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Foot - DIABETIC > Unit 1 - Diabetes > Flashcards

Unit 1 - Diabetes Flashcards

1
Q

Evidence from 2016 indicated that:

Diabetic complications are r/t (1)

Diabetes contributes to (4)

Diabetes is the leading cause of (1)

A

premature death (lifespan reduced by 5-15 years)

30% of strokes
40% of heart attacks
50% of kidney failure requiring dialysis
70% on non-traumatic lower limb amputations

vision loss

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2
Q

Seniors and Diabetes

What %age of people with diabetes are age 65 and older?

What are important for decreasing risk for developing diabetes in elderly people?

Describe diabetes in the elderly in comparison to that of younger people.

Therefore?

A

Approximately 25.9 %
.
Lifestyle interventions

Diabetes in the elderly is metabolically distinct from that of younger people
It therefore should be treated differently.
(Canadian Diabetes Association, 2013).

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3
Q

Aboriginal People and Diabetes

Aboriginal populations living in Canada are among…

Diabetes prevention efforts should focus on?

Diabetes screening for adults should occur how often?

Are males or females more impacted by DMII?
When?

Aboriginal women in Canada experience gestational diabetes at a rate that is…

A

the highest risk populations for diabetes and related complications

diabetes risk factors (obesity, proper management of gestational diabetes, smoking, inactivity, poor eating habits, and stress)

every 1-2 years for individuals with one or more risk factors

Aboriginal females are impacted by type 2 diabetes more than males, with the most noticeable difference being seen during reproductive years.

2-3 times higher than other women.

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4
Q

Diabetes and Psychiatric Illness

Psychiatric disorders are more prevalent in…

People diagnosed with psychiatric illness are more likely to

Those individuals with both diabetes and psychiatric illness have decreased (2)

Those individuals with both diabetes and psychiatric illness have increased (4)

Risk factors leading to insulin resistance and metabolic disorder? (4)

A

people with diabetes than in the general population.

develop diabetes than the general population.

medical adherence
self-care

functional impairment
risk of diabetic complications
healthcare costs
mortality

Psychotropic drugs cause weight gain
COMBINED WITH 
poor diet
inadequate exercise 
smoking common in this population
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5
Q

The Economic Costs of Diabetes

The economic burden of diabetes in Manitoba is estimated to be ? in 2010

How much was the cost expected in increase by 2020?

Estimated cots in 2020 (by Canadian Diabetes Association)?

A

$498 million in 2010 (measured in 2009 dollars)

28%

$639 million

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6
Q

Definitions

Diabetes

A

a metabolic disorder characterized by the inability to manufacture or properly use insulin
and
impaired ability to convert sugars, starches, and other foods into energy.

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7
Q

Definitions

Diabetes in terms of blood glucose (2)

A

FBG - fasting blood glucose > 7.0 mmol/L

or

2 hour blood sugar of > 11.1 mmol/L

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8
Q

Definitions

Type 1 Diabetes

More commonly Dx’ed in?

Etiology

A

children and adolescents

Pancreatic beta cell destruction causes the pancreas to stop producing insulin.
Without enough insulin, glucose isn’t metabolized properly, so it builds up in the bloodstream.

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9
Q

Type 1 Diabetes

What is thought to be the cause of beta cell destruction?

Onset?

Prevention?

A

an autoimmune process

can be sudden

Cannot be prevented.

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10
Q

Type 1 Diabetes

How is it treated?

A

diet
exercise
insulin (clients are dependent)

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11
Q

What % of people Dx’ed with diabetes have type 1?

A

10% of people diagnosed with diabetes have Type 1 diabetes.

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12
Q

Type 2 Diabetes

Commonly diagnosed in?

Etiology?

Onset?

A

adults

The pancreas does not produce enough insulin
or
the body does not use the insulin effectively (insulin resistance).

Can be slow in onset.

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13
Q

Type 2 Diabetes

How is it treated?

A

diet
exercise
oral medication and/or insulin

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14
Q

What % of people Dx’ed with diabetes have type 2?

A

90% of people diagnosed with diabetes have Type 2 diabetes.

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15
Q

Prediabetes is defined as?

Prediabetes is associated with?

A

blood sugars that are above normal levels
but
below those of diabetes

an increased risk of developing either diabetes or cardiovascular disease.

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16
Q

IFG

A

impaired fasting glucose

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17
Q

IFG - impaired fasting glucose is

A

6.1 to 6.9 mmol/L

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18
Q

IGT

A

impaired glucose tolerance

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19
Q

IGT - impaired glucose tolerance is

A

2 hour blood sugar of 7.8 to 11.1 mmol/L

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20
Q

What is a key feature of type 2 diabetes?

A

Insulin resistance

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21
Q

Define Insulin Resistance

A

a condition in which the body’s cells and tissues do not respond properly to the effects of insulin.

