Katie and Natalie - Diabetes mellitus is characterized as a...

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Diabetes mellitus is characterized as a disease of insulin availability that eventually results in high blood glucose concentrations” (Abram’s, pg. 714). Insulin is a storage hormone and is secreted by beta cells in the pancreas. When a person eats a meal, insulin secretion increases and moves glucose from the blood into muscle, liver, and fat cells. “The main functions of insulin are transportation and metabolization of glucose for energy, stimulation of glucose storage in the liver and muscle, signaling the liver to inhibit the release of glucose, enhancing the storage of dietary fat in the adipose tissue, and accelerating transport of amino acids into cells” (Abrams, p. 715). During fasting periods, insulin works together with glucagon to maintain a constant level of glucose in the blood, stimulating the release of glucose from the liver. Glucagon is secreted by alpha cells in the pancreas and is released when blood glucose levels decrease, which stimulates the liver to release stored glucose. The liver produces glucose through the breakdown of glycogen through a process called glycogenolysis. “After 8-12 hours without food, the liver forms glucose from the breakdown of noncarbohydrate substances, including amino acids (also known as glucogeogensis) (Brunner, pg. 1198). Normal fasting glucose levels are 60-100 mg/dL, but in order to be considered diabetic your levels must be 126 mg/dL or greater” (Wilson, 289). There are two main forms of diabetes, type I and type II. Type I diabetes is characterized by the absolute lack of insulin due to autoimmune destruction of beta cells. “Type I affects 5-10% of people, with the cause being unknown. Glucose cannot be stored in the liver but instead, remains in the blood stream and contributes hyperglycemia. When there is too much glucose in the blood, the kidneys are not able to absorb all of it, resulting in the appearance of glucose in the urine (glycosuria). When excess glucose is excreted in the urine, it is accompanied by excessive loss of fluids and electrolytes. This is called osmotic diuresis. Due to the absence of insulin, it cannot inhibit the breakdown of stored glucose and the production of new glucose; contributing in further hyperglycemia. Fat breakdown occurs, resulting in an increased production of ketones, which are byproducts of fat breakdown. Type I diabetes is most commonly seen in children and young adults.
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