Home' Australian Pharmacist : Australian Pharmacist July 2012 Contents 554 Australian Pharmacist July 2012 I ©Pharmaceutical Society of Australia Ltd.
Continuing Professional Development
The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.
COUNSELLING IN PRACTICE
1. Choose the CORRECT statement
about type 2 diabetes.
a) Type 2 diabetes is caused by
autoimmune destruction of pancreatic
b) Risk factors include obesity,
hypertension and a positive family
history in a rst-degree relative.
c) People with undiagnosed type 2
diabetes typically present with recent
weight loss, thirst, and polyuria.
d) Type 2 diabetes is a metabolic disorder
associated with peripheral insulin
resistance, but insulin secretion
2. Choose the INCORRECT statement
about treatment options in type 2
a) Drug therapy is added when adequate
glycaemic control is not achieved after
6--8 weeks of lifestyle modi cations.
b) In people with diabetes at high
cardiovascular risk, lipid-modifying
therapy can reduce the risk of
cardiovascular events even if lipid
levels are normal.
c) In over 50% of people diagnosed with
type 2 diabetes, lifestyle modi cations
will initially normalise blood
d) Sulfonylureas enhance or mimic the
incretin hormones that stimulate
insulin release following oral
a) enhances weight loss and reduces
b) causes gastrointestinal adverse e ects
in up to 20% of patients on initiation.
c) reduces hepatic glucose production
and insulin resistance.
d) All of the above.
4. Choose the INCORRECT statement
about insulin therapy in type 2
a) Insulin therapy improves insulin
sensitivity and secretion and reduces
b) Basal insulin analogues target
and are preferred when daytime
c) Insulin therapy may be considered
for patients on maximum tolerated
doses of metformin and a sulfonylurea
whose glycaemic control is suboptimal
over a 3--6 month period.
d) Glargine and detemir are associated
with a lower risk of hypoglycaemia
than isophane insulin.
5. Self-monitoring of blood glucose:
a) should be undertaken 3--4 times a
day once blood glucose levels are
b) can help to monitor blood glucose
responses to changes in therapy,
or when unstable glucose levels
c) after meals provides information about
baseline glycaemic control which
can be a ected by dietary intake and
A score of 4 out of 5 attracts 1.25 CPD credits.
and assist them with self-management
strategies including healthy eating,
physical activity and blood glucose
monitoring.4 Referral to a dietitian can
also assist people with newly-diagnosed
diabetes to adopt healthy eating habits
and reinforce dietary advice provided by
GPs and other clinicians. Other health
professionals who are frequently
involved in the care of patients with type
2 diabetes include endocrinologists,
ophthalmologists or optometrists,
podiatrists and dentists.4
Case study continued
You reassure Raymond that, although it is
normal to feel overwhelmed after being
diagnosed with diabetes, there is plenty
of information and support available to
help him manage his diabetes. You also
explain that type 2 diabetes can often
be managed initially with lifestyle
changes including healthy eating and
regular physical activity, and that a
healthy lifestyle can delay the need for
medicines and reduce the risk of long
term complications. You encourage him
to think about how he could improve
his eating habits and be more physically
active to achieve weight loss and lead a
healthier lifestyle. You suggest he return
to the pharmacy after his appointment
with the diabetes educator tomorrow if
he has any more questions or concerns.
You also recommend that he visit the
Diabetes Australia website at www.
diabetesaustralia.com.au which has a lot
of useful information about living with
diabetes. Raymond is also provided with
a Type 2 Diabetes Self Care Fact Card to
reinforce the discussion.
Hypoglycaemia [revised Sep 2010].
Diabetes Australia [online]. 2012.
1. The Merck Manual [online]. New Jersey: Merck Sharp & Dohme;
2011. At: www.merckmanuals.com
2. Harris P, Nagy S, Vardaxis N. Mosby's dictionary of medicine,
nursing & health professions. 2nd Australian and New Zealand
edn. Sydney: Elsevier Australia; 2010.
3. Shaw JE, Chisholm DJ. Epidemiology and prevention of type
2 diabetes and the metabolic syndrome [online]. MJA. 2003;
179(7): 379--83. At: www.mja.com.au/journal/2003/179/7/1-
4. Diabetes Australia. Diabetes management in general
practice -- guidelines for type 2 diabetes. 17th edn [online].
2011. At: www.racgp.org.au/Content/NavigationMenu/
5. Weight and waist measurements [revised Oct 2010]. Measure
Up [online]. Canberra: Australian Government Department of
Health and Ageing; 2012. At: www.measureup.gov.au
6. National Prescribing Service. NPS News 39 -- Reducing risk in
type 2 diabetes [online]. 2005. At: www.nps.org.au/__data/
7. Endocrinology Expert Group. Therapeutic Guidelines:
Endocrinology. Version 4. Melbourne: Therapeutic Guidelines;
8. National Prescribing Service. NPS RADAR Jul 2011 -- Sitagliptin,
vildagliptin and saxagliptin--dipeptidyl peptidase-4
inhibitors ('gliptins') for add-on therapy in type 2 diabetes
mellitus [online]. At: www.nps.org.au/health_professionals/
9. MacIsaac R, Cheung A, Jerums G. Type 2 diabetes --
controlling hyperglycaemia with early insulin use [online].
Aust Fam Phys. 2010; 39(8):565--9. At: www.racgp.org.au/
10. Diabetes Australia. Food Choices [revised Aug 2006] [online].
11. Diabetes Australia. Glycaemic Index (GI) [revised Feb 2010]
[online]. 2012. At: www.diabetesaustralia.com.au/en/Living-
12. Colagiuri S, Dickinson S, Girgis S, et al. National evidence based
guideline for blood glucose control in type 2 diabetes [online].
Canberra: Commonwealth of Australia; 2009. At: www.nhmrc.
13. Lowe J. Self-monitoring of blood glucose in type 2
diabetes [online]. Aust Prescr. 2010; 33:138--40. At: www.
14. Malanda UL, Welschen LMC, Riphagen II, et al. Self-
monitoring of blood glucose in patients with type 2 diabetes
mellitus who are not using insulin. Cochrane Database of
Systematic Reviews 2012, Issue 1. Art. No.: CD005060. DOI:
10.1002/14651858.CD005060.pub3. At: http://onlinelibrary.
Links Archive Australian Pharmacist June 2012 Australian Pharmacist August 2012 Navigation Previous Page Next Page