Diabetes Mellitus

Question 1

what is diabetes mellitus?

Answer 1

a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood

Question 2

what is type 1 diabetes mellitus (often known as IDDM)

Answer 2

characterised by extensive damage to pancreatic beta islet cells resulting from a T-cell mediated autoimmune attack

Question 3

where is insulin produces in the body?

Answer 3

in the beta cells located in the centre of the islets of langerhans in the pancreas

Question 4

where in the body is glucagon produced?

Answer 4

in the alpha cells located in the periphery of the islets of langerhans in the pancreas

Question 5

what is insulins role in the body?

Answer 5

to bind to insulin receptors on cells, allowing glucose to pass across cell membranes and to reduce glucose levels in the blood

Question 6

what is the role of glucagon in the body?

Answer 6

glucagon raises blood glucose levels by facilitating the breakdown of glycogen into glucose in the liver

Question 7

what is the name of the process by which the liver breaks down glycogen stores into glucose?

Answer 7

glycogenolysis

Question 8

what is the difference between IDDM and NIDDM?

Answer 8

IDDM (type 1) - is due to an autoimmune attack on the beta cells in the pancreas and results in an inability of the body to produce insulin. Hence, cells are unable to uptake glucose and levels in the blood increase

NIDDM (type 2) - is caused by a resistance to insulin.

Question 9

what are 4 common signs of uncontrolled IDDM and what are they?

Answer 9

polyphagia - eating a lot as muscles and cells are being starved despite there being a lot of glucose in the blood. They start to break down and cause weight loss, this catabolic state leaves people feeling hungry

glycosuria - glucose in urine

polyuria - increased urination. As glucose is osmotically active, water tends to follow it. Therefore when glucose is being ‘spilled’ into the urine, more water follows

polydipsia - increased thirst. As a result of increased urination people with uncontrolled diabetes become dehydrated and thirsty

Question 10

what is the treatment for IDDM?

Answer 10

lifelong insulin therapy

Question 11

what is DKA?

Answer 11

diabetic ketoacidosis - occurs in people with IDDM .

• When cells are starved of glucose, fat cells go through lipolysis and break down into fatty acids.
• The liver then breaks down these fatty acids into ketone bodies that can be used by the cells for energy.
• These ketone bodies increase the acidity of the blood causing acidosis
• people with DKA can develop Kussmaul respirations which are deep and laboured in an attempt to reduce acidity via expulsion of CO2
• hyperkalaemia (bit confused on this process)
• sweet fruit smell on breath as a result of acetone

Question 12

what are the symptoms of DKA?

Answer 12

• Kussmaul breathing
• sweet smelling breath
• high BGL
• loss of glucose in urine
• increased urination
• dehydration
• nausea
• vomiting
• altered mental status due to cerebral oedema

Question 13

when does DKA occur?

Answer 13

when someone with IDDM has high glucose levels in the blood

• first presentation
• when stressed or ill (increased glucagon release, also bc often not eating as much some people alter their insulin dose)
• non-compliance with insulin