Question

1. Discuss the pathophysiology of type one and type two diabetes. Develop a nutritional education plan for either a type one or type two diabetic. Include in your plan the nutritional considerations for one oral medication and one type of insulin used in the treatment of the disorder.

Answer 1

Diabetes mellitus refers to a group of metabolic syndrome characterized by elevated blood glucose levels. It is a chronic disease if left untreated results in serious damage to the vital organs heart,kidneys,retina and the nervous system.

Diabetes commonly results from disurption in uptake of glucose into the cells and tissues. Glucose is the common source of energy. Insulin a hormone secreted from pancreatic cells that helps in uptake of glucose into the cells and tissues.

Diabetes is classified into Type 1 diabetes, Type 2 diabetes, Gestational diabetes.

TYPE 1 Diabetes:

- Etiology is unknown. It is also termed as Insulin dependent diabetes/ Juvenile diabetes . Research studies found the selfdestruction of pancreas results in type 1 diabetes. The risk factors includes people of young age, family history of diabetes.

Pathophysiology: Type 1 Diabetes :

Etiological factors ( Family history of diabetes, Environmental influences)

   Recognizing pancreatic cells as foreign bodies by the immune system

  Formation of autoantigens on the betacells of pancreas

   Circulation of the autoantigens inthe blood and lymphatic system

   Results in activation of T lymphocytes

   Inflammatory reactions activated by the release of macrophages, and cytotoxic cells, B lymphocytes

   Destruction of beta cells of the pancreatic Langerhans

   Results in deficiency in insulin production

   Type 1 diabetes.

Type 2 Diabetes :

- It often refers to non insulin dependent diabetes, its a genetic disorder caused by defect in DNA. Obesity, liver disorders are the common causes contributing to Type 2 diabetes. The riskfactors includes age group above 40 years,family history of diabetes, heart diseases,poor dietary control,intake of excess of carbohydrates and triglycerides.

Pathophysiology: Type 2 Diabetes

Etiology factors ( obesity, poor life style, genetic predisposition, alcohol consumption,excess consumption of carbohydrates and triglycerides)

Inflammation of beta cells of pancreas

Dysfunction of beta cells of pancreas

Lack of insulin production results in excess circulation of glucose in the blood.

Hyperglycemia

Once left untreated results in microvascular complications(Retinopathy,Neuropathy, Nephropathy) and macrovascular complications ( Coronary artery disease,stroke and Peripheral arterial disease )

ORAL HYPOGLYCEMIC AGENTS:

- Drugs that used to reduce blood glucose levels.

- Biguanides a common class of drugs used for majority of patients. It acts on liver and reduces the hepatic glucose production, and also increases the insulin cell sensitivity. Examples : Metformin. Metformin acts by improving the insulin sensitivity and thereby decreases the higher blood glucose levels.