Michael Emory
NUR 101 / 2014
MTCC PNE
Diabetes Mellitus
Diabetes Mellitus is caused by insufficient insulin production or lack of responsiveness to insulin, resulting in hyperglycemia, causing the glucose in the blood not to be absorbed into the cells of the body (high blood glucose levels). There are 2 primary types of diabetes mellitus, Type I (insulin-dependent or juvenile-onset), which may be caused by an autoimmune response, and type II (non-insulin-dependent or adult-onset). Diabetes insipidus is typically due to hormonal dysregulation. (Web. 02 Dec. 2013)
The muscle cells and other tissues of the body require certain specific levels of glucose and carbohydrates to maintain their normal functions. The levels of glucose absorbed into the bloodstream by the intestines, and the method by which glucose enters the body’s cells, is controlled by the hormone, insulin. The insulin is produced in the pancreas, a gland about the size of a person’s hand that is located behind the lower part of the stomach. ( Web. 01 Dec.2013)
Diabetes is a disease characterized by excessive urination. An interesting fact, according to The American Heritage College Dictionary; Diabetes is named for one of its symptoms. The disease was known to the Greeks as Diabetes, which was derived from the verb “diabainien”, made up of the prefix “dia” meaning across or apart and the word “bainen” which means to walkor stand. The verb “diabainien” meant “to stride, walk, or stand with legs apart. Its derivation diabetes meant one that “straddles”, which gave rise to it being used to describe a disease involving the discharge of excessive urine.
Diabetes mellitus (DM) is a chronic metabolic disorder caused by an absolute or relative deficiency of insulin, an anabolic hormone. Insulin is produced in the pancrea sby the beta cells of the islets of Langerhans. Absence, destruction, or loss of these cells causes an absolute deficiency of insulin, leading to Type I Diabetes (insulin-dependent diabetes mellitus [IDDM]). Type I Diabetics must have daily injections of insulin to survive. There is currently no cure for Diabetes. This condition can however be managed so that patients cans live relatively normal lives. Treatment of Diabetes focuses on two goals; keeping blood glucose levels within normal range and preventing the development of long-term complications. Careful monitoring of diet, exercise, and blood glucose levels are as important as the use of insulin or oral medication in preventing complications of Diabetes. Most children with diabetes have IDDM, often referred to as juvenile diabetes, which begins most commonly in childhood and requires a lifetime dependence on exogenous insulin.( William H Lamb)
Type II diabetes, the most common form of the disease (non–insulin-dependent diabetes Mellitus [NIDDM]), is a heterogeneous disorder, in which the pancreas still has the ability to produce insulin, but the amount is not enough for the body’s needs. Patients with NIDDM have insulin resistance and their beta cells lack the ability to overcome this resistance. The symptoms for Type II Diabetes develop gradually and include; feeling tired or ill, frequent night urination, thirst, blurred vision, possible weight loss, frequent infections, and sores that heal slowly or not at all. Although this form of diabetes previously was uncommon in children, 20% or more of new patients with diabetes in childhood and adolescence now have NIDDM, a change associated with increased rates of obesity. (Mayo Clinic Research, 3-14, 2013. Web. 12-1, 2013)
Insulin is essential to process carbohydrate, fat, and protein. Insulin reduces blood glucose levels by allowing glucose to enter muscle cells and fat cells and by stimulating the conversion of glucose to glycogen as a carbohydrate store. Insulin also inhibits the release of stored glucose from liver glycogen and slows the breakdown of fat to triglycerides, free fatty acids, and ketones. Additionally, insulin slows the breakdown of protein for glucose production.(Martin,Terry R., 2010. Print)
