Unit 6 Endocrine System Diabetes

Endocrine System

The endocrine system is your body's messenger system .

It is made up of glands that produce hormones .

What are glands?

Glands are organs that make and release hormones .

Examples:

• Pituitary gland

• Thyroid gland

• Adrenal glands

• Pancreas

What are hormones?

Hormones are chemical messages that tell different parts of the body what to do.

Think of hormones like text messages sent through your blood.

Example:

• A hormone can tell your body to grow.

• A hormone can tell your body to use energy.

• A hormone can tell your body when to sleep.

"Glands secrete hormones directly into the bloodstream" Secret = release

So this means:

Endocrine glands release hormones directly into the blood.

The blood then carries the hormones all around the body to the cells that need the message.

Easy example:

1. Thyroid gland makes a hormone.

2. Hormone enters the bloodstream.

3. Blood carries it throughout the body.

4. Cells receive the message and respond.

What does the endocrine system regulate?

1. Metabolism

Metabolism = how your body uses energy.

It controls:

• How fast you burn calories

• How much energy do you have?

• How your body uses food

Example:

• Thyroid hormones help control metabolism.

2. Growth

Hormones help you:

• Get taller

• Build muscles

• Develop bones

Example:

• Growth hormone helps children and teens grow.

3. Development

Development means the body changes as you get older.

Examples:

• Puberty

• Sexual development

• Brain development

Hormones help control these changes

4. Tissue Function

Tissues are groups of cells that do a job.

Hormones help tissues:

• Work correctly

• Repair themselves

• Communicate with other body parts

Example:

• Insulin helps body cells take in glucose (sugar) for energy.

Negative Feedback System

This is the body's way of keeping hormone levels balanced.

Think of it like a thermostat in a house.

• Too cold → heater turns on.

• Too hot → heater turns off.

Your body does the same thing with hormones.

What does the endocrine system regulate?

When hormone levels are LOW

"Decrease of hormone level → RF, more is produced"

RF = Releasing Factor (or Releasing Hormone)

What happens:

1. Hormone level drops.

2. Brain detects the drop.

3. Releasing factors are sent out.

4. Glands are told to make more hormone.

5. Hormone level rises back to normal.

Easy example:

Not enough thyroid hormone:

• Brain notices low level.

• Sends signals.

• The thyroid gland produces more hormones.

• Levels return to normal.

When hormone levels are high "Hormone level is too high → production stops"

What happens:

1. Hormone level gets high enough.

2. Brain detects it.

3. Signal to make more hormone stops.

4. Gland slows down or stops production.

5. Hormone level falls back to normal.

Easy example:

Enough thyroid hormone:

• Brain says, "We have enough."

• Thyroid stops making extra hormone.

• Balance is maintained.

Endocrine System

Super Simple Memory Trick

LOW hormone = MAKE MORE

⬇ Hormone → Brain notices → Signal sent → More hormone made

HIGH hormone = STOP MAKING

⬆ Hormone → Brain notices → Signal stops → Less hormone made

One-Sentence Summary

The endocrine system is a group of glands that release hormones into the bloodstream to control metabolism, growth, development, and tissue function , and it uses negative feedback to keep hormone levels balanced by doing more when levels are low and stopping production when levels are high.

Endocrine Glands = Hormone Factories

1-3

These glands make hormones and send them into the blood to tell the body what to do.

Think of each gland as having a special job.

1. Pituitary Gland 🧠 Nickname: "The Master Gland"

Location:

• Under the brain

Job:

• Controls many other endocrine glands.

• Helps with growth, reproduction, and water balance.

Think: The boss of the hormone system.

The pituitary gland has two parts :

Previous Pituitary (Front Part)

It makes hormones that:

• Help you grow

• Control the thyroid

• Control the adrenal glands

• Help reproduction

Easy memory:
Previous = Action
(It sends out lots of hormones.)

Posterior Pituitary (Back Part)

Stores and releases hormones that:

• Control water in the body

• Help during childbirth

Easy memory:
Later = Water & Birth

2. Thyroid Gland 🦋

Location: Front of the neck

Job: Controls metabolism

Metabolism = how fast your body uses energy.

Think:
The body's speed controller.

If it works faster:

• More energy, Faster calorie burning

If it works slower:

• Less energy, Slower calorie burning

Easy memory:
Thyroid = Thermostat for body speed.

3. Parathyroid Glands 🦴

Location:Tiny glands behind the thyroid

Job:Control calcium levels

Calcium helps:

• Bones, Teeth, Muscles, Nerves

Think:
Parathyroid = Calcium manager.
Para = Protects calcium.

Endocrine Glands = Hormone Factories

4. Adrenal Glands ⚡

Location: Sit on top of the kidney

Job: Help during stress and emergencies

They release hormones that:

• Increase heart rate

• Raise blood pressure

• Give extra energy

Think:
Fight-or-flight gland.
You almost get hit by a car

Your adrenal glands say

"Emergency! Get ready!"

Your body gets a burst of energy.
Adrenal = Adrenaline = Action.

5. Pancreas 🍬

Location:

• Behind the stomach

Job:

• Controls blood sugar

Makes:

• Insulin → lowers blood sugar

• Glucagon → raises blood sugar

Think:
Blood sugar manager.
Pancreas = Sugar controller.

