Diabetes management

STUDY
PLAY
What is the name of the diet that is recommended in diabetic patients?
Mediterranean diet
How does metformin work?
Increases sensitivity to insulin
Decreases hepatic gluconeogenesis
Which two diabetic drugs can help with weight loss?
Metformin
GLP 1 receptor agonists: exenatide and liraglutide
4 components of a diabetes management
Sugar control and monitoring
Lifestyle: exercise and diet
Managing comorbidities: consider if pt should be on ACE inhibitor, statin or aspirin
Screening and management of complications
What are the two indications for ACE inhibitors?
Hypertension: No longer aiming for a blood pressure of around 130/80, now about 140/90 or less
Microalbuminuria: 30-300mg albumin per gram Cr
What are the components of a diabetic foot screen?
Skin assessed for integrity
Screen for peripheral artery disease
Test for sensation w monofilament + one other modality: tuning fork, pinprick sensation, ankle reflexes
What's the buzzword for non-proliferative diabetic retinopathy?
"Cotton wool" spots
What do you check if a pt has a normal pre-meal BSLs and a high HbA1c?
Check the post-prandial sugars
What do you do if a pt has asymptomatic hypoglycaemia?
Let the sugars run high for a couple of weeks - targeting BSL 8-11
What is the HbA1c target in older pts w multiple comorbidities?
HbA1c <8%