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Outline the pathophysiology of Type 1 Diabetes Mellitus
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Outline the pathophysiology of Type 1 Diabetes Mellitus
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Diabetes Mellitus Is a multisystem disease related to abnormal insulin production, impaired insulin utilization, or both. Diabetes Mellitus is a serious health problem throughout the world. It is the 5th leading cause of death in the U.S. It is the leading cause of heart disease, stroke, adult blindness, and nontraumatic lower limb amputations. Etiology and Pathophysiology Current theories link the cause of diabetes, singly or in combination, to genetic, autoimmune, viral, and environmental factors (obesity, stress). Regardless of its cause, diabetes is primarily a disorder of glucose metabolism related to absent or insufficient insulin supplies and/or poor utilization of the insulin that is available. The two most common types of diabetes are classified as type I or type II diabetes mellitus. Gestational diabetes and secondary diabetes are other classifications of diabetes commonly seen in clinical practice Normal Insulin Metabolism Insulin is a hormone produced by the B cells in the islets of Langerhans of the pancreas. Under normal conditions, insulin is continuously released into the bloodstream in small pulsatile increments (a basal rate), with increased release (bolus) when food is ingested. The activity of released insulin lowers blood glucose and facilitates a stable, normal glucose range of approximately 70 to 120 mg/dl. The average amount of insulin secreted daily by and adult is approx. 40 to 50 U, or 0.6 U/kg of body weight. Other hormones (glucagons, epinephrine, growth hormone, and cortisol) work to oppose the effects of insulin and are often referred to as counterregulatory hormones. These hormones work to increase blood glucose levels by stimulating glucose production and output by the liver and by decreasing the movement of glucose into the cells. Insulin and the these counterregulatory hormones provide a sustained but regulated release of glucose for energy during food intake and periods of fasting and usually maintain blood glucose levels within the normal range. An abnormal production of any or all of these hormones may be present in diabetes. Insulin is released from the pancreatic B cells as its precursor, proinsulin, and is then routed through the liver. Proinsulin is composed of two polypeptide chains, chain A and chain B, which are linked by the C-peptide chain. The presence of C peptide in serum and urine is a useful indic... ... middle of paper ... ...d at bedtime). Pancreas Transplantation Is used as a tx option for patients with type I diabetes mellitus who have end-stage renal disease and who have had or plan to have a kidney transplant. Kidney and pancreas transplants are often done together. If renal failure is not present, the ADA recommends that pancreas transplantation should only be considered for patients who exhibit the following three criteria: *A history of frequent, acute, and severe metabolic complications (hypoglycemia, hyperglycemia, ketoacidosis) requiring medical attention *Clinical and emotional problems with exogenous insulin therapy that are so severe as to be incapacitating *Consistent failure of insulin-based management to prevent acute complications Successful pancreas transplantation can improve the quality of life of people with diabetes, primarily by eliminating the need for exogenous insulin, frequent daily blood glucose measurements and many of the dietary restrictions imposed by the disorder. Pts who undergo pancreas transplantation require immunosuppression to prevent rejection of the graft and potential recurrence of the autoimmune process that might again destroy pancreatic islet cells.
According WebMD 2014. Diabetes mellitus (or diabetes) is a chronic, lifelong condition that affects your body's ability to use the energy found in food. There are three major types of diabetes. Type 1 diabetes mellitus, type 2 diabetes mellitus and gestational diabetes. It is a hormonal disorder of the pancreas either decrease in insulin level also known as hypoinsulinism or increase in insulin level also known as hyperinsulinism. Lowered amounts, insufficient of, or ineffective use of insulin leads to the disorder of diabetes mellitus. It is common chronic disease requiring lifelong behavioral and lifestyle changes. According to Peakman (2012). The development of type 1 diabetes mellitus is a genetic and an autoimmune process that results in destruction of the beta cells of the pancreas, leading to absolute insulin deficiency. There is usually a pre-diabetic phase where autoimmunity has already developed but with no clinically apparent insulin dependency. Insulin autoantibodies can be detected in genetically predisposed individuals as early as 6-12 months of age. In persons genetically susceptible to type 1 diabetes, a triggering event, possibly a viral infection the leads to production of autoantibodies that kill the beta cells and results in decline and a lack of insulin secretion. According to Wherrett. It is caused by impaired insulin secretion and insulin resistance and has a gradual onset. Those with type 2 diabetes may eventually need insulin treatment. Gestational diabetes mellitus is glucose intolerance during pregnancy in a woman not previously diagnosed with diabetes, this may occur if placental hormones counteract insulin, causing insulin intolerance. Complications in diabetes mellitus includes: Hypoglycemia it is ca...