6. Gonads (Reproductive Glands)

Job:

• Take sex hormones

• Help reproduction

There are two types:

Male Gonads = Testes ♂

Location: In males

Job:

• Testosterone production

• Produce sperm

Female Gonads = Ovaries ♀

Location: In females

Job:

• Make estrogen and progesterone

• Produces eggs

Endocrine Glands

SUPER EASY CHART

Gland	Main Job	Easy Memory
Pituitary	Controls other glands	Boss gland
Anterior Pituitary	Growth & control hormones	Action
Posterior Pituitary	Water balance & birth	Water & Birth
Thyroid	Metabolism	Speed controller
Parathyroid	Calcium levels	Calcium manager
Adrenal	Stress response	Emergency gland
Pancreas	Blood sugar	Sugar controller
Testes	Testosterone & sperm	Male hormone factory
Ovaries	Estrogen, progesterone & eggs	Female hormone factory

"Boss, Speed, Calcium, Stress, Sugar, Boys, Girls"

• Boss = Pituitary

• Speed ​​= Thyroid

• Calcium = Parathyroid

• Stress = Adrenal

• Sugar = Pancreas

• Boys = Testes

• Girls = Ovaries

Pancreas 🍬

The pancreas is the body's blood sugar manager .

Its main job is to keep the amount of sugar (glucose) in your blood at a healthy level.

Think of it like a thermostat:

• Blood sugar too high → lower it

• Blood sugar too low → raise it

To do this, the pancreas uses two hormones :

1. Insulin

2. Glucagon

INSULIN What does insulin do?

Insulin lowers blood sugar (glucose) levels.

Think: Insulin = "Put sugar away."

When you eat food, especially carbohydrates (bread, pasta, rice, fruit, candy), your blood sugar rises.

The pancreas releases insulin to bring it back down.

"Decreases blood glucose levels" Blood glucose = blood sugar

After eating: Blood sugar goes up

Insulin tells the body:

"Take some sugar out of the blood."

Result:

• Blood sugar decreases

• Returns to normal

Insulin = LOWERS blood sugar.

"Promotes CHO storage (glycogen synthesis)" CHO = Carbohydrates

Carbohydrates are foods that become glucose.

Examples: Bread, Rice, Paste, Cereal, Fruit

Glycogen

Glycogen is the body's stored form of glucose .

Think:

• Glucose = spending money

• Glycogen = savings account

Your body stores extra glucose for later.

Glycogen Synthesis

"Synthesis" means doing something .

SW:

Glycogen synthesis = making glycogen from glucose.

Insulin tells the liver and muscles:

"Store the extra glucose for later."

Insulin helps save extra sugar.

"Brings glucose into cells for energy"

Cells need glucose for fuel.

Think of glucose as gasoline for a car.

Without glucose:

• Cells can't work properly

• You have less energy

Insulin acts like a key.

It unlocks cells and says: "Come in, glucose."

Then the cells use glucose for energy.

Insulin = key that lets glucose into cells.

"Essential for metabolism and storage of fat and protein" Metabolism

Metabolism = how your body uses food for energy.

Insulin helps the body:

• Use glucose, Store nutrients, Make energy

at Storage

When there's extra energy, insulin helps store it as fat for later use.

Protein Storage

Insulin also helps the body:

• Build muscle, Store protein, Repair tissues

Insulin helps use and store nutrients.

Pancreas

GLUCAGON

What does glucagon do?

Glucagon raises blood sugar levels.

Think: Glucagon = "Release more sugar."

"Increases blood glucose levels"

When you haven't eaten for a while:

• Blood sugar drops

• The body still needs energy

The pancreas releases glucagon.

Glucagon tells the liver:

"Send more glucose into the blood."

Result: Blood sugar goes up

Glucagon = RAISES blood sugar.

"Stimulates glycogen breakdown (glycogenolysis)"

Big word, easy meaning.

Glycogenolysis

• Glycogen = stored sugar

• Lysis = break apart

Glycogenolysis = breaking stored glycogen into glucose.

The liver takes stored glycogen and turns it back into glucose.

Glucagon breaks open the sugar savings account

"New glucose to be formed (gluconeogenesis)"

Gluconeogenesis

• Gluco = glucose

• Neo = new

• Genesis = creation

Gluconeogenesis = making new glucose.

If stored glycogen starts running low, the body can make new glucose from other materials.

Gluconeogenesis = creating brand-new glucose.

How Insulin and Glucagon Work Together

They are opposites.

Hormone	Blood Sugar
Insulin	Lowers it
Glucagon	Raises it

After a Meal 🍕

Blood sugar goes up.

Pancreas releases: ➡ Insulin

Insulin:

• Moves glucose into cells

• Stores extra glucose as glycogen

Blood sugar drops.

When You Haven't Eaten 🍽❌

Blood sugar goes down.

Pancreas releases: ➡ Glucagon

Glucagon:

• Breaks down glycogen

• Makes new glucose

Blood sugar goes up.

Pancreas

"Balance to maintain adequate blood glucose levels"

The body wants blood sugar to stay in a healthy range.

Not too high.
Not too low.

SW:

If blood sugar is high

➡ Insulin lowers it.

If blood sugar is LOW

➡ Glucagon raises it.

Together they keep blood sugar balanced.

Super Easy Summary

Pancreas = Blood Sugar Manager

Insulin 🗝

• Lowers blood sugar

• Moves glucose into cells

• Gives cells energy

• Stores extra glucose as glycogen

• Helps store fat and protein

Glucagon 📈

• Raises blood sugar

• Breaks glycogen into glucose ( glycgenolysis )

• Makes new glucose ( gluconeogenesis )

Main Goal 🎯

Keep blood sugar balanced:

• Too high → insulin

• Too low → glucagon

Insulin Secretion (How Insulin Is Released)

Basal Insulin Release

Basal = small amount all day long.

