Diabetes and diabetic pathophysiology

Diabetes

Prior to exploring the functional changes that accompany a diagnosis of diabetes, it is wise to understand what diabetes is, to explain the different types that exist, and what can cause this disease.

Diabetes is a disease of the body that occurs when one’s blood glucose (commonly called blood sugar) is elevated. As the main source of energy in our body, blood glucose is extracted from the food we eat and is used to power our brain and body throughout the day.

Insulin and Blood Glucose

When one’s blood glucose become too high, a hormone called insulin becomes affected. Insulin is made by the pancreas, a large gland located behind the stomach, and assists the glucose from food get into your body’s cells so it can be used for energy.

When one’s body does not make enough (or any) insulin, the glucose extracted from food via the digestive system begins to stay in the blood and does not reach the body’s cells. The state of having too much glucose in one’s body can cause health problems over time. This is what causes the disease of diabetes.

Different Types of Diabetes

Diagnoses of diabetes is not as simple as having one type or another. In fact, along with three main types of diabetes, one can be borderline diabetic (called prediabetes), where an individual shows signs of consistently high levels of glucose in the blood. Doctors will advise those with borderline symptoms to make changes in diet, suggest regular exercise, run blood tests, take medication, and other preventative measures.

The most common types of diabetes are Type 1, Type 2, and Gestational diabetes.

Type 1 Diabetic

In the case of Type 1 diabetes, the body does not create insulin. This causes the immune system to react, where it attacks and destroys pancreas cells in order to try and make insulin. The diagnosis of Type 1 is typically found in young adults and children; however, it can appear in any age. Those with this type of diabetes must take insulin daily in order to stay alive, as there is no cure for this disease.

Type 1 diabetes is not directly caused by poor diet, lack of exercise, or other life decisions, but is a disease that one can get due to existing biological disfunction of the pancreas and resulting lack of insulin.

Type 2 Diabetic

Type 2 diabetes is the most common form of diabetes and is found most often in middle-age and older individuals. In this type, the body does not use insulin well or does not create insulin. This form of the disease can be a result of poor diet, high sugar consumption, existing high blood pressure, lack of exercise, and other life choices, but this is not always the case. Some cases are a result of age, family history, and even race, where hereditary factors may come into play.

Those with Type 2 diabetes also take insulin to elevate their levels, whether their body does not make any insulin, or makes very little on its own. This type of the disease comes on gradually and can take years to develop and for symptoms to appear.

Gestational Diabetes

Gestational diabetes is a specific form of the disease that develops in some women when they are pregnant. In most cases, gestational diabetes goes away on its own after giving birth. However, those who have had gestational diabetes does have a greater risk of developing Type 2 diabetes later in life.

The Importance of the Pancreas

The pancreas is a large gland located behind the stomach, and its job is to secrete digestive enzymes into what is called the duodenum — the first portion of the small intestine just beyond the stomach.

The role of the pancreas in the body is important, as it is the control centre for collecting glucose from food and secreting it into the blood in the form of the hormones insulin and glucagon. When the body is affected by diabetes, the pancreas’ beta cells produce little or no insulin.

In Type 1 diabetes, the body’s immune system attacks the beta cells that produce the needed insulin, the pancreas struggles to produce enough to keep one’s blood sugar levels down. This is when the symptoms of diabetes begin to appear.

In Type 2 diabetes, the body begins to build up a resistance to insulin and therefore more insulin is needed to bring down one’s glucose levels. Since the pancreas cannot produce more insulin, synthetic insulin may be needed to compensate.

Other Ways the Body is Affected

As a gland, the pancreas is crucial to two different organ systems: the endocrine and exocrine systems. The endocrine system includes all of the body’s organs that create hormones, which are sent through the bloodstream to regulate metabolism, mood, and growth. The exocrine system is made up of many glands that release substances like saliva, and in the case of the pancreas, digestive enzymes.

The cells inside of the pancreas are called the Islets of Langerhans, which sense glucose in the blood and produce the correct amount of insulin to normalize the blood sugar (glucose levels) for one’s body. When the pancreas is attacked by the body’s immune system as it does in diabetes, these cells no longer function as they should.

Other organs and the health of the body can become affected due to the nature of the illness. This is mainly because of the high blood glucose levels that lead to various problems throughout the body.

Over time, high blood sugar can lead to problems such as:

  • Stroke
  • Heart disease and failure
  • Kidney disease and failure
  • Dental diseases such as gum disease
  • Eye problems such as blindness
  • Nerve damage through the body, especially the legs and feet
  • Foot problems such as amputations

Diabetic Pathophysiology

The functional or physiological changes that accompany diabetes and any other abnormal state such as disease is called pathophysiology.

The signs and symptoms of diabetes disseminated in a more medical vernacular include some of the more classic symptoms an individual may display when they are Type 1 Diabetic:

  • Fatigue
  • Nausea
  • Blurred vision
  • Polydipsia (abnormally severe thirst)
  • Polyuria (abnormal production of large volumes of diluted urine)
  • Polyphagia (excessive hunger and large intake of food)
  • Unexplained weight loss
  • Diabetic ketoacidosis

The onset of a patient’s symptomatic disease may be sudden in Type 1 while more gradual in Type 2. For sudden onset of diabetes Type 1, it is not unusual for individuals to present with diabetic ketoacidosis (DKA).

Conclusion

While there may not be a medical cure for the disease, there are treatments that can control and maintain blood glucose levels (via insulin therapy); maintain a medication regimen, create an exercise and nutrition plan; and in advanced cases, patients may be able to receive pancreas, kidney, and islet cell transplants.

Online Care Courses offer a number of person centric care training courses for health care professionals.  These include;

Diabetic Care Training

Disability Awareness Training

Elderly Care Training

Stroke Awareness Training

Patient Handling

Other resources;

QCF Level 7 Care Management Training

NHS

 

 

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