DM Lecture 2

  • Importance of Flow of Actions

    • Each action within the body contributes to the overall metabolic processes.

    • Imaginary line drawn through a diagram can help visualize the process, separating different diabetic conditions.

  • Type 1 Diabetes

    • Characterized by insufficient insulin production.

    • Glucose enters the mitochondria to be used for energy when insulin is present.

    • Excess blood glucose leads to storage as glycogen in the liver, and further complications arise like high blood sugar and ketoacidosis.

  • Type 2 Diabetes

    • Insulin is present but not effectively utilized.

    • Results in excessive blood glucose which can trigger glucagon release leading to lipolysis (breakdown of fat) and increased ketone production.

    • Risk of Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS).

  • Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)

    • Characterized by high blood sugar and concentrated (hyperosmolar) blood.

    • "Syrup-like" blood consistency due to high glucose levels.

    • Absence of ketones in this condition.

  • Diabetic Ketoacidosis (DKA)

    • Involves elevated blood sugar levels and the presence of ketones in the blood.

    • Commonly seen in Type 1 diabetics, especially during stress or emergencies.

  • Hypoglycemia Causes

    • Over-supplying insulin without adequate glucose intake leads to low blood sugar.

    • Physical activity can increase metabolic rate and lead to hypoglycemia if not balanced with insulin.

    • Skipping meals further compounds the risk of hypoglycemia.

  • Example Scenario

    • Patient receives rapid-acting insulin but refuses to eat breakfast.

    • Likelihood of developing hypoglycemia due to excess insulin.

  • Signs of Hypoglycemia

    • Symptoms include:

      • Cold and clammy skin ("cool and clammy, needs some candy").

      • Paleness, irritability, hunger.

    • Neurological Symptoms:

      • Brain requires glucose to function.

      • Symptoms like irritability, lethargy, confusion indicate low brain glucose.

      • Physical manifestations: shakiness, slurred speech, confusion.

    • Brain cannot utilize fat or protein for energy, emphasizing the need for sugar.

  • Assessment and Management of Hypoglycemia

    • Important to recognize symptoms for prompt treatment.

    • Utilization of mnemonic aids in assessment can help recall critical signs and symptoms.