Even when you're not eating, your pancreas releases a little insulin to keep blood sugar stable.

Think:
➡ Background insulin working 24/7.

Peaks With Meals

When you eat, blood sugar rises.

Your pancreas releases more insulin to help move that glucose into cells for energy.

Think:
➡ Eat food → blood sugar rises → insulin rises.

Stored Insulin Is Released

A healthy pancreas already has insulin stored and ready.

When you eat:

1. Blood sugar goes up.

2. Pancreas quickly releases stored insulin.

3. Blood sugar returns toward normal.

Think:
➡ Insulin is waiting on standby.

Coordinated Insulin Secretion

The pancreas releases the right amount of insulin at the right time .

This helps keep blood sugar healthy.

Think:
➡ Not too much insulin, not too little.

Insulin Secretion

gluts 2-4

GLUT2 What is GLUT2?

A transporter (a doorway) that lets glucose enter beta cells in the pancreas.

When glucose enters beta cells:
➡ The pancreas knows blood sugar is high.
➡ Insulin is released.
GLUT2 = glucose detector for insulin release.

GLUT4 What is GLUT4?

A transporter (doorway) found in body cells.

Insulin tells GLUT4 to open.

Then:
➡ Glucose enters the cells.
➡ Cells use it for energy.

Think:
GLUT4 = lets glucose into cells.

• GLUT2 = tells pancreas to release insulin

• GLUT4 = lets glucose into body cells

Glycogenolysis

• Glycogen = stored glucose

• Lysis = break apart

Glycogenolysis = breaking stored glucose apart to use for energy.

This happens:

• During fasting, Between meals, When blood sugar gets low

Think:
➡ Your body opens its glucose storage when it needs energy.

GLP-1 and GLP-2

These are hormones called incretins .

They:
✅ Increase insulin release

✅ Helps lower blood sugar

✅ Prevent the liver from making extra glucose

Think:
➡ GLP-1 & GLP-2 help insulin do its job.

DPP-4

DPP-4 is an enzyme.

Its job is to break down (turn off) GLP-1 and GLP-2.

• enzyme that inactivates incretins (GLP-1, GLP-2)

Think:
➡ GLP-1 and GLP-2 help insulin.
➡ DPP-4 stops GLP-1 and GLP-2.

Insulin Secretion

Quick Memory Chart

Term	Easy Meaning
Basal insulin	Small amount released all day
Meal peak	More insulin released after eating
GLUT2	Detects glucose and triggers insulin release
GLUT4	Lets glucose into cells for energy
Glycogenolysis	Breaks stored glucose into usable glucose
GLP-1 & GLP-2	Increase insulin and reduce liver glucose production
DPP-4	Turns off GLP-1 and GLP-2

GLUT2 senses glucose → pancreas releases insulin → GLUT4 lets glucose into cells for energy.
GLP-1 and GLP-2 help insulin work better, while DPP-4 shuts them off.

When you haven't eaten, glycogenolysis breaks down stored glucose to keep blood sugar normal.

Glucagon Secretion (Easy Version)

Think of glucagon as the hormone that raises blood sugar when it gets too low .

When is glucagon released?

• Between meals 🍽

• During fasting (when you haven't eaten for a while)

If your blood sugar starts dropping, your body says:

"We need more glucose!"

So the pancreas releases glucagon .

Released from the pancreas

Glucagon is made and released by the pancreas .

Think:
➡ Pancreas = blood sugar manager

Activates glycogenolysis in the liver

Glycogenolysis = breaking down stored glucose.

The liver stores extra glucose as glycogen .

Glucagon tells the liver:

"Open the storage and release glucose!"

This raises blood sugar.
➡ Glycogenolysis = opening the glucose storage closet.

Stimulates gluconeogenesis in the liver

Gluconeogenesis = making new glucose.

If the liver needs more glucose, glucagon tells it:

"Make new glucose!"

This also helps raise blood sugar.
➡ Gluconeogenesis = creating brand-new glucose.

Glucagon Secretion

Super Easy Summary

Glucagon = raises blood sugar.

When blood sugar gets low:

1. Pancreas releases glucagon.

2. Liver breaks down stored glucose ( glycogenolysis ).

3. Liver makes new glucose ( gluconeogenesis

4. Blood sugar goes back up.

Memory Trick

Insulin puts sugar away ⬇
Glucagon gives sugar back ⬆

Negative Feedback for Blood Sugar Levels

The Goal 🎯

Your body wants blood sugar to stay just right .

• Not too high ❌

• Not too low ❌

• Just right ✅

This is called homeostasis (balance).

Step 1: You Eat 🍔

You eat food.

The food is broken down into glucose (sugar) .

➡ Blood sugar goes UP .

Step 2: Pancreas Notices 👀

The pancreas checks blood sugar levels.

It sees:

"Whoa! Blood sugar is getting high."

Step 3: Pancreas Releases Insulin 🔑

The pancreas releases insulin into the blood.

Think:

Insulin = the key that helps glucose leave the blood.

Step 4: Cells Take In Glucose 🚪

Insulin tells body cells:

"Open up and let glucose in!"

The cells take in glucose and use it for energy.

Step 5: Liver Stores Extra Glucose 🏪

The liver takes extra glucose and stores it as glycogen .

Think:

• Glucose = sugar you use now

• Glycogen = sugar saved for later

Step 6: Blood Sugar Goes Down ⬇

Because:

• Cells are using glucose

• The liver is storing glucose

There is less glucose in the blood.

