Diabetes and the Role of Occupational Therapy

A set of flashcards covering key concepts related to diabetes and occupational therapy from the lecture.

Diabetes

A heterogeneous metabolic disorder characterized by the presence of hyperglycemia due to the impairment of insulin secretion, defective insulin action or both.

Type 1 Diabetes

A form of diabetes where the pancreas produces little or no insulin, causing glucose to build up in the bloodstream.

• insulin deficiency, which is prone to ketoacidosis

• pretty consistent

Type 2 Diabetes

A form of diabetes characterized by the pancreas producing insulin but the body's cells being resistant to it, leading to high glucose levels.

• may range from predominant insulin resistance with relative insulin deficiency to predominant secretory defect with insulin resistance (ketosis not as common)

• progressive, can change

Hyperglycemia

An abnormally high level of glucose in the blood, often associated with diabetes.

• mild → increased thirst & urination, weight loss, fatigue

• moderate-severe → blurred vision, extreme thirst, light-headedness, flushed/dry/hot skin, restlessness/drowsiness or difficulty walking

• additionally/diabetic ketoacidosis → rapid, deep breathing, strong fruity breath.odour, fast heart rate, weak pulse

Hypoglycemia

An abnormally low level of glucose in the blood, which can occur when there is too much insulin relative to glucose.

• neurogenic (autonomic) - effects on nervous system

  • trembling, palpations, sweating, anxiety, hunger, nausea, tingling

• neuroglycopenic - effects on brain

  • difficulty concentrating, confusion, weakness, drowsiness, vision changes, difficulty speaking, headache, dizziness

Insulin

A hormone produced by the pancreas that regulates glucose levels in the bloodstream.

Glycemic Index (GI)

A scale from 1 to 100 that ranks carbohydrate-rich foods by how much they raise blood glucose levels after meals.

• high GI greater than 70 (rapid rise in blood glucose)

• low GI less than 55

• important for type 1 diabetes management

Microvascular Complications

Long-term complications of diabetes affecting small blood vessels, often resulting in conditions like retinopathy, nephropathy, and neuropathy.

Macrovascular Complications

Long-term complications of diabetes affecting large blood vessels, leading to conditions like heart attacks, strokes, and circulatory disease.

Cognitive Assessment

A tool used by occupational therapists to evaluate the cognitive functions of patients with diabetes, especially when complications affect daily functioning.

Medication Management

The process of overseeing and facilitating the correct use of medications, including insulin and other diabetes medications, to manage diabetes effectively.

• insulin delivery methods: pills, syringes, insulin pens, insulin pumps

• continuous glucose monitoring system

• blood sugar testing

• oral medications

Foot Care/Wound Management

A critical aspect of diabetes management that involves regular foot checks and care to prevent ulcers or infections.

• takes longer for wounds to heal

• wounds on feet can cause mobility issues

Case Study

An in-depth analysis of a patient or situation, used as a work tool to address specific issues related to diabetes and the role of OT.

Blood Glucose Monitoring

The routine testing of blood sugar levels to manage diabetes effectively.

• traditional - glucose monitors

• CGM - continuous glucose monitors

Diabetic Retinopathy

A painless complication of diabetes that affects the eyes, causing damage to the retina, which can lead to blindness if untreated.

Emotional Impact

The psychological effects that managing a chronic illness like diabetes can have on patients, including stress, anxiety, and depression.

Functional Mobility

The ability to move and perform daily activities, which can be affected by complications from diabetes.

• benefits: improve insulin resistance, decrease LDL (bad) cholesterol, increase HDL (good) cholesterol, decrease triglycerides, decrease blood pressure

Gestational Diabetes

A type of diabetes that first occurs during pregnancy and usually resolves after birth. Glucose intolerance

• increases the risk of developing Type 2 diabetes later.

Hemoglobin A1c (HbA1c)

A blood test measuring the average blood glucose levels over the past 2 to 3 months.

Diabetic Neuropathy

Nerve damage caused by chronic high blood sugar, often resulting in numbness or pain in the hands and feet.

Diabetic Nephropathy

Chronic kidney disease caused by damage to the small blood vessels in the kidneys due to long-term diabetes.

Health Literacy

The ability of an individual to find, understand, and use information and services to make health-related decisions for diabetes management.

Continuous Glucose Monitor (CGM)

A wearable device that tracks blood glucose levels in real-time throughout the day and night.

• placed on skin (~14 days)

• measures glucose in cellular fluids not blood glucose

Pre-diabetes

A condition where blood sugar levels are higher than normal but not yet high enough to be diagnosed as Type 2 diabetes.

Lifestyle Modification

Behavioral changes, such as improved diet and increased physical activity, implemented to improve blood glucose control and overall health.

OT role in diabetes

• nutrition

• exercise

• mental health/coping

• cognitive assessment

• medication management

• vision/foot care/wound management

• driving

Functional aspects of diet & nutrition

• barriers to healthy eating (money)

• planning & meal prep (overwhelming)

• grocery shopping (transportation, computer, energy)

• kitchen adaptation (not accessible kitchens)