Hyperglycemia results when insulin deficiency leads to uninhibited gluconeogenesis and prevents the use and storage of circulating glucose. The kidneys cannot reabsorb the excess glucose load, causing glycosuria, osmotic diuresis, thirst, and dehydration. Increased fat and protein breakdown leads to ketone production and weight loss. Without insulin, a child with IDDM wastes away and eventually dies from diabetic ketoacidosis. Information on mortality rates is difficult to ascertain without complete national registers of childhood diabetes, although age-specific mortality probably is double that of the general population. Particularly at risk are children aged 1-4 years who may die with DKA at the time of diagnosis. Adolescents also are a high-risk group. Most deaths result from delayed diagnosis or neglected treatment and subsequent cerebral edema during treatment for DKA, although untreated hypoglycemia also causes some deaths.(Molitch, Mark E., U.S. National Library of Medicine, 17 Jan. 0090. Web.02 Dec. 2013)
IDDM complications are comprised of 3 major categories: acute complications, long-term complications, and complications caused by associated autoimmune diseases. Acute complications reflect the difficulties of maintaining a balance between insulin therapies, dietary intake, and exercise. Acute complications include hypoglycemia, hyperglycemia, and DKA. Long-term complications arise from the damaging effects of prolonged hyperglycemia and other metabolic consequences of insulin deficiency on various tissues. While long-term complications are rare in childhood, maintaining good control of diabetes is important to prevent complications from developing in later life. The likelihood of developing complications appears to depend on the interaction of factors such as metabolic control, genetic susceptibility, lifestyle, pubertal status, and gender. Most cases of IDDM are the result of environmental factors interacting with a genetically susceptible person. This interaction leads to the development of autoimmune disease directed at the insulin-producing cells of the pancreatic islets of Langerhans. These cells are progressively destroyed, with insulin deficiency usually developing after the destruction of 90% of islet cells. (Mayo Clinic Research, 3-14, 2013. Web. 12-1, 2013)
Resources:
1) Pediatric Type 1 Diabetes Mellitus Clinical Presentation
Author: William H Lamb, MBBS, MD, FRCP(Edin), FRCP, FRCPCH; Chief Editor: Stephen Kemp, MD, PhD
2) Martin, Terry R. Hole's Human Anatomy & Physiology: Laboratory Manual, Twelfth Edition [by] David Shier, Jackie Butler, [and] Ricki Lewis. New York: McGraw-Hill Higher Education, 2010. Print.
Websites:
3) Molitch, Mark E. Diabetes Mellitus. U.S. National Library of Medicine, 17 Jan. 0090. Web. 02 Dec. 2013..
4) Staff, Mayo Clinic. "Definition." Mayo Clinic. Mayo Foundation for Medical Education and Research, 14 Mar. 2013. Web. 01 Dec. 2013..
5) "Diabets.org." Diabets.org. N.p., n.d. Web. 02 Dec. 2013..
6) "Diabetes." Diabetes. N.p., n.d. Web. 01 Dec. 2013..
NUR 101 / 2014
MTCC PNE
Diabetes Mellitus
Diabetes Mellitus is caused by insufficient insulin production or lack of responsiveness to insulin, resulting in hyperglycemia, causing the glucose in the blood not to be absorbed into the cells of the body (high blood glucose levels). There are 2 primary types of diabetes mellitus, Type I (insulin-dependent or juvenile-onset), which may be caused by an autoimmune response, and type II (non-insulin-dependent or adult-onset). Diabetes insipidus is typically due to hormonal dysregulation. (Web. 02 Dec. 2013)
The muscle cells and other tissues of the body require certain specific levels of glucose and carbohydrates to maintain their normal functions. The levels of glucose absorbed into the bloodstream by the intestines, and the method by which glucose enters the body’s cells, is controlled by the hormone, insulin. The insulin is produced in the pancreas, a gland about the size of a person’s hand that is located behind the lower part of the stomach. ( Web. 01 Dec.2013)
Diabetes is a disease characterized by excessive urination. An interesting fact, according to The American Heritage College Dictionary; Diabetes is named for one of its symptoms. The disease was known to the Greeks as Diabetes, which was derived from the verb “diabainien”, made up of the prefix “dia” meaning across or apart and the word “bainen” which means to walkor stand. The verb “diabainien” meant “to stride, walk, or stand with legs apart. Its derivation diabetes meant one that “straddles”, which gave rise to it being used to describe a disease involving the discharge of excessive urine.