Blood sugar returns to normal.

Step 7: Insulin Stops 🛑

The pancreas sees:

"Blood sugar is normal again."

So it stops releasing extra insulin.

This is called negative feedback .

Negative Feedback for Blood Sugar Levels/ pancreas

Why Is It Called Negative Feedback?

The body fixes the problem by doing the opposite.

Problem	Body's Response
Blood sugar too high	Release insulin
Blood sugar returns to normal	Stop insulin release

Super Easy Memory Story

🍔 Eat food

⬆ Blood sugar rises

👀 Pancreas notices

🔑 Insulin released

🚪 Cells take in glucose

🏪 Liver stores extra glucose as glycogen

⬇ Blood sugar returns to normal

🛑 Insulin stops

✅ Balance restored

One-Sentence Summary

When you eat, blood sugar rises, the pancreas releases insulin, cells and the liver take up glucose, blood sugar falls back to normal, and insulin release stops—this is a negative feedback loop.

Normal Blood Glucose

Test	Normal Result	Easy Meaning
FBS (Fasting Blood Sugar)	70–99 mg/dL	Your blood sugar after not eating for about 8 hours.
HbA1c	Less than 5.7%	Shows your average blood sugar over the last 2–3 months.
GTT (Glucose Tolerance Test)	Less than 140 mg/dL	Checks how well your body handles sugar after drinking a glucose drink.

• FBS = Blood sugar right now while fasting

• HbA1c = Blood sugar over the last few months

• GTT = How your body handles a sugar challenge

Super Short Summary

✅ FBS 70–99 = Normal fasting blood sugar
✅ HbA1c < 5.7% = Normal average blood sugar over months
✅ GTT < 140 = Normal response after drinking glucose/sugar

Prediabetes Diagnosis

Prediabetes means your blood sugar is higher than normal, but not high enough to be diabetes yet.

Think:

➡ Normal → Prediabetes → Diabetes

Prediabetes is a warning sign that diabetes could develop if changes aren't made.

Blood Sugar Numbers for Prediabetes FBS (Fasting Blood Sugar)

100–125 mg/dL

This is your blood sugar after not eating for about 8 hours.

HbA1c

5.7%–6.4%

Shows your average blood sugar over the last 2–3 months .

GTT (Glucose Tolerance Test)

140–199 mg/dL

Shows how your body handles sugar after drinking a glucose drink.

Prediabetes Diagnosis

Treatment

1. Modify Lifestyle

Make healthier daily habits.

Think:
➡ Better choices every day.

2. Exercise 🏃

Move your body regularly.

Exercise helps:

• Lower blood sugar

• Help insulin work better

3. Weight Loss (if needed) ⚖

If a person is overweight, losing some weight can help lower blood sugar.

4. Nutrition Changes 🥗

Eat healthy foods and reduce excess sugar and unhealthy foods.

Examples:

• More fruits and vegetables

• More whole grains

• Less sugary drinks and sweets

5. Reassess 🔄

Check blood sugar again later to see if it has improved.

Prediabetes = blood sugar is higher than normal but not diabetes yet.

Numbers:

• FBS: 100–125

• HbA1c: 5.7–6.4%

• GTT: 140–199

Treatment:
✅ Healthy lifestyle
✅ Exercise
✅ Weight loss (if needed)
✅ Better nutrition
✅ Recheck blood sugar later (reassess)

Diabetes Diagnosis

Diabetes means your blood sugar is too high because your body isn't using insulin properly or isn't making enough insulin.

Numbers That Mean Diabetes

🔹 FBS (Fasting Blood Sugar)

• 126 mg/dL or higher

• Blood sugar after not eating for about 8 hours.

🔹 HbA1c

• 6.5% or higher

• Average blood sugar over the last 2–3 months.

🔹 GTT (Glucose Tolerance Test)

• 200 mg/dL or higher

• Blood sugar after drinking a glucose (sugar) drink.

Test	Normal	Prediabetes	Diabetes
FBS	70–99	100–125	126+
HbA1c	<5.7%	5.7–6.4%	6.5%+
GTT	<140	140–199	200+

Super Short Summary

If FBS is 126+, HbA1c is 6.5%+, or GTT is 200+, it means diabetes because blood sugar is staying too high. 🩸⬆🍬

Type 1 Diabetes Mellitus (Type 1 DM)

What is it?

Type 1 diabetes is a disease where the body does not make insulin at all.

Think:

➡ No insulin = glucose can't get into cells properly.
➡ Blood sugar stays high.

Usually Before Age 20

Often diagnosed in:

• Children

• Teenagers

• Young adults

That's why it used to be called juvenile diabetes .

Very Thin

Many people with Type 1 diabetes are often thin when diagnosed because their body can't use glucose properly for energy.

Absolute Insulin Deficiency

This means:

🚫 No insulin production

The cells in the pancreas that make insulin are destroyed.

Insulin-Dependent (IDDM)

Because the body makes little or no insulin:

✅ They must take insulin (shots or a pump) to live.

Cause : Genetics 🧬

It can run in families.

Autoimmune Disease ⚔

The body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas.

Type 1 Diabetes Mellitus (Type 1 DM)

What is it?

Type 1 Diabetes = the pancreas stops making insulin.

• Usually starts before age 20

• Often thin at diagnosis

• No insulin production

• Must take insulin

• Caused by genetics and an autoimmune attack on the pancreas

Type 1 = "No insulin is made." 🚫💉➡ Need insulin injections.