The main cause of diabetes is that the insulin produced by the pancreas is not working properly so the body has an abnormally high blood glucose level. There are two important reasons why this happens: either there is no insulin present in the body, Type 1 Diabetes, or there is insulin present but it is unable to work, Type 2 Diabetes.
Insulin is a hormone that is produced by specialized cells on the surface of the pancreas called pancreatic islets or Islets of Langerhans. It causes changes to occur in the plasma membrane of the cell that cause the cell to pull in glucose from the blood stream. The hormonal counterpart of insulin is glycogon, which serves to promote the rele...
Throughout the whole of the United Kingdom, between 2 and 3 of every 100 people have a known form of diabetes (DTC, 2004). What is diabetes? Explained simply, it is a disease in which the body does not produce or properly use insulin. In the normal state of glucose function, there is a stable release and uptake of glucose, regulated by two hormones produced in the pancreas, glucagon and insulin. There are two distinct mechanisms which give rise to the abnormal blood glucose levels seen in patients with type I and type II diabetes. In type I diabetes, a deficiency in insulin production at the pancreas results in elevated blood glucose levels due to the lack of hormonal regulation. In type II diabetes, although the pancreas produces regular levels of insulin, the body resists the effect of insulin, inhibiting the ability of insulin to break down glucose in the blood. Because of the inherent differences in the biochemical mechanisms of these two diseases, the characteristics associated with type I and type II diabetes are very different. The typical onset of type I diabetes is usually ...
Diabetes is a disease in which a person’s body in unable to make or utilize insulin properly which affects blood sugar levels. Insulin is a hormone that is produced in the pancreas, which helps to regulate glucose (sugar) levels, break down carbohydrates and fats, and is essential to produce the body’s energy. The CDC (2013) offers reliable insight, summarized here, into the different types of diabetes, some causes, and health complications that may arise from the disease.
Diabetes Mellitus is a common chronic disease in which patients with it, will require lifelong behavioral and lifestyle changes. In the Unites States, DM is one of the leading causes of blindness, end stage kidney disease with dialysis or kidney transplant, along with lower extremity amputations. It is characterized by hyperglycemia or high blood sugar causing lack of insulin.
Carbohydrates, mainly glucose, are an important source of energy for living organisms. Some tissues of the body (e.g., brain) need a continuous delivery of glucose. Maintenance of blood glucose concentrations within a normal range is critical to the regulation of normal fuel use by the organs. This is primarily accomplished by the two hormones, Insulin and Glucagon, which are secreted by the alpha and beta cells of the pancreas, respectively. The function of Insulin is to keep the blood glucose in check by helping it to move inside the cells of our body, thereby decreasing its concentration in the blood. Glucagon does exactly the opposite. Other hormones of our body like glucocorticoids, epinephrine and the growth hormone also function like Glucagon.
Diabetes is a disease that affects the body’s ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy. Diabetes falls into two main categories: type 1, or juvenile diabetes, which usually occurs during childhood or adolescence, and type 2, or adult-onset diabetes, the most common form of the disease, usually occurring after age 40. Type 1 results from the body’s immune system attacking the insulin-producing cells in the pancreas. The onset of juvenile diabetes is much higher in the winter than in the summer. This association has been repeatedly confirmed in diabetes research. Type 2 is characterized by “insulin resistance,” or an inability of the cells to use insulin, sometimes accompanied by a deficiency in insulin production. There is also sometimes a third type of diabetes considered. It is gestational diabetes, which occurs when the body is not able to properly use insulin during pregnancy. Type 2 diabetes encompasses nine out of 10 diabetic cases. Diabetes is the fifth-deadliest disease in the United States, and it has no cure. The total annual economic cost of diabetes in 2002 was estimated to be $132 billion, or one out of every 10 health care dollars spent in the United States. Diabetes risk factors can fall into three major categories: family history, obesity, and impaired glucose tolerance. Minority groups and elderly are at the greatest risk of developing diabetes.
Diabetes mellitus type 2 is an endocrine disorder that causes impaired use of carbohydrates while enhancing the use of proteins and lipids. This is called insulin resistance, in which the pancreas cannot make enough insulin to keep blood glucose levels normal, or the body is unable to use what is produced. The impairment causes blood glucose levels to rise higher than normal. There is no cure for type 2 diabetes mellitus and it is life threatening when left untreated. Signs and symptoms of this disorder include vision changes, increased thirst, increased hunger, increased frequency of urination, stomach pain, nausea and vomiting, erectile dysfunction, and absence of menstruation.
