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Onset and type 2 non insulin dependent mature onset

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Unformatted text preview: ith potassium loss – aspirin less effective • Withdrawal • Any stress including surgery Objective 5: • Identify symptoms of insulin deficiency and distinguish between type 1 (insulin dependent, juvenile onset) and type 2 (non-insulin dependent, mature onset) diabetes. Effects of insulin • increases glucose into cells – and therefore synthesis of glycogen • increases amino acids into cells – and increases synthesis of protein • increases fatty acids into cells – and increases synthesis of fat Insulin deficiency results in • Hyperglycemia • Polyuria, thirst, dehydration • Ketoacidosis, fruity breath, hunger – coma can result from either or both dehydration and acidosis • vascular damage (eye, extremities, heart) – Hyperglycemia directly affects endothelium – Impaired fat metabolism affects atherosclerosis Diabletes is a disorder of fat metabolism as much as it is of glucose metabolism Microaneurysms Retinopathy Neuropathy Diabetes Mellitus • 11 million diabetics diagnosed in U.S. – probably 17 million really have the disease or 6.2% of population – 6th leading cause of death in America counting only the 200,000/yr that list it as a cause on the death certificate. • Two Main types of diabetes include: – Type I with marked insulin deficiency – Type II with some capacity for insulin production Type I "Juvenile onset“ Insulin Dependent Diabetes Mellitus (IDDM) • 10-15% of diabetics • Failure of Beta cells (insulin production) • evidenced by age 20. Type II "Maturity onset“ Non-Insulin Dependent Diabetes Mellitus (NIDDM) • Symptoms usually obvious after age 40 • Insulin secretion less responsive to increasing blood glucose • Or lack of response in insulin receptors Early cases are NIDDM Later, may become insulin dependent Metabolic Syndrome or “Syndrome X” • • • • • Abdominal obesity High BP (130/85 mmHg) High blood glucose (110-126mg%) High triglycerides (over 150 mg/dl) Low HDL (Below 40mg/dl—50 in females) Up to ¼ of US Population has this syndrome Objective 6: • Identify the role of insulin injections, oral hypoglycemic agents, and dietary control and exercise in alleviating symptoms of both type 1 and type 2 diabetes. Insulin dependent: Type I • 15% of diabetics • requires insulin injections • various forms available: – short acting (onset 1/2 hour, duration 6-8) – to intermediate acting (onset 1 hour, duration 24 hours) – to long acting (onset 4 hours, duration 36 hours) • Absorption slowed by combining insulin with a large protein such as protamine (NPH insulin) or combining insulin with zinc (lente) or both. • Note: Amount of insulin given must be carefully matched to each individual, their activity level, and their diet. Non-insulin depen...
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