diabetes 1

Overview of Diabetes

• Diabetes: A growing problem in both developed and developing countries; associated with long-term health care issues.

• Two forms of diabetes:

  • Type 1 Diabetes: Results from destruction of beta cells in the pancreas, leading to decreased insulin production.

  • Type 2 Diabetes: Characterized by insulin resistance and is often associated with obesity.

Regulation of Glucose

• Blood Glucose Regulation: Essential for maintaining energy levels in cells.

  • Glucose must enter cells to provide energy.

  • Insulin: A hormone secreted by the pancreas that enables glucose entry into cells.

  • Insulin functions as a key, allowing glucose to pass through the cell membrane.

• Role of Insulin:

  • Insulin secretion is triggered by blood glucose levels.

  • Even in healthy individuals, insulin is always present at some level to facilitate glucose uptake.

Consequences of Ineffective Glucose Regulation

• If insulin is too low, glucose cannot enter cells, resulting in:

  • Increased hunger as the body attempts to raise glucose levels by stimulating appetite.

  • Symptoms of high blood glucose (hyperglycemia).

• Type 1 Diabetes Symptoms:

  • Fasting hyperglycemia due to unchecked glucose production by the liver.

  • Potential for ketoacidosis if blood glucose remains excessively high.

Hemoglobin A1c (HbA1c) Test

• HbA1c: Indicates average blood glucose levels over the previous three months.

  • Used for monitoring compliance with diabetes treatment regimens.

• Interpretation of values:

  • Less than 7%: Normal control of blood glucose levels.

  • Over 6%: Prediabetes.

  • 8% or greater: Indicates inadequate control of blood glucose.

Hypoglycemia

• Occurs when blood glucose levels fall too low (e.g., below 70 mg/dL).

• Symptoms of Hypoglycemia:

  • Adrenergic symptoms: Anxiety, confusion, sweating.

  • CNS symptoms: Dizziness or impaired consciousness.

• Management of Hypoglycemia:

  • If asymptomatic, recheck blood glucose levels.

  • Provide fast-acting carbohydrates; follow with protein and starch.

  • Use the 15-15 rule: 15 grams of carbs, wait 15 minutes, recheck.

Diabetic Ketoacidosis (DKA)

• Primarily affects Type 1 diabetes, but can also occur in Type 2.

• Causes:

  • Insufficient insulin, increased insulin requirement (e.g., illness).

• Pathophysiology:

  • Ineffective glucose metabolism leads to the breakdown of proteins and fats.

  • Results in the production of ketones, increased blood glucose levels, acidosis, and dehydration.

• Symptoms:

  • Classic signs: Polyuria, polydipsia, polyphagia, and weight loss.

Importance of Monitoring and Treatment

• Regular monitoring of blood sugar levels is crucial, especially during illness or stress.

• Education: Patients should be informed of how stress and illness can affect insulin needs and glucose levels.

• Long-term Management:

  • With proper support and monitoring, many patients can manage diabetes effectively and avoid complications.