Question

Save Submit 4 Question 2 of 2 A diabetes educator typically below? mets with patients who harve a wide variety of problems,concerns, and abilitis. What suggestions can be offend to patients who harve the problems lised An 18-year-old college woman with type 1 diabetes has a date at an unfamliaurant andis unertain how she wil alealate the correst dose idgi . the food A 75 year-old man with type 2 diabetes has developed retinopathy and can no longer read the digital display on his bBlood glucose monitor. dellnh0Th Ch20.02

Answer 1

Answer

First question :

Adjusting insulin doses

Insulin doses should be titrated slowly. A one-off, high glucose level is not likely to be problematic, however hypoglycaemia can be frightening for a patient to experience and may progress to a coma. Care in avoiding hypoglycaemia is the priority.

In most cases the following recommendations for adjusting insulin doses should be appropriate:

• Short- and rapid-acting insulin — adjust by no more than two units (or 10 per cent of the current dose) daily
• Intermediate-acting, long-acting and pre-mixed insulin — adjust by no more than two units, or 10 per cent (whichever is greater), every three to four days

Answer for second question:

General changes to be brought in are:

General recommendations for lifestyle modification usually include: more exercise, reduced sugar and monosaccharides, and less alcohol and nicotine. With the knowledge of the effects of specific dietary ingredients, it might be possible to modify a regular diet in such a way as to benefit people with type 2 diabetes, to substantially improve quality of life.

The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes. A combination of diet, exercise, and medication can bring your levels down. People with diabetes should have an A1c test every 3 months to make sure their blood sugar is in their target range.

Answer for third question:

Medical control

Controlling your blood sugar and blood pressure can stop vision loss. Carefully follow the diet your nutritionist has recommended. Take the medicine your diabetes doctor prescribed for you. Sometimes, good sugar control can even bring some of your vision back. Controlling your blood pressure keeps your eye’s blood vessels healthy.

Medicine

One type of medication is called anti-VEGF medication. These include Avastin, Eylea, and Lucentis. Anti-VEGF medication helps to reduce swelling of the macula, slowing vision loss and perhaps improving vision. This drug is given by injections (shots) in the eye. Steroid medicine is another option to reduce macular swelling. This is also given as injections in the eye. Your doctor will recommend how many medication injections you will need over time.

Laser surgery

Laser surgery might be used to help seal off leaking blood vessels. This can reduce swelling of the retina. Laser surgery can also help shrink blood vessels and prevent them from growing again. Sometimes more than one treatment is needed.

Vitrectomy

If you have advanced PDR, your ophthalmologist may recommend surgery called vitrectomy. Your ophthalmologist removes vitreous gel and blood from leaking vessels in the back of your eye. This allows light rays to focus properly on the retina again. Scar tissue also might be removed from the retina.

Preventing vision loss from diabetic retinopathy

• If you have diabetes, talk with your primary care doctor about controlling your blood sugar. High blood sugar damages retinal blood vessels. That causes vision loss.
• Do you have high blood pressure or kidney problems? Ask your doctor about ways to manage and treat these problems.
• See your ophthalmologist regularly for dilated eye exams. Diabetic retinopathy may be found before you even notice any vision problems.
• If you notice vision changes in one or both eyes, call your ophthalmologist right away.
• Get treatment for diabetic retinopathy as soon as possible. This is the best way to prevent vision loss.