Question

Med Surge Ch50

1. Explain the pathophysiology signs and symptoms complications diagnostic tests and treatment of diabetes mellitus and hypoglycemia

2. Explain the difference between type 1 and type 2 diabetes mellitus.

3. Describe the role of insulin in the body

Answer 1

ANSWER.

1)

Diabetes mellitus is increased blood sugar levels.

Hypoglycemia is nothing but decreased blood sugar levels.

DIABETES MILETUS.

Pathophysiology of diabetes mellitus :-

When exposed to risk factors that includes:- obesity,high cholesterol ,environmental factors it triggers infectious conditions that may affect Immune system and attacks the immune system and destroys beta cells of pancreas gland .

This cause dysfunction of pancreas gland. That leads to decrease insulin levels , which maintains blood glucose levels in the body.

Decreased insulin levels may cause of decrese insulin function, results in unable to maintain blood sugar levels in body.

Signs and symptoms:-

Polyuria :- Excessive feeling of urination.

Build up of sugar in blood cause kidney can't filter out , it cause extra sugar and fluids travel through the urine , this cause polyuria.

Poly dipsIa :- excessive feeling of thirst.

When high sugar levels are present in body , kidney eliminate more fluids to remove sugar levels in body this cause loss of fluids this leads to polydipsia.

Increased hunger :- Due to lack of insulin body can't convert the food into energy it cause hunger.

Blurred vision :-

High sugar levels in body cause eye lens swelling results in blurred vision.

Fatigue ,weight loss :- Due to loss of fluids this symptoms may occur.

Diabetes mellitus complications :-

* Cardiovascular disease.

* Nerve damage.

* Kidney damage.

* Eye damage.

* Foot damage.

* Hearing imparment.

* Alzheimer's disease.

Diagnostic tests for diabetes mellitus :-

* Fasting blood sugar levels :- more than 126 mg/ DL indicates diabetes.

* Post Prandial glucose test :- more than 200 mg / dl indicates diabetes.

* Random blood sugar levels :- more than 200 mg / dl indicates diabetes mellitus.

* Glycated hemoglobin test ( HB A1C):- 6.5% or more indicates diabetes mellitus.

Treatment :-

* Diet maintainance is important.

* Medications includes :-

- Metformin.

- Sulfonylureas.etc.

* Insulin therapy.

* Excercise.

HYPOGLYCEMIA:-

Pathophysiology :- when exposed to risk factors that maybe using diabetes medications,taking less glucose diet, doing excercise more than normal.

This cause to fall blood sugar levels and patient may experience symptoms.

Signs and symptoms :- Due to low blood sugar levels individual may experience fatigue, excessive sweating , light headed ness, fainting, mental confusion, dryness of lips, nausea , vomiting,blurred vision, headache , etc.

Complication :- hypoglycemia may cause accidents , injuries , even coma , dementia , heart attack. Etc.

Diagnostic tests for hypoglycemia:-

* Fasting blood sugar test :-

Less than 70 mg/ dl indicates hypoglycemia and needs immediate treatment.

MTT( Mixed meal tolerance test) is a diagnostic test done after taking special drinks which raises blood sugar levels.

Treatment :-

Diet :- high sugar diet and fluids.

Medications include :-

* glucose supplements.

* Glucagon.

* Inhibiting insulin secretion:- it is used in emergency situations to increase glucose levels.

Examples :-

* Diazoxide .

* Dextrose also used in emergency situations.

2)

Type 1 diabetes:-

This is the condition in which body produces little or no insulin. This is mostly seen in adolescents. Complications of this condition :-

* Nerve damage.

* Kidney damage.

* Heart and blood vessels disease.

* Eye damage.

* pregnancy complications.

* Foot damage,etc.

Thus condition is managed by taking insulin to control blood sugar levels.

Type 2 diabetes:-

This is the condition in which body does not produce any insulin or body stay resistance to insulin or body does not react for the insulin. This is mostly seen in adults. Some common complications like type 1 diabetes are:-

* Nerve damage.

* Kidney damage.

* Heart and blood vessels disease.

* Eye damage.

* pregnancy complications.

* Foot damage,etc.

This condition have some more complications which are not present in type 1 diabetes. They are:-

* Slow healing of any wound or injury.

* Hearing impairment.

* Sleep apnea.

* Some skin problems, etc.

This condition is controlled by taking insulin, medications, diet, exercise, etc.

3)

Insulin :- it is a natural hormone produced by beta cells in pancreas. It controls blood sugar levels in the body by allowing glucose to enter the cells and stores extra glucose in the liver. It acts like key to allow or store glucose in the body. When body needs glucose, insulin releases glucose to the cells, when extra glucose is present in body it stores in liver, in the form of glycogen.

By this process insulin maintains glucose levels in the body.