...Diabetes Pathophysiology * The underlying pathophysiologic defect in type 1 diabetes is an autoimmune destruction of pancreatic beta cells. Following this destruction, the individual has an absolute insulin deficiency and no longer produces insulin. Autoimmune beta cell destruction is thought to be triggered by an environmental event, such as a viral infection. Genetically determined susceptibility factors increase the risk of such autoimmune phenomena. * About 90% of diabetic Americans have type 2 diabetes. The prevalence of type 2 diabetes is higher in African Americans, Native Americans, Hispanics, and Pacific Islanders than it is in Caucasians. Most type 2 diabetes patients are overweight, and most are diagnosed as adults. The genetic influence in type 2 diabetes is greater than that seen with type 1. While concordance rates between monozygous twins for type 1 diabetes are about 30 to 50%, the rate is approximately 90% for type 2 diabetes. Although the genetic predisposition to type 2 diabetes is strong, no single genetic defect has been found. In addition to genetic influences, acquired risk factors for type 2 diabetes include obesity, advancing age, and an inactive lifestyle. CLINICAL MANIFESTATION * Type 1 Diabetes: About 5 to 10 percent of those with diabetes have type 1 diabetes. It's an autoimmune disease, meaning the body's own immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Patients with type 1 diabetes have very...
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...female reproductive organs. Costochondritis vs Angina Pectoris vs Myocardial Infarctions. Rheumatoid arthritis Gout lab findings Week 3 Fluid Balance and Edema Electrolyte imbalances of sodium, potassium, calcium, and magnesium. Intra and Extra cellular concentrations of sodium and potassium as related to osmotic balance. Know the physical signs/symptoms of electrolyte imbalances including hyper and hypo natremia, kalemia, and calcemia. SIADH lab and imaging findings Diabetes insipidus lab and imaging findings Week 4 Topic 4 Acidosis and Alkalosis Know your acid-bases! Week 5 Topic 5 Cardiovascular Causes of Fatigue Cor-pulmonale, cardiomyopathies Week 6 Topic 6 Thyroid, Adrenal, Liver Fatigue Hashimoto’s thyroiditis vs. DeQuervain vs. nodular goiter vs. secondary hypothyroidism Cirrhosis, Addison disease lab tests and hormone responsible. Is it high or low? Week 7 Topic 7 Bleeding as Indicator of Disease Pathophysiology of Disseminated Intravascular Coagulation Pathophysiology of Hemophilia Ulcers Week 8 Topic 8 Fever and Chills Beta-hemolytic streptococcus and Rheumatic fever signs/symptoms and lab findings (and Infective Endocarditis). Acute lymphocytic leukemia, Acute myelogenous leukemia, Chronic myelogenous leukemia, Hodgkin lymphoma, Burkitt lymphoma, Multiple Myeloma signs, symptoms, and lab findings Glomerulonephritis, mononucleosis Week 9 Topic 9 Respiratory...
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...Diabetes Mellitus Machelle Van N140 Instructor’s Name November 5, 2012 Diabetes Mellitus According to the Australian Institute of Health and Wellness, “Diabetes Mellitus is a chronic condition in which the body makes too little of the hormone insulin or cannot use it properly” (pg. 1, para 1). The pancreas produces insulin which helps glucose to enter cells through the bloodstream; the sugar is then converted into energy. Diabetes is uncontrollable when there is a build-up of glucose in the bloodstream, and there is not enough glucose entering the cells. If left untreated, diabetes can cause damage to the brain, kidney disease, heart disease, stroke, and complications to other parts of the body. Diabetes often appears in childhood or adolescence. Etiology The disease affects more than 20 million Americans and more than 40 million Americans have pre-diabetes that can lead to type 2 diabetes. In type 2 diabetes, the cells become resistant to the action of insulin, and the pancreas is unable to produce enough insulin to overcome the resistance. Three Major Types of Diabetes Type I Diabetes | Type 2 Diabetes | Gestational Diabetes | Diagnosed in childhood or adolescence; the disease can occur in adults. | Common than type 1 diabetes; makes up many of the disease. | Develops at any time during pregnancy. | The body cannot produce insulin. | Occurs frequently in young people, and adulthood. | Women are at a higher risk of developing type...
