Limit intake, and always have a ? containing snack ? and ? consuming alcohol.

Answer 6

hypoglycaemic
hypo
cab
before
after

Question 7

Arrange review to see progress on lifestyle advice in ? months
o HbAlc target: 6.5% (48mmol/mol).
—• 6.5% / 48 mmol/L is the target HbAlc initially.
—• ?% / ? mmol/L is the target for all patients on ? / taking a drug associated with ?.

Answer 7

3
7
53
insulin
hypoglycaemia