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Study-Unit Description

Study-Unit Description

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CODE MED5101

 
TITLE Management of Type2 Diabetes

 
UM LEVEL 05 - Postgraduate Modular Diploma or Degree Course

 
MQF LEVEL 7

 
ECTS CREDITS 10

 
DEPARTMENT Medicine

 
DESCRIPTION This study-unit will focus on the use of:

1. appropriate dietary and exercise regimes in T2 DM with special attention to the older population;
2. the various oral and injectable hypoglycaemic agents available, their modes of action, indications, side effects and efficacy - sulfonylureas, biguanides, meglitinides, GLP1 receptor analogs, DPP4 inhibitors, SGLT1 and 2 inhibitors, alpha glucosidase inhibitors, thiazolidinediones, amylin analogs;
3. Insulin in the management of T2 diabetes, the pharmacokinetics of the different types of insulin available, the indications for and the barriers to starting insulin, and the routes of administration of insulin therapy. The need to assess patient abilities and wishes when choosing between the different formulations is emphasised.

Participating healthcare professionals will be able to appreciate and explore the challenges encountered in prevention and management of obesity and diabetes. Global initiatives and strategies and their success will be analysed as will the feasibility of applying such strategies locally. The National Obesity Strategy will be reviewed as will the National Diabetes Plan with a review of achievements to date and analysis of the obstacles encountered in their implementation. Patient education initiatives, the role of the diabetes specialist nurse, and patient support groups will be reviewed and their effectiveness in helping subjects achieve their targets. Students will be provided with the skills and competences to contribute to an expansion of multidisciplinary health service provision at primary and secondary levels and into the community. Cutting edge innovative treatment modalities of both chronic conditions will also be reviewed and discussed with reference to bariatric surgery in individuals with diabetes and obesity. Lectures, bedside teaching and online case based discussions as well as seminars will be used as the main teaching and learning modalities.

Study-unit Aims:

The aim of this study-unit is to provide students with an in depth knowledge regarding the use of oral and injectable forms of hypoglycaemic agents in Type 2 diabetes, the available formulations, pharmacokinetics, modes of delivery, and the evidence base supporting the use of one formulation as opposed to the other. Students will also obtain an understanding of the new technologies available for glucose monitoring and injectable agent delivery, which patients will benefit from a particular formulation. Students will understand the role of bariatric surgery in the prevention and treatment of diabetes, patient selection, patient support by a multidisciplinary team of health care professionals (diabetologists, surgeons, nurses, physiotherapists, dietitians, psychologists), and the evidence base governing these aspects.

Learning Outcomes:

1. Knowledge & Understanding:
By the end of the study-unit the student will be able to:

a. Discuss clinical inertia in initiating insulin therapy and discuss the barriers in both patients with type 2 Diabetes and healthcare professionals;
b.Compare the pharmacokinetics of different types of hypoglycaemic agents;
c. Explain the importance of adjusting medication dose in acute illness, in conjunction with carbohydrate counting and in response to elevations of preprandial insulin;
d. Understand the challenges associated with non pharmaceutical interventions in prevention and care of obesity and glycaemic disorders;
e. Appreciate the benefits of individual and population based educational and promotional interventions in obesity and diabetes prevention and management;
f. Understand the financial and human resource burden to healthcare in tackling obesity and diabetes.

2. Skills:
By the end of the study-unit the student will be able to:

a. Appraise diverse therapeutic options - non-pharmaceutical, pharmaceutical and surgical in the management of obesity and diabetes;
b. Select and review treatment algorithms and medication charts;
c. Implement the use of technology to empower patients to self monitor and self adjust treatment within certain prescribed parameters;
d. Identify the indications for the initiation of insulin;
e. Appraise different insulin regimes and their suitability for individual patients on the basis of case studies;
f. Evaluate the effectiveness of different interventions to achieve weight loss, weight maintenance and glycaemic control;
g. Implement and review different preventive strategies in the management of obesity and diabetes;
h. Practice the techniques necessary to promote lifestyle changes.

Main Text/s and any supplementary readings:

Main texts

- Bray GA, Fr眉hbeck G, Ryan DH, Wilding, JPH 2016 Management of Obesity Lancet Volume 387, No. 10031, p1947鈥�1956, 7 May 2016.
- A Healthy Weight for Life: A National Strategy for Malta https://deputyprimeminister.gov.mt/en/Documents/National-Health-Strategies/hwl_en.pdf
- Griffin JE and Ojeda SR (2012) Textbook of Endocrine Physiology (6th Edition) Oxford. Oxford University Press.
- Tobias ES, Connor M, Ferguson -Smith Malcolm 2011 Essential Medical Genetics 6th Editon. Wiley -Blackwell.
- Holt RLG & Hanley NA 2012 Essential Endocrinology and Diabetes 6th Edition Wiley-Blackwell.

Supplementary texts

- International Diabetes Federation (2015) IDF Diabetes Atlas 7th ed. Available online at: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas.html
- International Diabetes Federation (2015) IDF Diabetes Atlas 7th ed. interactive map Available online at:http://www.diabetesatlas.org/across-the-globe.html
- NICE guideline on type 2 Diabetes (2015) 鈥� NG 28
- NICE (2016) Diabetes in Adults Available online at: https://www.nice.org.uk/guidance/qs6/resources/diabetes-in-adults-pdf-58299425989
- World Health Organisation (2016) Global Report on Diabetes World Health Organisation Press Geneva Available online at: http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf
- American Diabetes Association (2017) Standards of Medical Care in Diabetes - 2017, Diabetes Care, 40(Suppl. 1) pp. S11鈥揝24, DOI: 10.2337/dc17-S005.
- Calleja N., Azzopardi Muscat N., Reiff S., Fava S., Vassallo J., Torpiano J., Grixti M., Caruana M., Theuma R., Grixti M., Camilleri P., Zammit McKeon A. (2015) Diabetes: A National Public Health Priority; A National Strategy for Diabetes. Ministry of Health, Malta. Available online at: https://deputyprimeminister.gov.mt/en/Documents/National-Health-Strategies/NDS-EN.pdf

 
STUDY-UNIT TYPE Blended Learning

 
METHOD OF ASSESSMENT
Assessment Component/s Assessment Due Sept. Asst Session Weighting
Case Study (Take Home) SEM2 Yes 40%
Assignment SEM2 Yes 60%

 
LECTURER/S

 

 
The University makes every effort to ensure that the published Courses Plans, Programmes of Study and Study-Unit information are complete and up-to-date at the time of publication. The University reserves the right to make changes in case errors are detected after publication.
The availability of optional units may be subject to timetabling constraints.
Units not attracting a sufficient number of registrations may be withdrawn without notice.
It should be noted that all the information in the description above applies to study-units available during the academic year 2025/6. It may be subject to change in subsequent years.

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