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...Treating Diabetes Mellitus Type II Treating Diabetes Mellitus Type II Type II diabetes (T2D) is a metabolic disorder characterized by chronically elevated blood glucose levels. It characteristically results from a surplus caloric intake, as compared to energy consumption, combined with inadequate insulin secretion, due to dysfunction of the insulin-secreting pancreatic beta cells (Pfeiffer & Klein, 2014). Type II diabetes has reached pandemic levels, despite efforts to slow its progression. In a society where healthcare is ever-changing, primary care physicians, along with advanced practitioners are now treating this disease more readily, as compared to specialist and endocrinologist in the past. As with many disease processes, there are several options when choosing a treatment plan for type II diabetes. Combining knowledge and evidence-based research, the practitioner will be able to establish an individualized treatment plan for treating type II diabetes mellitus. Pathophysiology Type II diabetes is a very complex, non-communicable disease that effects more than 370 million people throughout the world. The symptoms of this disease can vary from patient to patient. Without intense and concentrated efforts to address the pathogenesis and treatment of this syndrome, the destructive macrovascular and microvascular outcomes of type II diabetes will remain a major problem for years to come (Kahn, Cooper, & Del Prato, 2014). In T2D plasma insulin levels may be low,...
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...Some of the symptoms involves with congenital hypothyroidism are difficulty eating, hoarse cry, and protruding tongue. Skeletal growth might also be stunted caused by impaired protein synthesis, poor absorption of nutrients, and lack of bone mineralization. Pathophysiology of hypothyroidism involves the loss of thyroid function cause by the lack of production of thyroid hormone and increased release of thyroid stimulating hormone and thyrotropin-releasing hormone. The causes of primary hypothyroidism include autoimmune thyroiditis, surgical loss of the thyroid, and medications.The causes of central hypothyroidism include pituitary failure to stimulate the release of TSH and TRH and example of a reason this would happen is a pituitary tumor, brain injury, subarachnoid hemorrhage, or pituitary infarction. Some of the clinical manifestations of hypothyroidism is decrease metabolism, low basal metabolic rate, cold intolerance, lethargy, and lower basal body temperature. Other signs include myxedema. The treatment for hypothyroidism includes hormone replacement...
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...Insulin Resistance and Beta Cell Dysfunction in Type 2 Diabetes Mellitus Andrea Kingsley North Island College Insulin Resistance and Beta Cell Dysfunction in Type 2 Diabetes Mellitus Type 2 diabetes (T2D) is a disease that alters the health of individuals worldwide (Nolan, Damn, & Prentik, 2011). T2D requires a genetic predisposition, which, in combination with environmental factors and lifestyle leads to its development (McCance, 2012). Insulin resistance is a key factor responsible for the progression, which may lead to beta cell dysfunction (Schofield & Sutherland, 2012). In the pre-diabetic phase, glucose levels remain normal but once beta cell dysfunction occurs, sufficient amounts of insulin secretion decreases (Ismail-Beigi, 2012). The purpose of this paper is to relate beta cell dysfunction and insulin resistance to the development of type 2 diabetes. In this paper I discuss both the pathogenesis and risk factors of the disease. I examine how the cells of the pancreas respond to increased glucose levels and how this progresses. I also consider the treatment and prevention of the disease. Defining Diabetes Mellitus Diabetes mellitus can be defined as a disorder that results in chronic hyperglycemia (McCance, 2010). T2D is characterized by insulin resistance and elevated glucose production, (Mannino & Sesti, 2012), associated with excessive lipid accumulation in tissue (Corpeleijn et al., 2008). Etiology T2D is a result of both genetic...
