CB

Diabetes Overview and Carbohydrate Metabolism

Carbohydrates and Insulin

  • Carbohydrates: Key source of energy in diet. Example: Red pasta.
  • Insulin: Hormone crucial for glucose utilization. Body may struggle to produce or use insulin, leading to high glucose levels.

Consequences of Increased Glucose Levels

  • Long-term high glucose can result in:
    • Cardiovascular disease
    • Renal damage
    • Peripheral vascular disease (due to damage to small blood vessels)
  • Analogy: Think of glucose as sandpaper scraping the inside of blood vessels.

Small Blood Vessels in Diabetes

  • Significant areas affected:
    • Eyes: Diabetics at risk for retinopathy.
    • Feet: Risk of neuropathy; high importance of foot care to prevent wounds.

Diabetes Types

Type 1 Diabetes
  • Autoimmune disorder: T cells attack beta cells in the pancreas – no insulin production.
  • Symptoms manifest quickly; often diagnosed in youth.
  • Key signs (3 P's):
    • Polyuria (excessive urination)
    • Polydipsia (excessive thirst)
    • Polyphagia (excessive hunger)
Type 2 Diabetes
  • Insulin resistance: Body produces insulin but does not use it effectively.
  • Risk factors:
    • Sedentary lifestyle
    • Obesity
  • Diagnosis often happens in adulthood; progression is slower compared to Type 1.

Glucose Metabolism

  • Glycogenesis: Formation of glycogen, primarily in the liver and muscles.
  • Glycogenolysis: Breakdown of glycogen for energy when blood glucose levels fall.
  • Fasting: Generally, an 8-hour lapse of food and drink – normal glucose levels should be 70-100 mg/dL.

Blood Glucose Levels

  • Normal range: 70-100 mg/dL after fasting.
  • Hypoglycemia: Blood glucose below 70 mg/dL – symptoms include sweating, irritability, and clammy skin.
  • Hyperglycemia: May result in fruity breath odor due to excessive ketones in severe cases.

Insulin Functions

  • Insulin levels influence blood glucose:
    • Hyperinsulinemia: Excessive insulin leading to low glucose.
    • Hypoglycemia: Low glucose due to too much circulating insulin.
  • Glucagon is used to counteract severe low blood glucose levels.

Risk Management in Diabetes

  • Metabolic syndrome presents higher risks, including stroke and cardiovascular disease (CVD).
  • Monitoring blood glucose levels is crucial in managing diabetes. Target HbA1c should be less than 7%.

Complications from Diabetes

  • Short term: Ketoacidosis can occur due to inadequate glucose utilization.
  • Long-term: Damage to small vessels can lead to:
    • Diabetic retinopathy: eye complications.
    • Peripheral neuropathy: loss of sensation in extremities, risk of injury and slow healing.
    • Nephropathy: diabetic kidney disease.

Foot Care in Diabetics

  • Monitor feet regularly using a handheld mirror to check for injuries.
  • Regular podiatrist visits recommended; avoid soaking feet to prevent skin damage.
  • Even minor wounds can lead to significant complications due to impaired circulation.

Dietary Considerations and Management

  • Alcohol consumption lowers blood glucose; caution necessary when on insulin.
  • Encourage a healthy diet and exercise as foundational elements of treatment, particularly for Type 2 diabetes.

Conclusion

  • Adherence to Treatment: Regular glucose monitoring and adherence to prescribed medications are paramount.
  • Understanding insulin types and their administration is pivotal for effective management of diabetes.