Type 1 Diabetes Symptoms (Super Easy)

Hyperglycemia 🩸⬆

High blood sugar

• Blood glucose is 126 mg/dL or higher after fasting for 8 hours.

• Happens because there is not enough insulin.

Glycosuria 🚽

Sugar in the urine (pee)

• Blood sugar gets so high that some sugar spills into the urine.

Polyuria 🚽🚽

Frequent urination (peeing a lot)

• Extra sugar pulls water out of the body.

• You pee more often.

Polydipsia 🥤

Very thirsty

• Because you're losing lots of water from peeing.

Polyphagia 🍔

Very hungry

• Cells aren't getting enough glucose for energy.

• The body thinks it needs more food.

Drowsiness/Fatigue 😴

Tired all the time

• Cells aren't getting enough energy.

Dry Skin 🌵

Skin becomes dry

• Caused by dehydration from excessive urination.

Ketoacidosis (DKA) 🍎

Dangerous condition

• Blood sugar is usually over 250 mg/dL .

• The body starts burning fat for energy.

• Breath may smell fruity or sweet .

Think:
➡ Not enough insulin → body burns fat → DKA.

Unexplained Weight Loss ⚖⬇

Losing weight without trying

• The body can't use glucose properly.

• It starts breaking down fat and muscle for energy.

Type 1 Diabetes Symptoms (Super Easy)

Easy Memory Trick

The 3 P's of Type 1 Diabetes:

✅ Polyuria = Peeing a lot
✅ Polydipsia = Very thirsty
✅ Polyphagia = Very hungry

Plus:
✅ High blood sugar
✅ Tired
✅ Dry skin
✅ Weight loss
✅ Fruity breath (DKA)

Type 1 diabetes causes high blood sugar because there is no insulin. People often pee a lot, feel very thirsty, very hungry, tired, lose weight, and may develop fruity-smelling breath if DKA occurs. 🍬⬆💉❌

Diagnosis of Type 1 Diabetes (Super Easy)

Doctors use blood tests and urine tests to see if someone has diabetes.

Blood Draws 🩸 FBS/FBG (Fasting Blood Sugar)

• 126 mg/dL or higher (twice) = diabetes

• Taken after not eating for 8 hours

Think:
➡ High fasting blood sugar = diabetes

Random Blood Sugar

• 200 mg/dL or higher = diabetes

• Can be checked at any time

HbA1c

• Shows average blood sugar over the last 3 months

• Normal = less than 5.7%

• Diabetes = 6.5% or higher

Think:
➡ 3-month report card for blood sugar

GTT (Glucose Tolerance Test)

• Shows how well the body handles sugar

• In diabetes, the body is glucose intolerant (can't handle sugar normally)

Urinalysis (Urine Test) 🚽 Glycosuria

• Sugar in the urine

Proteinuria

• Protein in the urine

• Can be a sign the kidneys are being affected

Ketones Present

• Body is burning fat for energy because it can't use glucose properly

BUN and Creatinine Elevated

These are blood tests that check kidney function .

If they are elevated:
➡ The kidneys may be under stress or not working as well.

Diagnosis of Type 1 Diabetes (Super Easy)

Super Short Study Guide

• Blood draws

  • FBS or FBG >or =126 mg/dL (X 2) or random BS >or =200 mg/dL

  • HbA1c: BS control over previous 3 mos (normal is <5.7%, diagnosis of diabetes is at 6.5% or higher)

  • GTT: intolerant

• Urinalysis: glycosuria, proteinuria, ketones present

• BUN and creatinine elevated

✅ FBS ≥ 126 = Diabetes
✅ Random BS ≥ 200 = Diabetes
✅ HbA1c ≥ 6.5% = Diabetes
✅ Glycosuria = Sugar in urine
✅ Proteinuria = Protein in urine
✅ Ketones = Burning fat for energy
✅ High BUN & Creatinine = Possible kidney problems

Blood: High sugar 🩸
Urine: Sugar, protein, ketones 🚽
Kidneys: High BUN & creatinine 🫘 (kidney function tests)

Complications of Diabetes (Super Easy)

Complications = problems that can happen when blood sugar stays high for a long time.

pt.1

👀 Retinal Hemorrhages

Bleeding in the blood vessels of the eye.

Think:
➡ Eye damage

👁 Blindness

Diabetes can damage the eyes and cause vision loss.

Think:
➡ Can't see well or may lose vision

🫘 Renal Dysfunction

Renal = kidneys

The kidneys may not filter blood properly.

Think:
➡ Kidney damage

🤕 Neuropathy

Nerve damage

Can cause:

• Numbness

• Tingling

• Pain (especially in feet and hands)

Think:
➡ Nerve problems

🦠 Recurrent Skin Infections

Frequent skin infections that keep coming back.

Think:
➡ More infections

Complications of Diabetes (Super Easy)

Complications = problems that can happen when blood sugar stays high for a long time.

pt.2

♀ Vaginal Infections

High blood sugar can make these infections more common.

Think:
➡ Frequent vaginal infections

❤ Heart Disease

Diabetes can damage blood vessels and increase heart problems.

Think:
➡ Heart damage

🧠 Stroke

Blood flow to the brain can become blocked.

Think:
➡ Brain damage from poor blood flow

🍽 GI Problems

GI = Gastrointestinal (digestive system)

Can cause:

• Stomach problems

• Digestion problems

Think:
➡ Digestive issues

👶 Fertility Problems

Can make it difficult to have children.

