Question

Med Surge Ch50

1. Explain the pathophysiology signs and symptoms complications diagnostic test and treatment of diabetes mellitus and hypoglycemia.
2. Explain the difference between type 1 and type 2 diabetes mellitus.

Answer 1

#. Diabetes Mellitus

A group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both .

Signs and symptoms :-

Excessive urination, excessive thirst, dry mouth, and dry skin, acetone breath (fruity smell) blurred vision and headache, rapid pulse, lower blood pressure, and loss of consciousness

#. 4 methods to confirm Diabetes

1. Fasting plasma glucose level ≥126mg/dL x 2 results

2. 2 hour Oral glucose tolerance test (OGTT) level ≥ 200mg/dL using a glucose load of 75gm

3. A1C ≥ 6.5%

4. Random/casual plasma glucose ≥ 200mg/dL + symptoms (3 P's)

#.

#. Acute Complications

-Hypoglycemia (Insulin Shock): An excess of insulin causes a deficit of glucose in the blood

-Diabetic Ketoacidosis: Results from low insulin levels, which leads to high blood glucose levels and mobilization of lipids

-Hyperosmolar hyperglycemic nonketotic coma: Due to an insulin deficit, hyperglycemia and dehydration occur

Chronic Complications

-Microangiopathy: Obstruction or rupture of capillaries and small arteries, resulting in neuropathy and loss of function

-Macroangiopathy: Obstruction of large arteries, leading to heart attacks, strokes, and peripheral vascular disease in diabetics

-Also leads to neuropathy, infections, cataracts, and complications during pregnancy

Pathophysiology :-

There are 2 stages in the pathophysiology of Diabetes:

-An insulin deficiency leads to the Initial Stage

-If the insulin deficit is severe or prolonged, Progressive Effects occur

-This results in additional consequences, which could ultimately be diabetic ketoacidosis

#. Difference :-

Type 1 Diabetes Mellitus

Condition in which impaired glucose tolerance results because of destruction of beta cells in the pancreatic islets; results in deficient insulin production, but the patients retains normal sensitivity to insulin action; also called insulin-dependent diabetes mellitus.

Type 2 Diabetes Mellitus

Diabetes in which the body produces insulin, but not enough, or there is insulin resistance (a defective use of the insulin that is produced)--the patient usually is not dependent on insulin for survival