DIABETES AND HYPOGLYCEMIA What is Diabetes Mellitus STARVATION

DIABETES AND HYPOGLYCEMIA

What is Diabetes Mellitus? • “STARVATION IN A SEA OF PLENTY”

Glucose Homeostasis GLYCOGENOLYSIS GLUCONEOGENESIS LIVER & MUSCLE GLUCAGON ISLET -CELLS HYPERGLYCEMIC HORMONES MEALS SERUM GLUCOSE NORMAL SERUM GLUCOSE 80 -120 mg/dl ISLET -CELLS X INSULIN LIVER & MUSCLE SERUM GLUCOSE UPTAKE METABOLIC DEMANDS

What is Diabetes Mellitus? • Hyperglycemia – Polyuria – Osmotic diuresis • • • Polydipsia Ketosis Ketonuria Acidosis Coma Death

Types of Diabetes Mellitus • Type II

Type I • Lack of -cells in the pancreatic islet • Little or no insulin production • Usually occurs during childhood/adolescence – Once known as juvenile diabetes • Autoimmune disease – Possibly triggered by infection – Genetic predisposition

Type II • Insulin resistance – Followed by a decrease in -cell numbers • Usually occurs during adult life – Once known as adult onset diabetes • Strong genetic predisposition • Environmental factors – Obesity – Lack of exercise • Resistin: Protein from fat cells & macrophages • Gestational Diabetes

Effects of Uncontrolled Diabetes Mellitus on the Body

Primary effect of Insulin deficiency • • Hyperglycemia Polyuria Polydipsia Ketosis Ketonuria Acidosis Coma Death

Aberrant glucagon secretion • Why do diabetics hypersecrete glucagon when blood sugar levels are much higher than normal?

Diabetic vascular disease • Microvascular changes • Macrovascular changes

Secondary effects of insulin deficiency • • Retinopathy Peripheral neuropathy Renal disease Cardiovascular disease Wound healing/Infection Skin disease Bone and joint complications

Monitoring and Diagnosing Diabetes Mellitus • Glucosuria, glucose in the urine • Blood glucose levels – Fasting: 80 -120 mg/dl • Glucose tolerance test – 3 hr. – 6 hr. • Glycosylated hemoglobin – Hb. A 1 C

Treatments for Diabetes Mellitus

Type I • • Insulin Diet Exercise Support

Type II • • • Diet & exercise Oral hypoglycemic drugs Insulin Reversing insulin resistance Support

Hypoglycemia • • What is hypoglycemia? What causes hypoglycemia? Treatment Relationship of hypoglycemia to type -II diabetes