QuestionSBA
QuestionChoice
Although intense exercise can increase the risk of hypoglycaemia, NICE recommend that patients should be counselled on self-monitoring and adjusting insulin doses for intense exercise, rather than avoiding it altogether. Physical activity is an important factor in improving T1DM prognosis.
10000432
b
Avoid intense exercise
QuestionChoice
NICE guidelines suggest the provision of carbohydrate-counting courses as part of type 1 diabetes mellitus self-management. Carbohydrate counting is a meal planning method by which an individual manages blood glucose by approximating insulin doses with carbohydrate levels in each meal.
10000431
a
Meal planning courses
QuestionChoice
This is the opposite of what is recommended for insulin-injecting patients. Patients regularly self-administrating insulin should regularly rotate insulin injection sites to avoid lipodystrophy and cutaneous amyloidosis.
10000434
d
Avoid switching injection sites
QuestionChoice
Individuals self-managing type 1 diabetes with insulin should never omit insulin doses, especially when unwell. Stopping insulin self-administration increases the risk of diabetic ketoacidosis (DKA). If a patient does not know how to adjust insulin doses when unwell, they should be advised to contact their diabetes team. When unwell, blood glucose monitoring should be increased to every 1-2 hours. Patients should be counselled to seek urgent medical advice if they experience symptoms of DKA.
10000435
e
Omit insulin doses when severely unwell
QuestionChoice
Although patients beginning insulin therapy that will last >3 months must inform the DVLA, he does not need to stop driving as long as he maintains hypoglycaemia awareness. If an individual has more than one episode of severe hypoglycaemia per year they must stop driving and inform the DVLA.
10000433
c
He must inform the DVLA and stop driving his car
Concept
Chapter
2693
3763
Type 1 Diabetes Mellitus
Topic
133
Endocrinology
12633
A 24-year-old male presents to General Practice with a 3-week history of fatigue, malaise, and polyuria. After examination and further investigation, he is diagnosed with type 1 diabetes mellitus. He is due to begin insulin therapy after the consultation today and is interested in ways to improve his glycaemic control.

Which of the following advice is most appropriate to discuss with him?
a