Think:
➡ Problems with reproduction

Complications Associated with Diabetes

Super Easy Memory Trick

Diabetes can damage:

👀 Eyes
🫘 Kidneys
🤕 Nerves
🦠 Skin
❤ Heart
🧠 Brain
🍽 Stomach/Digestion
👶 Fertility

Super Short Summary

High blood sugar over time can damage many parts of the body, especially the eyes, kidneys, nerves, heart, brain, skin, digestive system, and reproductive system.

Sources of Insulin (Super Easy)

Insulin can come from 3 places :

1. Humans 👨

Insulin made from human sources.

Think:
➡ Human insulin

2. Animals 🐮🐷

In the past, insulin was taken from:

• Cows

• Pigs

Think:
➡ Animal insulin

3. Recombinant DNA / Genetic Engineering 🧬

Scientists use bacteria or other cells to make insulin that is almost identical to human insulin.

This is the most common source today.

Think:
➡ Lab-made human insulin

Super Easy Memory Trick

HAG

👨 H = Human
🐮🐷 A = Animal (cows & pigs)
🧬 G = Genetic engineering

Super Short Summary

Insulin can come from humans, animals (cows/pigs), or be made in a lab using genetic engineering. Today, most insulin is made using genetic engineering. 🧬💉

Types of Insulin (Super Easy)

1. Regular Insulin 💧

• Clear (looks clear)

• Short-acting (starts working fairly quickly)

• Can be mixed with NPH insulin

Memory: ➡ Regular = Clear & Short-acting

2. NPH Insulin ☁

• Cloudy (looks cloudy)

• Intermediate/longer acting

• Works longer than Regular insulin

Memory: ➡ NPH = Cloudy & Lasts Longer

Mixing Regular and NPH

When drawing them into the same syrinx:

Rule:

Clear before Cloudy

1. Draw up Regular (clear) first

2. Draw up NPH (cloudy) second

Memory:

➡ Clear before Cloudy

Premix Insulin (Novolin 70/30)

Already mixed for you:

• 70% NPH (cloudy, longer acting)

• 30% Regular (clear, short acting)

Benefits:

• Starts working quickly

• Lasts longer

Memory:

➡ 70/30 = 70% NPH + 30% Regular

Quick Study Sheet

💧 Regular = Clear, short-acting
☁ NPH = Cloudy, longer-acting
💉 Mixing = Clear before Cloudy
📦 70/30 = 70% NPH + 30% Regular (premixed)

Human DNA Insulin (Super Easy)

What is it?

This is insulin made using genetic engineering to be very similar to human insulin.

Think:
➡ Lab-made human insulin 🧬

Clear

It looks clear , not cloudy.

Think:
💧 Clear insulin

Cannot Be Mixed With Other Insulin

This means:

❌ Don't combine it in the same syringe with another type of insulin.

It must be given by itself.

Think:
➡ Human DNA insulin likes to work alone.

Super Short Summary

🧬 Human DNA insulin = lab-made human insulin
💧 Clear appearance
❌ Cannot be mixed with other insulins in the same syringe

• Clear; cannot be mixed with any other insulin

Types of Insulin (Super Easy)

rapid vs short vs intermediate

1. Rapid-Acting Insulin ⚡

Works very fast

• Starts working: 5–10 minutes

• Strongest effect (peak): 1–2 hours

• Lasts: up to 4 hours

Think:
➡ Rapid = Fast in, fast out

Usually taken right before eating.

2. Short-Acting Insulin 🕒

Works a little slower

• Starts working: 30–60 minutes

• Peak: 2–3 hours

• Lasts: 6–8 hours

Think:
➡ Short = Slower than fast, lasts longer

Usually taken about 30 minutes before eating.

3. Intermediate-Acting Insulin ⏳

Works much longer

• Starts working: 2–4 hours

• Peak: 4–14 hours

• Lasts: up to 24 hours

Think:
➡ Intermediate = Slow start, long-lasting

Helps control blood sugar throughout the day.

Easy Memory Trick

⚡ Rapid = Starts in minutes

🕒 Short = Starts in about 30–60 minutes

⏳ Intermediate = Starts in hours and lasts most of the day

Super Short Summary

• Rapid: 5–10 min start, lasts up to 4 hr

• Short: 30–60 min start, lasts 6–8 hr

• Intermediate: 2–4 hr start, lasts up to 24 hr

The faster it starts, the shorter it lasts. 😊💉

4. Long-Acting Insulin ⏳

Long acting

Works for a long time

• Starts working: 2–4 hours

• Lasts: up to 24 hours

Think:
➡ Long-acting = all-day protection

It helps keep blood sugar steady throughout the day and night.

5. Combination Products 💉

These are insulins that are already mixed together by the manufacturer.

Example:

• Fast-acting insulin + longer-acting insulin in one injection

Important:

❌ Do NOT mix them with other insulins.

They're already mixed correctly and ready to use.

Think:
➡ Combination = premixed insulin
➡ Leave it alone—don't add other insulins

⏳ Long-acting = Slow start, lasts all day

💉 Combination = Already mixed, cannot be mixed with other insulins

Super Short Summary

• Long-acting insulin: starts in 2–4 hours and works up to 24 hours.

• Combination insulin: premixed insulin that should not be mixed with any other insulin.

