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Level 2 Certificate in Understanding the Care and Management of Diabetes Introduction

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NCFE Level 2Certificate in Understanding the

Care and Management of Diabetes

Part A

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Disclaimer:All references to individuals, groups and companies contained within these resources are fictitious and do not relate to any person or company.

These learning resources and assessments have been reviewed and approved by NCFE as meeting the requirements of the Level 2 Certificate in Understanding the Care and Management of Diabetes.

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Level 2 Certificate in Understanding the Care and Management of Diabetes Introduction

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Welcome to this Level 2 Certificate in Understanding the Care and Management of Diabetes.

Understanding the Care and Management of Diabetes

We hope you find all of the information contained in this resource pack interesting and informative. This learning resource and the assessment questions have been approved by NCFE as a great way to meet the learning outcomes for this qualification. (A complete list of the learning outcomes can be found on the last page of this resource.)

The course is made up of two parts (A and B). This is Part A which contains two units:

UNIT 1: Understand diabetes

UNIT 2: Prevention and early intervention of Type 2 diabetes

As you start to read through each page you will be able to make notes and comments on things you have learnt or things you may want to revisit at a later stage. At the end of each section, you will be asked to go to your assessment booklet and answer the relevant questions.

Once you have answered the questions go to the next section and continue studying until all of the assessments have been completed.

Please make sure that you set aside enough time to read each section carefully, making notes and completing all of the activities. This will allow you to gain a better understanding of the subject content and will help you to answer all of the assessment questions accurately.

Good luck with your study. Now let’s begin!

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Level 2 Certificate in Understanding the Care and Management of Diabetes Unit 1

Unit 1: Understand diabetes

Welcome to unit one.

This unit is split into five sections. These are:

Section 1: The function of glucose in the blood

Within this section you will learn about:

• ‘Blood glucose’

• Simple and complex carbohydrates

• Technical terms relating to blood glucose levels

• Pre-diabetic states.

Section 1: The function of glucose in the blood

Section 2: The function of insulin in the blood

Section 3: Different forms and causes of diabetes

Section 4: Risk factors for developing Type 2 diabetes

Section 5: How diabetes is confirmed

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‘Blood glucose’

Q. What is blood glucose?

A. Blood glucose is sugar that is found in the blood of humans and animals. It is the main source of energy for the body’s cells.

The blood glucose level is the amount of glucose in the blood, sometimes called the serum glucose level. This level is naturally regulated by the body’s metabolism, or other chemical processes.

Peaks in the level of blood sugar occur following meals. However, for people with diabetes, blood sugar levels will fluctuate more widely, as the following graph shows.

Breakfast Lunch Dinner

Key Fact

The terms ‘blood glucose’ and ‘blood sugar’ are interchangeable and refer to levels of glucose in the blood which is crucial to the health of the body - especially for people with diabetes.

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Simple and complex carbohydrates

Carbohydrates are divided into two types: simple and complex. Whether they are simple or complex depends on:

• Their chemical structure

• How quickly the sugar is digested and absorbed.

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Q. How are simple and complex carbohydrates relevant to diabetes?

A. Although carbohydrates are necessary for a healthy diet, eating too many carbohydrates in a meal can make blood sugar levels rise sharply. Having the right balance will help keep blood sugar at the correct level.

Activity: Simple or complex?

Identify which carbohydrates are simple and which are complex by putting a tick in the correct column.

Carbohydrate Simple ComplexRice

Syrup

Fruit

Milk

Bread

Pasta

Fizzy drinks

Broccoli

Kidney beans

Chickpeas

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Try the following activity to see if you can identify which carbohydrates are simple and which are complex.

Simple carbohydrates Complex carbohydrates

• Simple carbohydrates are also called simple sugars

• They are chemically made of one or two sugars

• They are absorbed quickly by the body

• Simple carbohydrates raise blood sugar much faster and usually higher than complex carbohydrates

• Complex carbohydrates are also known as starches

• They are made of three or more linked sugars

• They are absorbed slowly by the body, taking longer to digest so blood sugar levels don’t rise as high or as fast

Check your answers at the end of this workbook.

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Syrup and fizzy drinks are examples of simple carbohydrates. Simple carbohydrates also include foods such as fruit and milk. These are better sources of simple carbohydrates because they contain vitamins, fibre, and important nutrients like calcium.

Bread, pasta and rice are complex carbohydrates, as well as vegetables like broccoli, and pulses such as kidney beans and chickpeas. These take the longest to digest.

Key Fact

Simple carbohydrates are absorbed quickly by the body, and eating too many may cause blood glucose levels to rise sharply to an inappropriate level.

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Some important technical terms relating to blood glucose levels that you will come across are:

Technical term Meaning

Glycaemia The presence or level of glucose or sugar in the blood.

Hypoglycaemia An unusually low level of sugar in the blood.