Diabetes Mellitus is a disease of the endocrine system primarily differentiated between type 1 and type 2. Type 1 diabetes occurs when the pancreas is unable to produce insulin and was previously seen in the younger generation which is no longer the case.1 Type 2 diabetes is the more prevalent of the two types and involves elevated blood sugar levels due to the insufficient production of insulin. Risk factors that make an individual higher risk for type 2 diabetes include increasing age, obesity, family history, a sedentary lifestyle.1,2 Innovative drug therapies for type 2 diabetes remain important for the treatment and reduction of the disease.
Diabetes refers to a set of several different diseases. It is a serious health problem throughout the world and fourth leading cause of death by disease in the country. All types of diabetes result in too much sugar, or glucos in the blood. To understand why this happens it would helpful if we understand how the body usually works. When we eat, our body breaks down the food into simpler forms such as glucose. The glucose goes into the bloodstream, where it then travels to all the cells in your body. The cells use the glucose for energy. Insulin, a hormone made by the pancreas, helps move the glucose from bloodstream to the cells. The pathophysiology of diabetes mellitus further explains the concept on how this disease works. Pancreas plays an important role of the metabolism of glucose by means of secreting the hormones insulin and glucagon. These hormones where then secreted by Islets of Langerhans directly to the blood. Inadequate secretion of insulin results on impaired metabolism of glucose, carbohydrates, proteins and fats which then result to hyperglycemia and glycosuria. Hyperglycemia is the most frequently observed sign of diabetes and is considered the etiologic source of diabetic complications both in the body and in the eye. On the other hand, glucagon is the hormone that opposes the act of insulin. It is secreted when blood glucose levels fall.
During one of my rotations, I was assigned a young adult patient who had run out of insulin and had been admitted to the hospital following a Diabetes Ketoacidosis (DKA) episode. I realized that my patient was probably torn between buying insulin and buying healthy food because her chart showed several admissions in the past following the same problems. This particular patient was in her room, isolated in a corner, and she was irritable. As her student nurse, I was actively involved in her care; I was her advocate for the day. The patient lived with her single mother and worked at a fast food restaurant. Since this was my first time dealing with a patient with DKA, it became a definite challenge for me.
Type II diabetes can develop from a variety of sources which may or may not act in conjunction with each other; some of these are: poor diet, family history, low activity levels, ethnicity. Symptoms for Type II diabetes often develop slowly ...
Insulin is a hormone in the body that is critical in many of the body’s functions. Insulin is a hormone made up of a small polypeptide protein that is secreted by the pancreas it affects carbohydrate, protein, and fat metabolism. Your body breaks these nutrients down into sugar molecules, amino acid molecules, and lipid molecules. The body can also store and reassemble these molecules into more complex forms. Insulin causes the storage of these nutrients. After eating a meal blood sugars rise rapidly especially after eating carbohydrates, this signals the release of insulin. Insulin binds to insulin receptors on the outside of cells to open up channels for glucose to move into the cell for storage by the means of GLUT-4 inside the cell. With insulin resistance the pancreas has to work harder to make up for the insulin resistance but as the resistance gets worse the pancreas can not keep up and blood glucose levels stay elevated. A major way to prevent type II diabetes and high blood glucose is to improve a patient’s insulin sensitivity.
Diabetes is a killer; in fact, it is among the top ten killers of adults in the United States. "It can lead to, or contribute to, a number of other serious diseases" (Sizer and Whitney 112). Diabetes means "syphon" or "to run through" (Sizer and Whitney 112) therefore denoting the increase in urinary volume excreted by people suffering from this disease. Mellitus means "sweet". Diabetes mellitus means increased excretion of sugars being released with the urine, creating a sweet smell at the time of elimination. The patient with this type of disease has a problem with his insulin production or usage. Insulin is a hormone produced in the pituitary gland, that helps to digest the sugars and use them for energy, and must be given through an injection into the arms or legs; if this is not done the gastrointestinal enzymes in a person's stomach will digest the hormone. A diabetic does not produce adequate insulin or cannot use his own. Diabetes mellitus is not a single disease. This is a heterogeneous syndrome for which several theories of etiology (explanation of the cause of the disease) have been proposed (WebMd Health). Diabetes is a life-threatening disease, but it is not a death sentence. With proper maintenance of insulin, exercise, and diet, diabetes can be controlled. Advances in medicine will create a larger variety of treatment options and help remove the stigma, as well as fears, associated with diabetes.