Diabetes mellitus (DM) is a chronic metabolic disorder caused by an absolute or relative deficiency of insulin, an anabolic hormone. Insulin is produced in the pancrea sby the beta cells of the islets of Langerhans. Absence, destruction, or loss of these cells causes an absolute deficiency of insulin, leading to Type I Diabetes (insulin-dependent diabetes mellitus [IDDM]). Type I Diabetics must have daily injections of insulin to survive. There is currently no cure for Diabetes. This condition can however be managed so that patients cans live relatively normal lives. Treatment of Diabetes focuses on two goals; keeping blood glucose levels within normal range and preventing the development of long-term complications. Careful monitoring of diet, exercise, and blood glucose levels are as important as the use of insulin or oral medication in preventing complications of Diabetes. Most children with diabetes have IDDM, often referred to as juvenile diabetes, which begins most commonly in childhood and requires a lifetime dependence on exogenous insulin.( William H Lamb)
Type II diabetes, the most common form of the disease (non–insulin-dependent diabetes Mellitus [NIDDM]), is a heterogeneous disorder, in which the pancreas still has the ability to produce insulin, but the amount is not enough for the body’s needs. Patients with NIDDM have insulin resistance and their beta cells lack the ability to overcome this resistance. The symptoms for Type II Diabetes develop gradually and include; feeling tired or ill, frequent night urination, thirst, blurred vision, possible weight loss, frequent infections, and sores that heal slowly or not at all. Although this form of diabetes previously was uncommon in children, 20% or more of new patients with diabetes in childhood and adolescence now have NIDDM, a change associated with increased rates of obesity. (Mayo Clinic Research, 3-14, 2013. Web. 12-1, 2013)
Insulin is essential to process carbohydrate, fat, and protein. Insulin reduces blood glucose levels by allowing glucose to enter muscle cells and fat cells and by stimulating the conversion of glucose to glycogen as a carbohydrate store. Insulin also inhibits the release of stored glucose from liver glycogen and slows the breakdown of fat to triglycerides, free fatty acids, and ketones. Additionally, insulin slows the breakdown of protein for glucose production.(Martin,Terry R., 2010. Print)
Hyperglycemia results when insulin deficiency leads to uninhibited gluconeogenesis and prevents the use and storage of circulating glucose. The kidneys cannot reabsorb the excess glucose load, causing glycosuria, osmotic diuresis, thirst, and dehydration. Increased fat and protein breakdown leads to ketone production and weight loss. Without insulin, a child with IDDM wastes away and eventually dies from diabetic ketoacidosis. Information on mortality rates is difficult to ascertain without complete national registers of childhood diabetes, although age-specific mortality probably is double that of the general population. Particularly at risk are children aged 1-4 years who may die with DKA at the time of diagnosis. Adolescents also are a high-risk group. Most deaths result from delayed diagnosis or neglected treatment and subsequent cerebral edema during treatment for DKA, although untreated hypoglycemia also causes some deaths.(Molitch, Mark E., U.S. National Library of Medicine, 17 Jan. 0090. Web.02 Dec. 2013)
IDDM complications are comprised of 3 major categories: acute complications, long-term complications, and complications caused by associated autoimmune diseases. Acute complications reflect the difficulties of maintaining a balance between insulin therapies, dietary intake, and exercise. Acute complications include hypoglycemia, hyperglycemia, and DKA. Long-term complications arise from the damaging effects of prolonged hyperglycemia and other metabolic consequences of insulin deficiency on various tissues. While long-term complications are rare in childhood, maintaining good control of diabetes is important to prevent complications from developing in later life. The likelihood of developing complications appears to depend on the interaction of factors such as metabolic control, genetic susceptibility, lifestyle, pubertal status, and gender. Most cases of IDDM are the result of environmental factors interacting with a genetically susceptible person. This interaction leads to the development of autoimmune disease directed at the insulin-producing cells of the pancreatic islets of Langerhans. These cells are progressively destroyed, with insulin deficiency usually developing after the destruction of 90% of islet cells. (Mayo Clinic Research, 3-14, 2013. Web. 12-1, 2013)
Resources:
1) Pediatric Type 1 Diabetes Mellitus Clinical Presentation
Author: William H Lamb, MBBS, MD, FRCP(Edin), FRCP, FRCPCH; Chief Editor: Stephen Kemp, MD, PhD
2) Martin, Terry R. Hole's Human Anatomy & Physiology: Laboratory Manual, Twelfth Edition [by] David Shier, Jackie Butler, [and] Ricki Lewis. New York: McGraw-Hill Higher Education, 2010. Print.
Websites:
3) Molitch, Mark E. Diabetes Mellitus. U.S. National Library of Medicine, 17 Jan. 0090. Web. 02 Dec. 2013.
4) Staff, Mayo Clinic. "Definition." Mayo Clinic. Mayo Foundation for Medical Education and Research, 14 Mar. 2013. Web. 01 Dec. 2013.
5) "Diabets.org." Diabets.org. N.p., n.d. Web. 02 Dec. 2013.
6) "Diabetes." Diabetes. N.p., n.d. Web. 01 Dec. 2013.
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