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22
Q

Insulin resistance is a key feature of type 2 diabetes.

It is also implicated in? (2)

A

prediabetes and metabolic syndrome

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23
Q

Metabolic Syndrome is…

It is defined as people with 3 or more of the following 5 risk factors:

A

a grouping of conditions that is associated with a higher risk of developing diabetes and/or cardiovascular disease

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24
Q

Metabolic Syndrome is…

5 risk factors:

A

Fasting Blood Sugar > 6.1 mmol/L

Blood Pressure > 130/85

Triglycerides > 1.7 mmol/L

HDL- cholesterol
Men < 1.0 mmol/L
Women < 1.3 mmol/L

Waist Circumference
Men > 102 cm
Women > 88 cm

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25
How many of the five risk factors must the person have to be Dx'ed with metabolic syndrome?
3 or more
26
Targets for control of blood sugar NORMAL RANGE Hgb A1C % Fasting glucose 2 hour glucose
Hgb A1C %: < 6.0 Fasting glucose: 4.0 – 6.0 mmol/L 2 hour glucose: 5.0 – 8.0 mmol/L
27
Targets for control of blood sugar TARGETS FOR MOST DIABETICS Hgb A1C % Fasting glucose 2 hour glucose
Hgb A1C %: < 7.0 Fasting glucose: 4.0 – 7.0 mmol/L 2 hour glucose: 5.0 – 10.0 mmol/L
28
Risk Factors for Type 2 Diabetes Genetics (2)
Parent of sibling with diabetes | Belonging to high-risk group Aboriginal, African, Asian, South Asian, Hispanic descent
29
High risk groups
``` Aboriginal African Asian South Asian Hispanic ```
30
Risk Factors for Type 2 Diabetes Women's Woes (3)
Having baby that weighed more than 4kg (9 pounds) at birth Gestational diabetes (diabetes during pregnancy) polycystic ovary syndrome Dx
31
Risk Factors for Type 2 Diabetes Pre-exisiting diagnoses (4)
Prediabetes (impaired glucose tolerance or impaired fasting glucose) obstructive sleep apnea Acanthosis nigricans (darkened patches of skin) psychiatric disorders: schizophrenia, depression, bipolar
32
Risk Factors for Type 2 Diabetes High? (3)
High BP High cholesterol or other fats in the blood High weight (overweight), especially if mostly carried around the tummy
33
Risk Factors for Type 2 Diabetes Other (2)
Having health complications that are associated with diabetes Having been prescribed a glucocorticoid med
34
Prevention of Type 2 Diabetes EARLY SCREENING recommended For those without risk factors? For those with risk factors?
Q 3 years starting at age 40 For those with risk factors, testing should be done more frequently and from an earlier age.  Promotion of life style changes that include weight management through diet and regular physical activity for those with prediabetes and/or metabolic syndrome.
35
Prevention of Type 2 Diabetes In Manitoba, screening of obese children recommendations.
> 7 years of age ``` Q 2 years IF members of a high risk ethnic group or have a family hx ```
36
Treatment of Type 2 Diabetes Treatment is aimed at? Using? To?
control of blood sugar using diet, exercise, oral medications and/or injected insulin to control symptoms and reduce or prevent complications
37
Each 1% drop in Hgb A1C is associated with:
- 43% less risk of amputation - 37% less risk of microvascular complications - 21% less risk of diabetes complications - 21% less risk of death related to diabetes - 19% less risk of cataract extraction - 16% less risk of heart failure - 14% less risk of heart attack - 12% less risk of stroke - Reduced number of hospital stay days.
38
What is the ONLY treatment to prevent the onset and delay the progression of diabetic neuropathy?
Control of blood sugar to within the recommended target range is the ONLY treatment
39
Diet and Diabetes CDA 2013 Clinical Practice Guidelines recommend ...
nutrition counselling from a registered dietician for all diabetics. Refer to and other publications from the CDA website.
40
Diet and Diabetes Recommended CDA publication?
“Just the Basics - Tips for healthy eating, diabetes prevention and management”
41
Physical Activity and Diabetes Exercise and physical activity has been shown to be a very important part of...
controlling blood sugar and reducing complications in diabetes.
42
Physical Activity and Diabetes Recommended CDA publication?
“Physical Activity and diabetes management”
43
Diabetes, Depression and Anxiety Symptoms of depression are often seen in clients with diabetes and research is demonstrating that...?
approximately 15% of diabetics | have symptoms of major depression
44
Diabetes, Depression and Anxiety Many of the physical symptoms of depression and diabetes are?
the same  The CDA 2013 Clinical Practice Guidelines are now recommending that regular screening for depression and anxiety be done with referral to mental health professionals for those with depression, anxiety or eating disorders.  There is literature available for the public and professionals on the CDA website.
45
Diabetes, Depression and Anxiety Many of the physical symptoms of depression and diabetes are the same, therefore...? This may be leading to...?
