Ch. 30 Diabetes
Diabetes Mellitus: characterized by elevated levels of glucose in the blood
- Chronic illness, that affects many body systems & has devastating physical, social &
economic consequences
- Risk factors: heart disease, stroke, leading cause of amputations,blindness, and
end-stage kidney disease
Prediabetes: condition that puts people at increased risk for developing diabetes
Pathophysiology
Insulin: hormone produced by pancreas that controls blood glucose levels by regulating
the production, use, & storage of glucose
- Secreted by beta cells in islets of langerhans of the pancreas
- Anabolic (storage hormone)
- Insulin secretions increase & move glucose from blood into muscle, liver & fat cells when
pt eats a meal
- Insulin functions in cell:
- Transport & metabolize glucose for energy
- Stimulates storage of glucose as glycogen in liver & muscle cells
- Enhances storage of dietary fat in adipose tissue
- Accelerates transport of amino acids into cells
- Facilitates transport of potassium into cells
- Inhibits breakdown stored glucose, protein, & fat
- If blood sugar becomes too low, glucagon is secreted by alpha cells of islets of
langerhans
- Glucagon stimulates the liver to release stored glucose, increasing blood sugar
- Insulin promotes hypoglycemia: Glucagon promotes hyperglycemia
- Liver assists w/ glucose control by storing glucose in glycogen form
Type 1 Diabetes
- Most commonly affects children & young adults
- Characterized by destruction of pancreatic beta cells
- Primarily autoimmune, autoimmune diseases are caused by abnormal immune
responses in which antibodies are directed against normal tissues of the body &
responds to those tissues as if they’re foreign
- Beta cell destruction results in decreased insulin production, unchecked glucose
production by the liver & hyperglycemia
- Glucose derived from food cannot be stored in liver but instead remain in the blood &
contributes to postprandial (after meals) hyperglycemia
- If concentration of glucose in blood exceeds renal threshold for glucose usually 180-120,
kidneys cannot reabsorb all of the filtered glucose, glucose appears in pee
- Glucose is excreted in pee it is accompanied by excessive loss of fluids & electrolytes
(Osmotic Diuresis)
Ketones: organic acids
- Ketoacidosis develops if they are present in the blood
- Capillary glucose is measured using fingerstick
- Hemoglobin A1c is a measure of average glucose levels over a period of 2-3 months
Diabetes Mellitus: characterized by elevated levels of glucose in the blood
- Chronic illness, that affects many body systems & has devastating physical, social &
economic consequences
- Risk factors: heart disease, stroke, leading cause of amputations,blindness, and
end-stage kidney disease
Prediabetes: condition that puts people at increased risk for developing diabetes
Pathophysiology
Insulin: hormone produced by pancreas that controls blood glucose levels by regulating
the production, use, & storage of glucose
- Secreted by beta cells in islets of langerhans of the pancreas
- Anabolic (storage hormone)
- Insulin secretions increase & move glucose from blood into muscle, liver & fat cells when
pt eats a meal
- Insulin functions in cell:
- Transport & metabolize glucose for energy
- Stimulates storage of glucose as glycogen in liver & muscle cells
- Enhances storage of dietary fat in adipose tissue
- Accelerates transport of amino acids into cells
- Facilitates transport of potassium into cells
- Inhibits breakdown stored glucose, protein, & fat
- If blood sugar becomes too low, glucagon is secreted by alpha cells of islets of
langerhans
- Glucagon stimulates the liver to release stored glucose, increasing blood sugar
- Insulin promotes hypoglycemia: Glucagon promotes hyperglycemia
- Liver assists w/ glucose control by storing glucose in glycogen form
Type 1 Diabetes
- Most commonly affects children & young adults
- Characterized by destruction of pancreatic beta cells
- Primarily autoimmune, autoimmune diseases are caused by abnormal immune
responses in which antibodies are directed against normal tissues of the body &
responds to those tissues as if they’re foreign
- Beta cell destruction results in decreased insulin production, unchecked glucose
production by the liver & hyperglycemia
- Glucose derived from food cannot be stored in liver but instead remain in the blood &
contributes to postprandial (after meals) hyperglycemia
- If concentration of glucose in blood exceeds renal threshold for glucose usually 180-120,
kidneys cannot reabsorb all of the filtered glucose, glucose appears in pee
- Glucose is excreted in pee it is accompanied by excessive loss of fluids & electrolytes
(Osmotic Diuresis)
Ketones: organic acids
- Ketoacidosis develops if they are present in the blood
- Capillary glucose is measured using fingerstick
- Hemoglobin A1c is a measure of average glucose levels over a period of 2-3 months
