Alterations of Endocrine Function II Flashcards
What is insulin?
- Produced by Beta cells in the endocrine pancreas
- half-life is short (in 15mins you only have half of what was started with)
General physiological effects of insulin:
- control of postprandial plasma glucose levels
- promotes glucose storage as glycogen
- lipid and protein synthesis
What is diabetes Mellitus?
A group of disorders associated with alterations in insulin activity.
Type 1 diabetes Mellitus (DM)
What is it and possible causes?
Autoimmune disease: autoantibodies and cytotoxic T cells target beta cells and insulin
Possible causes: genetics and environmental factors
Patho of Diabetes Mellitus?
Autoimmune destruction of pancreatic beta cells leads to insulin deficiency
Decreased potassium uptake into cells leads to…
Hyperkalemia
Clinical manifestations of Diabetes Mellitus (DM)
Uncontrolled or undiagnosed type 1 DM
- UA (urinalysis)
- polyuria (increased urine output)
- usually hungry
Acute complications of type 1 diabetes
Hypoglycemia
Blood glucose level <50-60mg/dL
Causes in Diabetics
- overdose of insulin
- delayed or omitted meals
- increased exercise
- alcohol and drugs
Early manifestations of Type 1:
SNS (sympathetic nervous system) response to low blood glucose levels triggers the adrenal medulla to produce epinephrine
Later manifestations type 1:
Due to decreased CNS function
- brain is not getting enough glucose
- seizures
- always give sugar than insulin
Hypoglycemia unawareness
Typically occurs in long-term type 1 diabetes
-normal autonomic warning signs are not perceived
Diabetic Ketoacidosis (DKA)
Acute, life threatening hyperglycemia complication of type 1 DM
Causes of DKA
- Omission of insulin in a type 1 diabetic
- Undiagnosed type 1 diabetes Mellitus (high sugars)
Clinical consequences of DKA
- severe hyperglycemia
- hypotension and shock
- fluid and electrolyte imbalance
What is Type 2 DM?
Known as non-insulin-dependent diabetes or adult onset diabetes
Risk factors:
-ethnicity
- Polycystic ovarian syndrome
- Native America, Hispanic, Pacific Islander, African American
Patho Type 2 DM?
- Leads to Hyperinsulinemia
- insulin resistance
- decreased glucose uptake leads to hyperglycemia
Clinical Manifestations of Type 2 DM
- polyuria (increased urine output)
- polydipsia (thirst)
- other changes
Acute complication of Type 2 DM
Hyperosmolar Hyperglycemic Nonketonic Syndrome (HHNKS)
-no keytones being produced
Causes of Type 2 DM
> 60
- Failure to take meds
- taking Beta blockers
Chronic complications of DM
Related to hyperglycemia regardless of the type
Neuropathies
Peripheral neuron dysfunction
Increased risk of infection in DM
If a diabetic has a wound, it’ll take time to heal