DIABETIC DRUG THERAPY

Insulin: Antidiabetic Agents

Rapid acting

aspart                      Novolog®

lispro                   Humalog®

glulisine              Apidra®

        

Methods of Giving Insulin 💉

IV (Intravenous)

• Given directly into a vein

• Only Regular insulin can be given this way
  ➡ IV = Regulate insulin

Subcutaneous (SubQ)

• Injected into the fat under the skin

• Most common method

Think:
➡ Under the skin

Pump

• Small device that gives insulin continuously

Think:
➡ Automatic insulin delivery

Syringe & Needle

• Traditional insulin shot
  ➡ Insulin injection

Pen

• Insulin comes in a pen-like device

• Easier to use than a syringe
  ➡ Easy insulin shot

Storage & Ordering

🧊 Store insulin in the refrigerator

📏 Insulin is measured in units, not milligrams

Super Short Summary

• IV = Regular insulin only

• SubQ = under the skin

• Pump = automatic insulin

• Syringe = insulin shot

• Pen = easy-to-use insulin shot

• Store in refrigerator

• Ordered in units 💉🧊

Side Effects of Insulin (Super Easy)

Insulin Allergy 🤧

Some people may have an allergic reaction.

Signs:

• Swelling

• Itching

• Anaphylaxis (severe allergic reaction/emergency)

Think:
➡ Allergic reaction to insulin

Lipodystrophy 💉

Loss of fat under the skin where insulin is injected.

The skin may look:

• Pitted

• Dented

• Concave (sunken in)

Prevention:

✅ Rotate injection sites
➡ Don't inject in the same spot every time

Blurred Vision 👀

Vision may become blurry because blood sugar changes can affect the lens of the eye.

Think:
➡ Changes in eyesight

Hypoglycemia ⬇🍬

Low blood sugar

This is the most common side effect of insulin.
➡ Too much insulin = blood sugar drops too low

🤧 Insulin allergy = swelling, itching, anaphylaxis

💉 Lipodystrophy = loss of fat at injection site (rotate sites)

👀 Blurred vision = lens changes

⬇🍬 Hypoglycemia = low blood sugar (most important to remember)

Hypoglycemia ⬇🍬

What is it?

Hypoglycemia = low blood sugar

• Blood sugar is less than 70 mg/dL

Think:
➡ Too little sugar in the blood

Severe Hypoglycemia ⚠

• Blood sugar less than 50 mg/dL

• Can lead to insulin shock (diabetic shock/coma)
  ➡ Very low blood sugar = emergency

What to Do Before Insulin Shock Happens

Give something with sugar:

✅ Glucose tablets
✅ Juice
✅ Regular soda (not diet)
➡ Give sugar fast

Insulin Shock

Insulin shock = too much insulin causes blood sugar to drop too low.

Treatment:
✅ Give a hyperglycemic agent (something that raises blood sugar)

Think:
➡ Low sugar → give sugar

⬇ Hypoglycemia = Low Blood Sugar (<70)

⚠ Below 50 = Insulin Shock Emergency

🥤 Treat with glucose tablets, juice, or regular soda .

Hypoglycemia Symptoms (Low Blood Sugar) ⬇🍬

Hunger 🍔

• I feel very hungry

Irritability 😠

• Easily annoyed or moody

Headache 🤕

• Head starts hurting

Blurred Vision 👀

• Hard to see clearly

Anxiety/Nervousness 😟

• Feel worried or shaky

Fatigue 😴

• Very tired or weak

Sweating 💦

• Sweating more than normal

Jittery 🤲

• Shaky or trembling

Tachycardia ❤

• Fast heartbeat

Confusion 🤔

• Trouble thinking clearly

Easy Memory Trick

Low blood sugar = "Hungry, Shaky, Sweaty, Confused."

🍔 Hungry
🤲 Shaky/Jittery
💦 Sweaty
🤔 Confused

1. DIABETIC DRUG THERAPY

Insulin: Antidiabetic Agents full drug

Short acting

  regular                     Novolin R®, Humulin R®

Intermediate acting

NPH                        Humulin N® or Novolin N®                                                                                

           

Long acting

glargine                   Lantus® (basal acting insulin)

        

Combination Products

Humulin N and R   Humulin 70/30®

Insulin aspart protamine/insulin aspart          Novolog Mix 70/30®

1. DIABETIC DRUG THERAPY

2. Hyperglycemic Agents

drug

glucagon                         Glucagen®

50% Dextrose Solution

Non-Pharmacological Diabetic Care

Non-pharmacological = ways to manage diabetes without medicine.

🍞 Diet – Limit CHO (Carbohydrates)

• Eat fewer sugary and high-carb foods.

• No sugar or limit it as much as possible.

Think:
➡ Less sugar = better blood sugar control

🏃 Exercise

• Be physically active.

• Helps lower blood sugar.

⚖ Maintain Weight Control

• Maintain a healthy weight.

📚 Education

• Learn about diabetes and how to manage it.

🩸 Self-Monitoring of Blood Sugar (BS)

• Check your blood sugar regularly.

Think:
➡ Know your numbers

✅ Compliance

• Follow the treatment plan.

• Take medications as prescribed and follow healthy habits.

Super Short Summary

🥗 Healthy diet (less carbs/sugar)
🏃 Exercise
⚖ Healthy weight
📚 Learn about diabetes
🩸 Check blood sugar
✅ Follow the treatment plan (compliance)

Type 2 Diabetes Mellitus (Type 2 DM)

What is it?

Type 2 diabetes means the body still makes insulin, but it doesn't work well enough.

Think:
➡ Insulin is there, but the body doesn't use it properly.

Relative Deficiency

This means:

• Not enough insulin may be made

• The body's cells don't respond well to insulin ( insulin resistance )

• Insulin may not be released properly

Think:
➡ Insulin works poorly or there isn't enough of it.

