Health Science 2211- Module Lecture 4 (part 2)
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what is pre-diabetes?
occurs when patient's plasma glucose levels are higher than normal but not high enough for a diagnosis of diabetes.
what does pre-diabetes mean?
means patient is likely to develop diabetes and may already be experiencing the adverse health effects.
what can be used to detect pre-diabetes?
- fasting plasma glucose (FPG/ FBS)
- oral glucose tolerance test (OGTT)
what are some main facts about patients with pre-diabetes?
- often asymptomatic
- intervening early can actually return elevated plasma glucose levels to normal range
- should be checked for type 2 diabetes ever 1-2 years after diagnosis
Patients with pre-diabetes can prevent or delay the development of type 2 diabetes by?
lifestyle changes: changes in diet, increasing physical activity
what are the goals for tertiary prevention?
- glucose, blood pressure, lipid control to reduce development of complications
- improve health status
- achieve better clinical outcomes
- improve cost-efficiency
The cornerstone of tertiary prevention for diabetic patients is maintenance of blood glucose levels within normal limits by a combination of: (3)
- anti-diabetic agents
- diet and exercise
what is some examples of tertiary prevention of microvascular/macrovascular complications of diabetes? (2)
- regular eye examinations to prevent vision loss due to retinopathy
- routine foot examinations and proper daily foot care
what is the microalbumin test?
- test that measures amount of protein called microalbumin in the urine
- large amounts indicated kidney disease/damage
what are the main lifestyle changes need upon diagnosis of diabetes? (tertiary prevention) (6)
- self-monitor blood glucose
- plan and eat healthy meals
- stop smoking
- limit alcohol
- lower stress
what are the 4 steps in self-management of diabetes?
- regular blood-glucose monitoring
- following a meal plan (healthy nutrition)
- taking medication
- getting regular exercise
when should self-monitoring of blood glucose (SMBG) take place? (3)
- before meals and before taking insulin or medication
- 2 hours after meals
- before bedtime
What are some ways insulin can be delivered for patients with type 1 and some type 2 diabetes?
delivered by needle, syringe, insulin pen and insulin pump
Type 2 diabetes and pre-diabetes that are at risk of developing type 2 diabetes may take what to prevent or treat long-term complications?
take anti-diabetic medications
whata re 4 things oral drugs do in your body in diabetes treatment?
- increase insulin
- increase insulin sensitivity
- decrease absorption of glucose
- decrease glucose storage release
what function does biguanides, an oral anti-diabetic agents do have on lowering glucose levels?
lowers glucose by decreasing liver glucose release and by decreasing cellular insulin resistance
what function does alpha-glucose inhibitors, an oral anti-diabetic agents have on lowering glucose levels?
slows digestion and absorption of carbohydrates to maintain normal blood glucose levels
what function does meglitinides, an oral anti-diabetic agent have on lowering glucose levels?
stimulates pancreas to secrete insulin
what function does thiazolidinediones (TZD), an oral anti-diabetic agent have on lowering glucose levels?
- increases insulin sensitivity at receptor sites on liver muscle and fats cells
- make your cells more sensitive to insulin
How specifically does biguanides lower glucose levels by decreasing liver glucose release and by decreasing cellular insulin resistance in the liver? (2)
- 1. stimulates the binding of insulin to its receptors
- 2. increases translocation of the glucose transporters in various tissues
- both causing increased glucose uptake
what are 3 complications of insulin treatment?
- weight gain
- deterioration of the retinopathy
what are 3 challenges in the Canadian Health Care system? (tertiary prevention)
- structure of system designed for acute care not chronic disease
- healthcare under-funding is a barrier to diabetes care
- challenges to keep up with complications management
what are the challenges in the hospital based model? (tertiary prevention) (3)
- reduced funding and increased demand
- funding mechanism is problematic
- no formal evaluation on effectiveness
what can communities do to reduce the chance of developing diabetes? (3)
- promote physical activity , healthy eating and healthy weights
- provide affordable recreational facilities
- encourage local markets to provide better selections of healthy food
what can physicians and health care professionals do to reduce the chance of developing diabetes? (3)
- identify people at high risk of developing diabetes
- recommend services and tests for diabetes patients
- education for patients to prevent and reduce the risk
what can governments do to reduce the chance of developing diabetes?
- develop effective system to monitor the health impact of diabetes on the population
- provide more funding for research in diabetes-related fields
- more diabetes education programs to increase awareness
The establishment of ________________ and the _______________ with increased funding was a major improvement in diabetes research.
- Nutrition, metabolism, and diabetes
- Aboriginal people's health institutes
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