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Multi-system Disease; Diabetes Mellitus - Coggle Diagram
Multi-system Disease; Diabetes Mellitus
Insulin Deficit ; Type 1 Diabetes Mellitus
caused by exposure to a trigger in the environment: virus or toxins
stimulates cell-mediated destruction and a process of autoimmunity that promotes destruction of the beta cells
Clinical menifestation
Polydipsia
Polyuria
Polyphagia
Diagnosis
Check fasting blood sugar and random blood glucose level
Urinalysis
Glycosylated Hemoglobin
Treatment
Glycemic control
Exercise
Insulin replacement Therapy
Insulin resistance and Reduction; Type 2 Diabetes Mellitus
Cause is unknown but most significant risk factor is obesity
Defective insulin secretion by pancreatic β-cells and The inability of insulin-sensitive tissues to respond to insulin
May present same manifestation of Type 1 diabetes
Treatment
Weight control and oral glycemic agent
Acute Complications of Diabetes
Hypoglycemia
may result from
Hyperinsulinemia, Inadequate food intake
Frequent simple carbohydrate intake
Strenuous exercise or infections
manifestation
poor concentration, extreme hunger, clammy/cool skin, blurred vision, dizziness, confusion, headache
Prevention
calculating and administering insulin dosages with regard to nutritional intake and physical activity
Treatment
administration of 15 to 20 grams of carbohydrate
Glucagon injection
Diabetic Ketoacidosis
a problem of deficient insulin and severe hyperglycemia leading to state of metabolic acidosis and severe osmotic diuresis
Lack of insulin
mobilization of fatty acids for energy
increased production of ketones
Kidney doesn't excrete ketones and ketone accumulate in the blood
may result in acidosis
severe hyperglycemia, acidosis, and dehydration
Treatment
Administer insulin, fluid, and electrolyte solutions
Hyperglycemic Hyperosmolar Nonketotic Syndrome
result from increased insulin resistance and excessive carbohydrate intake
Hyperosmolarity results in water shifting from intracellular to extracellular spaces
leading to cellular dehydration and cell death
Manifestation
Diuresis, weight loss, weakness, signs of dehydration(leg cramps, poor tissue turgor, cool extremities, and tachycardia)
Treatment
careful fluid replacement with a tonicity matched to the level of hyperosmolarity
Somogyi effect
the presence of rebound hyperglycemia as a reaction to insulin-induced hypoglycemia
Hypoglycemia is met with morning or daytime hyperglycemia
Management
Adjustments in the evening snack or insulin type or dose may be required
Dawn phenomenon
A situation in which an individuals blood glucose level upon waking is higher than the level before going to bed in the evening
Management
limiting or regulating evening snacks or possibly increasing oral glycemic agents or basal insulin doses
Chronic complications of Disbetes
Microvascular complications
nephropathy
chanes in glomerular capillaries increase the intraglomerular pressure
cause hypertension within kidney
may contribute to glomerular sclerosis, hypoxia, and ultimately chronic renal failure
The development of complications
presense of excess glucose, which binds to collagen and proteins in the blood vessel walls.
permanently alters the structure of collagen and proteins in the blood vassels walls.
hardening and thickening of capillary basement and membrane
Result in obstruction or rupture of the capillaries
Retinopathy
retinal ischemia related to obstruction and rupture of capillaries
may result in blindness
Macrovascular Complications
caused by injuring intima
involve large vessels and include coronary artery disease, cerebrovascular disease, and peripheral vascular disease
hyperglycemia, hyperlipidemia, and hypertension contribute to the development of atherosclerotic plaques
Lipids are deposited in the walls of large vessels.
Platelets adhere to the damaged endothelial cells in the intima
Large vessels becomes sclerotic and obstructed
will eventually lead to hypoxia and anoxia related to necrosis of peripheral tissues
Neuropathies
Nerve degeneration that results in delayed nerve conduction and impaired sensory function
A result of thickening, sclerosis, obstruction, and ischemia of the vessels that supply nerve fibers
Somatic nerve degeneration and Automatic nerve degeneration
Demyelinization caused by impaired metabolism.
Infections
Excess glucose in the blood provides environment for the development of infections
Tissue ischemia(microvascular and macrovascular damages)
allows ready access to pathogens
Red blood cell destruction and high levels of glycosylated hemoglobin
prevent release of oxygen to the tissues
White blood cells are impaired without adequate glucose transport
unable to engulf and remove pathogens