Usually Over Age 40

Most common in adults, although younger people can get it too.

Often Overweight ⚖

Being overweight increases the risk of Type 2 diabetes.

Usually Non-Insulin Dependent

Many people can control it with:

🥗 Diet changes
🏃 Exercise
💊 Oral medications (pills)
💉 Sometimes injectable medications

Insulin may be needed later, but not always.

Causes

🧓 Aging

🍔 Poor diet

🧬 Genetics (family history)

🩸 Previous glucose intolerance (prediabetes)

Type 1 = No insulin ❌💉

Type 2 = Insulin doesn't work well ⚠💉

Super Short Summary

Type 2 diabetes usually happens in adults who are often overweight. The body still makes insulin, but it doesn't use it properly. It is often managed with diet, exercise, and medications. 🍽🏃💊

Type 2 Diabetes Mellitus (Symptoms) - Super Easy

Diagnosis

Doctors use the same tests as Type 1:

🩸 FBS (Fasting Blood Sugar)
🩸 HbA1c (3-month average blood sugar)
🚽 Urinalysis (checks urine for sugar)

Symptoms Hyperglycemia ⬆🍬

High blood sugar

• Fasting blood sugar 126 mg/dL or higher

Think:
➡ Too much sugar in the blood

Glycosuria 🚽

Sugar in the urine

• Extra sugar spills into the pee

Polyuria 🚽🚽

Peeing a lot

• High blood sugar causes more urination

Polydipsia 🥤

Very thirsty

• Because you're losing water by peeing a lot

Polyphagia 🍔

Very hungry

• Cells aren't getting enough energy

Drowsiness/Fatigue 😴

Feeling tired

• The body isn't using glucose properly for energy

Fertility Issues 👶

Problems with reproduction or getting pregnant

Unexplained Weight Gain ⚖⬆

Gaining weight without a clear reason

• Common in many people with Type 2 diabetes

Easy Memory Trick

The 3 P's:

🚽 Polyuria = Peeing a lot
🥤 Polydipsia = Very thirsty
🍔 Polyphagia = Very hungry

Plus:
😴 Tired
⚖ Weight gain
👶 Fertility problems

Super Short Summary

Type 2 diabetes causes high blood sugar. Common symptoms are the 3 P's (peeing, thirst, hunger), tiredness, weight gain, and fertility problems. 🍬⬆

Oral Hypoglycemic Agents

Sulfonylureas (Secretagogues)

💊 What are they?

A type of medicine used to treat Type 2 Diabetes .

AKA Secretagogues

"Secretagogue" means:

➡ Makes the pancreas secrete (release) more insulin.
💊 "Pushes the pancreas to make more insulin."

How Do They Work? (MOA)

These medicines attach to beta cells in the pancreas.

This causes the beta cells to:

➡Open a process that lets calcium (Ca++) enter the cell.

➡ Calcium tells the cell:

"Release insulin!"

➡ More insulin is released into the blood.

Super Easy Memory

💊 Sulfonylureas = Type 2 diabetes medicine

🏭 Work on beta cells in the pancreas

📈 Cause more insulin release

🍬 More insulin = lower blood sugar

Sulfonylureas help treat Type 2 diabetes by making the pancreas release more insulin. 💉⬆🍬⬇

• bind to beta cells of pancreas causing release of insulin; bind to K+ channel of beta cells; allow influx of Ca++ across membrane which triggers insulin release

Anti-Diabetic agents-Type 2 Diabetes

         Oral Hypoglycemic Agents

                 Sulfonylureas (secretagogues)

drug

formerly known as second generation

glyburide                            

glipizide                             

glimepiride

Anti-Diabetic agents-Type 2 Diabetes

         Oral Hypoglycemic Agents

Non-sulfonylureas (meglitinides, secretagogues)

repaglinide                          Prandin®

nateglinide                          Starlix®

Side Effects (SEs) of Sulfonylureas 💊

⬇ Hypoglycemia

Low blood sugar (most important side effect)

Think:
➡ Too much insulin = blood sugar drops too low

☀ Photosensitivity

Skin becomes more sensitive to sunlight.

Think:
➡ Sunburns more easily

🤢 GI Upset

Stomach problems such as:

• Nausea

• Diarrhea

⚖ Weight Gain

May cause weight gain.

🍺 Alcohol Reaction (Disulfiram-Type Reaction)

Do not drink alcohol while taking this medicine.

Alcohol can cause:

• Flushing (red face), Headache

• Nausea/vomiting, Fast heartbeat

• Dizziness, Low blood pressure

• Confusion
  ➡ Alcohol + Sulfonylurea = Bad reaction

😴 Weakness, Fatigue, Dizziness

May feel:Weak, Tired, Dizzy

Patient Teaching 📚 ❌ Sulfa Allergy

Do not take if allergic to sulfa drugs .

🍽 Take With Meals

Take the medication when eating.
➡ Helps lower the risk of low blood sugar.

Super Easy Study Sheet

SEs of Sulfonylureas

💊 Sulfonylureas = Make pancreas release more insulin

Side Effects:

• ⬇ Hypoglycemia

• ☀ Photosensitivity

• 🤢 Nausea/diarrhea

• ⚖ Weight gain

• 🍺 No alcohol

• 😴 Weakness, fatigue, dizziness

Patient Teaching:

• ❌ No sulfa allergy

• 🍽 Take with meals

Memory Trick

"More insulin = lower sugar, so watch for hypoglycemia." 🍬⬇