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HSCI 2211 - Final Exam > 5 - Diabetes Control Programs > Flashcards

5 - Diabetes Control Programs Flashcards

1
Q

Can type 1 diabetes be prevented?

A

No

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2
Q

Can type 2 diabetes be prevented?

A

Yes

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3
Q

Can long-term complications of type 1 diabetes be delayed or prevented?

A

Yes

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4
Q

How can long-term complications of type 1 diabetes be delayed or prevented?

A

Through strict control of blood glucose.

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5
Q

What lifestyle interventions can be used to prevent or delay type 2 diabetes?

A

Weight loss, diet, exercise.

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6
Q

How can long-term complications of type 2 diabetes be delayed or prevented?

A

Through strict control of blood glucose and blood pressure.

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7
Q

What is diabetes primary prevention?

A

Preventing the development of diabetes through reduction of modifiable risk factors in the general population and in individuals at high-risk.

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8
Q

What is the population strategy of diabetes primary prevention?

A

Reduce modifiable risk factors in the general population.

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9
Q

What is the high risk strategy of diabetes primary prevention?

A

Reduce modifiable risk factors in individuals at risk.

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10
Q

What is diabetes secondary prevention?

A

Early detection and screening those at high-risk of diabetes.

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11
Q

What is diabetes tertiary prevention?

A

Upon diagnosis of diabetes, prevention of complications, morbidity, and mortality, through adequate treatment.

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12
Q

What is the goal of diabetes primary prevention?

A

To prevent diabetes.

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13
Q

Who are the targets of diabetes primary prevention?

A

The general population and high risk groups.

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14
Q

What is the message of diabetes primary prevention?

A

Make healthy lifestyle choices.

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15
Q

What are the two current delivery models of primary prevention?

A

Population health and primary care.

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16
Q

Who does the high risk approach to diabetes primary prevention focus on?

A

Individuals who have other risk factors (obesity, physical inactivity, smoking, high BP, family history and genetic factors).

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17
Q

What are the interventions found in the high risk approach to diabetes primary prevention?

A

Dietary changes, weight reduction and increased physical activity.

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18
Q

What dietary recommendations are made in the high risk approach to diabetes primary prevention?

A

Monitor carbohydrates, limit foods with a high glycemic index, limit sweetened beverages, and monitor total daily calories consumed.

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19
Q

Sugar should made up what percent of total daily calories according to the high risk approach to diabetes primary prevention?

A

Less than 10%, approximately 12 teaspoons

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20
Q

What are barriers to effective clinical-system based lifestyle intervention programs?

A

Waiting until someone has elevated glucose is already too late, and diabetes is a common-source epidemic rooted in culture and society.

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21
Q

What does the population-based approach of diabetes primary prevention focus on?

A

Prevention strategies for the whole population.

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22
Q

Where can prevention strategies for the whole population take place?

A

Communities, workplaces, schools, social and healthcare settings.

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23
Q

Two types of market regulation and restrictions for diabetes primary prevention….

A

Access-restriction and strategic pricing.

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24
Q

What are examples of strategic pricing (used in market regulation and restriction for diabetes primary prevention)?

A

Taxation, food and menu labelling, and affordable foods.