Hyperglycaemia An unusually high level of sugar in the blood.

Technical terms relating to blood glucose levels

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Pre-diabetes risk factorsThere are several factors that make someone more at risk of pre-diabetes:

• Being overweight and over the age of 45

• High blood pressure

• Low level of high-density lipoproteins (HDL) – ‘good’ cholesterol

• Having a family history of diabetes, or gestational diabetes (see an explanation of this later in this unit)

• Although pre-diabetes may affect anyone, of any age, gender or racial type, some groups are genetically more prone - these include Afro-Caribbean and South Asian people.

Pre-diabetes:

• Is a metabolic condition and growing global problem that is closely linked to obesity

• Almost always leads to the development of Type 2 diabetes (Type 2 diabetes occurs when the body doesn't produce enough insulin to function properly, or the body’s cells don't react to insulin.)

• Is characterised by the presence of higher than normal blood glucose levels that are yet to reach diabetic levels

• Is a critical stage in the development of diabetes, because at this point lifestyle changes can be made to slow down or even halt the development of Type 2 diabetes.

Pre-diabetic states

Testing for pre-diabetesOne of the problems with pre-diabetes is the fact that the sufferer often does not know that they have the condition until Type 2 diabetes has developed. The only certain way of knowing is if a GP administers one of two tests.

These tests are called the Fasting Plasma Glucose test (FPG) and the Oral Glucose Tolerance Test (OGT). If a person fails the FPG test, they have impaired fasting glucose. If they fail the OGT they have impaired glucose tolerance.

The doctor should then clearly set out what the person has to do to lessen the risk of developing Type 2 diabetes.

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Q. What are the symptoms of pre-diabetes?

A. One of the few signs that a person is in a pre-diabetic state is darkened areas of the skin such as:

• The neck

• Armpits

• Elbows

• Knees

• Knuckles

However, it is quite possible for no symptoms or signs to be shown.

Key Fact

In the UK, the prevalence of pre-diabetes is estimated at 7 million people.

Source: Preventing the Type 2 diabetes epidemic, October 2009

If undiagnosed or untreated, pre-diabetes develops into Type 2 diabetes which whilst treatable is currently not fully reversible.

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Let’s summarise

Take a few moments to answer the following questions to help you summarise what you have learnt in this section. This will help you answer the questions in your assessment booklet.

1. Hyperglycaemia means an unusually low level of blood glucose.

True False

3. Which condition does pre-diabetes almost always lead to?

CONGRATULATIONS, YOU HAVE NOW COMPLETED SECTION 1. PLEASE NOW GO TO YOUR ASSESSMENT BOOKLET AND

ANSWER Q1 TO Q4.

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Section 2: The function of insulin in the blood

In this section you will learn about:

• How insulin is produced in the body

• How insulin affects blood glucose levels

• Insulin resistance.

Insulin is a hormone that is made in the pancreas. The pancreas is part of the digestive system and is located high up in the abdomen. It lies across the body where the ribs meet at the bottom. It is shaped like a leaf and is about six inches long. The wide end is called the head while the narrower end is called the tail, the mid-part is called the body.

How insulin is produced in the body

The pancreas produces insulin and other digestive hormones. It contains clusters of cells called islets. Cells inside these islets make insulin and release it into the blood.

The endocrine pancreas is the part of the pancreas that produces insulin and other hormones. When a person eats protein, insulin is released.

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Activity 2: How the body works – the pancreas

Use the link below to see a short video about the pancreas and how it produces insulin. Make notes in the space provided.

http://www.youtube.com/watch?v=j5WF8wUFNkI

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Key Fact

Insulin makes it possible for glucose to enter our body’s cells - without glucose in our cells they would not be able to function. Without insulin the glucose cannot enter our cells.

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How insulin affects blood glucose levels

The main job of insulin is to regulate sugar in the bloodstream and keep the level of sugar within a normal range. After eating carbohydrates, blood glucose levels rise.

The carbohydrates break down into sugar and enter the bloodstream in the form of glucose, our primary source of energy.

Normally the pancreas responds by producing insulin, which allows sugar to enter the tissues and cells by transporting it through the cell walls.

After you eat, when your insulin levels are high, excess glucose is stored in the liver in the form of glycogen. Between meals, when insulin levels are low, the liver releases glycogen into the bloodstream in the form of sugar. This keeps blood sugar levels within a narrow range.

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Activity 3: Insulin, glucose and you

Use the link below to see a short video about how insulin allows glucose, or blood sugar, to get into cells and provide them with energy. Make notes in the space provided.

http://www.youtube.com/watch?v=ae_jC4FDOUc

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Key Fact

The main job of insulin is to regulate sugar in the bloodstream and to keep the level of sugar within a normal range.

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Source of image: http://bbc.co.uk/science/

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