NURS 311: Patho Type I Diabetes Video

Diabetes Mellitus Overview

  • Diabetes Mellitus is described as a group of disorders caused by the improper function of insulin.
  • Insulin is a hormone produced by the pancreas responsible for regulating blood sugar (blood glucose) levels.
  • The dysfunction of insulin leads to conditions known as Hyperglycemia (high blood sugar).
  • There are various underlying pathophysiological mechanisms that can cause diabetes, leading to different presentations of the disease.

Pancreas Anatomy and Functions

  • The pancreas is anatomically located behind the stomach and nestled next to the small intestine.
  • Common description of the pancreas: comma-shaped. An analogy to the Minnesota Vikings helmet is suggested for visual recall.

Functions of the Pancreas

  • The pancreas performs two main functions: Exocrine and Endocrine.
      - Exocrine Function:
        - Secretes enzymes into the digestive tract.
        - Aids in chemically digesting food and nutrient absorption.
      - Endocrine Function:
        - Produces hormones that help regulate metabolism.
        - Insulin, produced by the pancreas, plays a critical role in the regulation of blood glucose levels.

Diabetes Types

Type 1 Diabetes

  • Type 1 Diabetes occurs when specific areas of the endocrine part of the pancreas are destroyed.
  • Result: The pancreas is unable to produce insulin.
  • Prevalence: About three out of every 1,000 people in the United States are affected.
Islets of Langerhans
  • The endocrine cells of the pancreas are located in the Islets of Langerhans.
      - Cell Types in Islets:
        - Alpha Cells (blue): Secrete glucagon.
        - Beta Cells (green): Secrete insulin.
  • Both hormones (insulin and glucagon) are essential for regulating metabolism and specifically blood glucose levels.
Mechanism of Blood Sugar Regulation
  1. Post-meal Scenario:
       - After eating, blood sugar levels rise.
       - Beta cells in the pancreas sense this rise and secrete insulin.
       - Insulin facilitates the absorption of glucose by cells for energy or storage in the liver, lowering blood glucose levels.
  2. Glucagon Response:
       - If blood sugar levels drop too low, alpha cells secrete glucagon.
       - Glucagon raises blood glucose levels by stimulating the liver to release glucose.
Implications of Type 1 Diabetes
  • In Type 1 Diabetes:
      - Destruction of beta cells results in an inability to produce insulin, leading to hypoglycemic failure and hyperglycemia.

Autoimmune Nature of Type 1 Diabetes

  • Underlying Cause: Type 1 Diabetes is classified as an autoimmune disease.
      - Genetic predisposition is involved, meaning individuals are more likely to develop Type 1 Diabetes due to their genes, although symptoms may not appear at birth.
      - Environmental triggers (potentially a virus, toxin, etc.) lead to autoimmune responses that attack the beta cells.
  • Outcome: Destruction of beta cells prevents insulin production, resulting in elevated blood sugar levels (hyperglycemia).

Symptoms and Diagnosis of Type 1 Diabetes

Symptoms of Type 1 Diabetes

  1. Starvation in the Face of Plenty:
       - The body experiences starvation despite high blood glucose levels, resulting in lethargy and fatigue.
       - The insulin absence prevents glucose from entering cells, hindering energy production.
  2. Effects on Kidneys:
       - High blood glucose levels overwhelm kidney reabsorption capacity, leading to glucose excretion in urine (glucosuria).
       - Glucosuria draws water from the body due to its osmotically active nature, resulting in polyuria (excessive urination) and dehydration.
  3. Thirst Response:
       - Due to dehydration, individuals often experience intense thirst.
  4. Potential for Diabetic Ketoacidosis (DKA):
       - Stress or illness in undiagnosed individuals can trigger DKA, characterized by severe dehydration and acidosis.
       - Diagnosis Stage Statistics:
         - Approximately 70% of individuals with Type 1 Diabetes are diagnosed before severe complications arise.
         - About 30% present with DKA as their initial symptom.

Conclusion

  • Type 1 Diabetes is an autoimmune disturbance leading to the destruction of pancreatic beta cells.
  • The result is an inability to produce insulin, leading to unregulated high blood sugar levels and subsequent symptoms.