Pathophysiology of Diabetes Mellitus Essay Assignment Paper
Pathophysiology of Diabetes Mellitus Essay Assignment Paper
Huether and McCance (2017), describe diabetes mellitus as a “group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both” (p. 471) and classifies DM into four categories. Three of the four categories include type 1, type 2, and gestational. DM is diagnosed from one of the several tests performed on two separate occasions including glycosylated hemoglobin (HbA1c), fasting plasma glucose, 2-hour plasma glucose levels during oral glucose tolerance testing, or by random glucose levels in an individual with symptoms (Huether, & McCance, 2017, p. 471).
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Diabetes mellitus is a heterogeneous disorder characterized by the presence of hyperglycemia and is a result of insulin dysfunction of the endocrine pancreas (Hammer, & McPhee, 2014). Insulin is important in DM, as its function is to transport glucose into cells where it becomes energy in the form of glycogen (Huether, & McCance, 2017). Insulin also partakes in fat storage and protein synthesis (Huether, & McCance, 2017).). Insulin also partakes in fat storage and protein synthesis (Huether, & McCance, 2017).
When describing the pathophysiology of DM, one must understand that the pancreas has four types of islet cells from the islets of Langerhans, each secreting a different product. Insulin comes from the Insulin-secreting β cells, and glucagon is secreted from glucagon-secreting α cells, and glucagon acts to increase blood glucose levels (Hammer, & McPhee, 2014). Knowledge about the islet cells of the pancreas is important because the different types of DM have distinctive alterations involving the pancreas.
DM type1 can either be idiopathic or caused by a progressive autoimmune T-cell-mediated disease. In autoimmune DM the beta cells of the pancreas are destroyed from lymphocyte and macrophage infiltration as an inflammatory response occurs, resulting in the decline of insulin synthesis.NURS 6501 WeeK 9 : Diabetes Essay Hyperglycemia develops due to the reduction of insulin synthesis (Huether, & McCance, 2017). Conversely, in DM type II adipokines, an increase in free fatty acids, inflammatory cytokines, decreased activity of ghrelin, results in insulin resistance. Insulin resistance increases the demand for insulin and causes hyperinsulinemia, or the tissue effect without hyperglycemia (Huether, & McCance, 2017). Insulin resistance and the increased demand for insulin synthesis, as well as the diminished activity of amylin, lead to a decrease in beta-cell mass and function causing hypoinsulinemia (Huether, & McCance, 2017). Dm type II is associated with inadequate insulin production, insulin resistance, and chronic hyperglycemia.
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