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25
Who is a patients first contact in the healthcare system?
Their family doctor/general practitioner.
26
What is the role of the primary care physician in terms of diabetes primary prevention?
To promote a healthy-lifestyle, included: a healthy diet, physical activity and a healthy bodyweight.
27
What are examples of effective education and public information that contributes to a change in individual behaviour?
Instituting education campaigns that enable people to read and understand food labels. And, providing training staff and volunteers for the skills required to promote population health
28
What is a school prevention strategy that is known to be effective for children?
Increasing time for physical activity.
29
What are examples of community-wise approaches to promoting health?
Community recreational facilities, networks of community-based organizations and services committed to improving nutrition and physical activity, and mandating a local health service such as a diabetes education centre.
30
What are examples of socio-environmental and workplace primary prevention strategy?
Public and social policy interventions. And, programs and polices that encourage behaviour change and create safer and healthier work environments.
31
What are some examples of programs and policies that encourage behavioural change and create safer and healthier work environments?
Smoke-free workplaces and public places. Physical activity programs at work.
32
What are seven areas involved in diabetes primary prevention?
Market regulation and restriction, intervention by primary health providers, public information, school-based interventions, community support, socio-environmental interventions, and workplace interventions.
33
What is the goal of diabetes secondary screening?
Early identification of those with dysglycemia.
34
Who is the target population for diabetes secondary screening?
Asymptomatic individuals who have diabetes or who are at a high risk of developing diabetes.
35
Examples of high risk populations for diabetes...
Overweight/obese, 45+ years, physically inactive, high blood pressure, low HDL cholesterol, high triglycerides, belonging to an ethnic or minority group at high risk for diabetes, a family history of diabetes, or a history of gestational diabetes.
36
Briefly describe the fasting blood glucose test (fasting plasma glucose test).
Blood is collected after an overnight fast, and glucose level is measured.
37
Briefly describe a random blood glucose test.
Blood is collected at a random, non-fasting, time, and glucose level is measured.
38
Briefly describe an oral glucose tolerance test.
Blood is collected after fasting and agains 2 hours after drinking a glucose-rich drink, and glucose level is measured.
39
Briefly describe a glycated hemoglobin A1C test.
This test measures the percentage of hemoglobin molecules that have glucose attached. This test indicates an average blood glucose level for the past 3 months.
40
Hemoglobin
A protein that makes red blood cells red-coloured.
41
What happens when hemoglobin picks up a glucose molecule?
It becomes glycosylated.
42
What does HbA1c stand for?
Glycosylated hemoglobin
43
A1C score for diagnosis of diabetes
6.5% or higher.
44
A1C score for diagnosis of prediabetes
6% - 6.4% (according to Canadian guidelines)
45
A1C score of a healthy adult without diabetes
less than 5.7%
46
Are patients with pre-diabetes usually symptomatic or asymptomatic?
Asymptomatic
47
What is the result of intervening early if someone has pre-diabetes?
Plasma glucose levels will return to the normal range.
48
How often should someone with pre-diabetes be screened for diabetes?
Ever 1.2 years.
49
Compared to someone without pre-diabetes, what is the risk of cardiovascular disease for someone with pre-diabetes?
Someone with pre-diabetes has a 1.5-fold higher risk of cardiovascular disease.
50
Compared to someone without diabetes, what is the risk of cardiovascular disease for someone with diabetes?
Someone with diabetes has a 2-fold to 4-fold increased risk of cardiovascular disease.
51
In people with pre-diabetes, what other factors can influence risk of cardiovascular disease?
Tobacco use, high blood pressure, and high cholesterol.
52
Who is tertiary prevention geared toward?
People who already have diabetes.
53
What are the main interventions involved in diabetes tertiary prevention?
Physical activity, nutrition, weight management, and medication.
54
Give examples of areas of concern for diabetics in managing their condition...
blood glucose levels, blood glucose control, cholesterol, kidneys, eyes, feet, nerve damage, blood pressure, nutrition, diet, weight, and exercise.
55
People with diabetes require continuing medical care and ongoing patient management, education and support to prevent ___ complications.
acute
56
People with diabetes require continuing medical care and ongoing patient management, education and support to reduce the rest of ___ microvascular and macrovascular complications.
longterm
57
Examples of longterm microvascular and macrovascular complications of diabetes...
retinopathy, neuropathy, nephropathy, atherogenesis, blindness, limb amputation, kidney failture, coronary heart disease, myocardial infarction, and stroke.
58
The cornerstone of diabetes tertiary prevention is...
maintenance of blood glucose levels within normal limits.
59
How are blood glucose levels controlled in diabetes tertiary prevention?
A combination of insulin replacement, medication, diet and exercise.
60
Why are regular eye exams an important part of diabetes tertiary prevention?
To prevent vision loss due to retinopathy.
61
Why are regular foot exams and proper foot care an important part of diabetes tertiary prevention?
Vascular and neurological damage to the extremities can lead to amputation.
62
4 types of exams/tests important in diabetes tertiary prevention.
Blood tests (A1C, microalbumin and lipid tests). Blood pressure tests. Eye exams. Feet exams.
63
Microalbumin test
This test measures the amount of a protein called microalbumin in the urine. This test can indicate kidney disease if large amounts of the protein are found.
64
Examples of lifestyle changes needed upon diagnosis of diabetes
Self-monitoring blood glucose, exercise, eat healthy meals, stop smoking, limit alcohol, and lower stress.
65
Glucagon
A pancreatic hormone that raises blood glucose levels
66
4 key pieces to diabetes self-management.
Regular blood sugar testing, following a healthy meal plan, take medication, and get regular exercise.
67
Aim of nutrition self-management?
Prevent or delay the onset of complications.
68
What types of foods are encouraged for diabetic patients?
Whole grains, vegetables, fruits, low fat meats, non-fatty dairy products, and fish.
69
What types of foods should people with diabetes avoid.
Sugary foods, such as pastries, candy bars, and pies.
70
What is the aim of exercise in diabetes self-management?
To improve blood glucose control and insulin sensitivity, and to reduce cardiovascular risk, independently of weight loss, by reducing the risk of type 2 diabetes.
71
How much exercise is recommended for diabetic patients?
30 minutes a day, at least 3 days a week.
72
How does exercise improve blood sugar levels?
It lowers blood sugar levels by improving cell uptake of glucose, causing the body to process glucose faster.
73
What type of medication doe everyone with type 1 diabetes require?
Insulin.
74
What is the goal of taking antidiabetic medications?
To prevent long-term complications, such as cardiovascular disease.
75
Why might insulin treatment be started in a patient with type 2 diabetes?
It might be started if a relative deficiency of insulin secretion develops over time, due to the progressive nature of diabetes.
76
How does insulin work?
It promotes glucose uptake by the tissues to facilitate normal body metabolism.
77
How does Metformin work?
It lowers the amount of sugar released by the liver, it increases the cells' sensitivity to insulin, and it slows absorption of sugars from the intestines.
78
What current screening methods are effective, as they are being carried out now?
Screening for blood pressure and lipids.
79
What current screening methods are deficient, as they are being carried out now?
Screening for microvascular disease complications: retinopathy, nephropathy, neuropathy and foot exams.
80
What does a multi-tiered public health response to diabetes include?
Efficient identification and referral of high risk people to structured lifestyle programs using clinical-community partnerships. And, broad population-targeted approaches aimed at food, social, and economic environment to ultimately change trends in the epidemic.

HSCI 2211 - Final Exam (11 decks)

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