| CODE | MED5200 | ||||||||||||
| TITLE | Diabetes Complications: Prevention, Screening and Management 1 | ||||||||||||
| UM LEVEL | 05 - Postgraduate Modular Diploma or Degree Course | ||||||||||||
| MQF LEVEL | 7 | ||||||||||||
| ECTS CREDITS | 10 | ||||||||||||
| DEPARTMENT | Medicine | ||||||||||||
| DESCRIPTION | This study-unit provides an overview of the pathological processes underpinning the development of various complications and co-morbidities that affect the lives of those with Diabetes. The complexities of managing the multisystem disorder that constitutes diabetes will be reviewed and discussed. A multidisciplinary faculty will introduce students to the importance of screening, investigating and managing the macroand microvascular complications of diabetes. It is intended that this study-unit, the first of two dedicated to this area, covers cardiovascular disease which is the cause of death in approximately 66% of subjects with Diabetes Mellitus. Furthermore, cerebrovascular disease which is associated with significant morbidity and mortalitiy poses a significant burden for patients, relatives and healthcare providers. Another major contributor to morbidity and to significant economic problems is diabetic neuropathy - peripheral and autonomic- and this will be discussed as it relates to the cardiovascular and cerebrovascular systems in this module. Students will analyse the tools that can be employed to screen and diagnose various comorbitidies, and the healthcare burden of these will be highlighted. Through placements with various practitioners in the different fields they will develop the skills and competencies to identify and manage such complications in their area of expertise as part of a multidisciplinary team. Study-unit Aims: The aim of this study-unit is to enable students to evaluate and reflect on the pathological mechanisms underlying the development of the complications of diabetes, the triggers and mediators in these pathological processes. Students should be able to critically analyse and evaluate strategies in the prevention and management of diabetes complications. Relevant risk factors such as hypertension, hyperlipidaemia, smoking and obesity will be discussed and the relevant guidelines and evidence base for risk factor management in diabetes will be highlighted. Awareness of the importance of and the availability of non- pharmacological interventions such as lifestyle, cardiac rehabilitation, physiotherapy, occupational therapy, psychological support as well as pharmacological interventions useful in the management of the acute and chronic phases of these macrovascular complications as well as rehabilitation will be analysed. Learning Outcomes: 1. Knowledge & Understanding: By the end of the study-unit the student will be able to: a. Discuss the evidence regarding the effectiveness of intensive risk factor management (Glucose, BP and lipids) in preventing macrovascular disease; b. Critically anlayse the evidence regarding the ability of drugs (hypoglycaemic agents, antihypertensives, lipid lowering agents) to improve cardiovascular outcomes both through aggressive risk factor control as well as independently of risk factor control - UKPDS, EDIC, DCCT, VADT, ACCORD, ADVANCE, ADVANCE ON, as well as the trials related to GLP1 analogs, Gliptins, SGLT2 inhibitors etc.; c. Plan health care that is patient centred, with due consideration of their needs, provision of adequate support and the development of individualised management plans with realistic target appropriate to the needs of the person concerned; d. Apply the skills and competencies acquired to contribute to an integrated multidisciplinary approach to the management of diabetes related complications; e. Critically analyze the specific needs of individuals with diabetes, the inequitable distribution of healthcare as well as regional differences in Diabetes care and their drivers. 2. Skills: By the end of the study-unit the student will be able to: a. Propose and implement different management strategies for the effective prevention and management of the various complications and co-morbidties; b. Screen subjects with diabetes for risk factors contributing to cardiovascular disease, carry out a risk stratification exercise through the use of case studies and using established calculators; c. Select and interpret different investigative modalities - clinical chemistry and imaging - angiography, CT, MRI; d. Plan the relevant care pathway for individual patients; e. Utilise technological advances to empower patients to self monitor and self adjust treatment within certain prescribed parameters. Main texts - 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. - Kasper D L, Fauci AS, Hauser SL Harrisons Principles of Internal Medicine 19th Edition. McGraw Hill. - Melmed S, Polonsky KS, Reed Larsen P Krnenberg HM, Williams Textbook of Endocrinology 13th Edition Elsevier. 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 (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–S24, 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 |
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| STUDY-UNIT TYPE | Blended Learning | ||||||||||||
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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 2023/4. It may be subject to change in subsequent years. |
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