many health professionals assume that depression is inevitable with chronic illness this may be leading to under-diagnosis
46
Diabetes, Depression and Anxiety There is evidence of ??? among diabetics than in the general population.
There is evidence of more generalized anxiety disorder among diabetics than in the general population.
47
Diabetes, Depression and Anxiety What % of diabetics have some anxiety Sx? Often experienced is...?
14% fear of hypoglycemia
48
The Diabetes Management Team The person with diabetes needs to? In order to? This can seem like?
balance diet, exercise and medication control their disease and manage complications a difficult and daunting undertaking for many
49
The Diabetes Management Team This is most successfully done with the help of a multidisciplinary team that may include... DD E FF P
``` dietician diabetes educator nurse endocrinologist foot care specialists family doctor pharmacist ```
50
The Diabetes Management Team What is essential for the long-term management and support that diabetics need?
Good communication and common current standards of care among caregivers
51
The Diabetes Management Team CDA Clinical Practice Guidelines also make recommendations for?
the integration of mental health professionals and the use of CBT based techniques onto the diabetes team
52
The Foot Care Nurse as a Member of the Diabetes Health Care Team (5)
Know the current basics of diabetic management Know where clients can get diabetes education locally Be prepared to make and receive referrals within your local team Support ALL positive efforts that clients make to improve self care Document and follow up all referrals.
53
The Foot Care Nurse as a Member of the Diabetes Health Care Team Know the current basics of diabetic management:
targets for glucose testing and Hgb A1C managing hypoglycemia managing ‘sick days’ current care recommendations for foot care (CDA Diabetes Service Directory 2018 Clinical Practice Guidelines)
54
The Foot Care Nurse as a Member of the Diabetes Health Care Team Know where clients can get diabetes education locally
health resource centres, hospital or clinics - Manitoba Health – Chronic Diseases Branch – Diabetes home care resource pharmacy web based resources - Canadian Diabetes Association - WRHA Diabetes Service Directory health links
55
The Foot Care Nurse as a Member of the Diabetes Health Care Team Be prepared to make and receive referrals within your local team
keep referral information readily available know what information is needed to make a referral keep business cards with your information handy be prepared to explain what you do to others
56
The Foot Care Nurse as a Member of the Diabetes Health Care Team Support ALL positive efforts that clients make to improve self care
encourage them to seek answers to their questions encourage them to persist in their efforts be prepared give support repeatedly
57
The Foot Care Nurse as a Member of the Diabetes Health Care Team Document and follow up all referrals.
That's it.
58
S/S hyperglycaemia
Excess glucose in the blood creates an osmotic effect that results in increased thirst, hunger, and increased urination. The patient may also report nonspecific symptoms of fatigue, mild confusion, lethargy blurred vision HA warm, dry skin
59
Hyperglycaemia Tx
Insulin ``` Exercise Regularly. ... Control Your Carb Intake. ... Increase Your Fiber Intake. ... Drink Water and Stay Hydrated. ... Implement Portion Control. ... Choose Foods With a Low Glycemic Index. ... Control Stress Levels. ... Monitor Your Blood Sugar Levels. 9. Get Enough Quality Sleep Eat Foods Rich in Chromium and Magnesium ```
60
S/S hypoglycaemia
``` Capillary blood glucose level, weakness, fatigue, muscle cramps, decreased muscle tone, insomnia, tachycardia, tachypnea, dizziness, headaches, numbness/ tingling, decreased level of consciousness, or change in consciousness, seizure, visual impairment ``` anxiety, irritability, dizziness, diaphoresis, pallor, tachycardia, headache, shakiness, and hunger. severe hypoglycemia may lead to alteration of mental function that proceeds to headache, malaise, impaired concentration, confusion, disorientation, irritability, lethargy, slurred speech, and irrational or uncontrolled behavior
61
Hyperglycaemia Tx
Eat or drink 15 to 20 grams of fast-acting carbohydrates. These are sugary foods without protein or fat that are easily converted to sugar in the body. Try glucose tablets or gel, fruit juice, regular — not diet — soft drinks, honey, and sugary candy. Recheck blood sugar levels 15 minutes after treatment. If blood sugar levels are still under 70 mg/dL (3.9 mmol/L), eat or drink another 15 to 20 grams of fast-acting carbohydrate, and recheck the blood sugar level again in 15 minutes. Repeat these steps until the blood sugar is above 70 mg/dL (3.9 mmol/L). Have a snack or meal. Once your blood sugar is normal, eating a snack or meal can help stabilize it and replenish your body's glycogen stores.

Foot - DIABETIC (2 decks)

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