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...227,000 people suffer from an acute MI (heart attack) each year (British Heart Foundation Statistics Website). To put this figure in to perspective this equates to one person every 2 minutes. Mortality is at approximately 30% which is 68,100 deaths in the UK per year. The National Service Framework (NSF) for Coronary Heart disease (CHD) is a 10-year programme published by the Department of Health in 2000 and has set key standards for the prevention and treatment of CHD. Access to the right treatment for those who suffer from an AMI, is essential to reduce morbidity and mortality and improve clinical outcomes. People with diabetes mellitus constitute a group of patients who have a higher risk of having an MI and also a poorer prognosis post infarction. The higher death and complication rates appear to be multifactorial but a significant finding in the Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) Trial showed to reduce one year mortality by 30% (Malberg et al., 1995). It’s recommended 1.1 Primary Objective To determine the relationship between HbA1c and prognosis of patients in East Lancashire having a myocardial infarction. 1.2 Secondary Objectives To assess the prognosis of patients below the glucose cut off threshold for DIGAMI treatment and whether or not this borderline category falls in to the highest risk group in terms of mortality and morbidity. To determine if there is both a clinical and analytical case to use fluoride oxalate...
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...Discuss the current knowledge of the contribution of cellular and molecular components of the immune system to the pathology of type 1 diabetes Abstract An autoimmune disease resulting in insulin deficiency, Type 1 diabetes mellitus. There have been countless studies into its causes; there is still no solid answer. Previous studies strongly implicated Th1 cells to play a key role in the progression of type 1 diabetes, however, recent studies have been showing that this is inadequate to explain the pathology of the autoimmune disease Type 1 diabetes. In fact other constituents of the immune system are accountable; Th17 cells play a huge role in the cellular pathology of Type 1 diabetes. Introduction Type 1 Diabetes mellitus is an autoimmune disease which results from faults in immune response thus activating self-destroying T cells working against beta cells that produce insulin in the pancreas, causing a deficiency in insulin. Patients of Type 1 diabetes are required to inject insulin daily. Diagnosis of type 1 diabetes can occur at any age; however it is a chronic disease that is most common in childhood (Atkins et al. 2014.) Discoveries from epidemiological studies in humans with type 1 diabetes have shown that islet cell destruction goes through a number of stages (Campbell et al. 1990) the consequent low levels of insulin lead to higher levels of blood glucose. Common symptoms of this disease are frequent urination, increased thirst and weight gain. Before symptoms become...
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...Diabetes Case Study Reflection NUR 427 February 23rd, 2015 Amy Highland Diabetes Case Study Reflection The graded assignment and feedback discussed the missed opportunity for education in consistently following Jenna’s recommended dietary changes. Her noncompliance was due to a lack of understanding of the pathophysiology of Type 2 Diabetes. As a 14 year old, Jenna displayed feelings of resentment and being singled out in her family. Familial education may have proved beneficial for Jenna and her family. Dietary education that included the whole family would have helped the entire family to gain an understanding of the disease process and the need for lifestyle changes. Jenna and her family need education on signs and symptoms of hyperglycemia. The WebMD (2015) websites list the below signs and symptoms: •High blood glucose. •High levels of sugar in the urine. •Frequent urination. •Increased thirst. Jenna and her family also need education on the signs and symptoms of hypoglycemia. The WebMD (2015) websites list the below signs and symptoms: •Confusion. •Dizziness. •Feeling shaky. •Hunger. •Headaches. •Irritability. •Pounding heart; racing pulse. •Pale skin. Describing each of the signs and symptoms and how they would be displayed by a patient would ensure that Jenna and her mother understand when medical intervention may be needed. The opportunity for Jenna to attend support groups amongst her peers would have given Jenna a platform to discuss her...
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...with numbers. There are not enough doctors and other para medical staffs to meet the growing number of patients. One way of dealing such problem is to educate the patients so that they can self mange their disease or conditions. It can only happen when they have knowledge about the disease they are suffering from.. In this essay, the client or the subject of study is a person suffering from type II diabetes. So what is diabetes education? It is all about assisting the client, their family and their care takers to gain knowledge about the disease, and empower them with skills and motivation power that will help in self management of the disease. This provides them with certain knowledge of what to do, when to do, how to do, and when to seek the help of a professional health practioner? The next question in this field which emerge is who can be an educator? Those persons who are recognized by the medical council of the respective countries are eligible for providing education to the patient. A person must seek diabetes education when he/she being diagnosed with any type of diabetes, need of monitoring blood glucose level at home, difficulty to access the facilities , insulin therapy starting, hospitalization situation comes frequently etc. There are many other...
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...that his father and paternal grandmother had developed diabetes. The other risk factor is obesity because B.Z. is 5’8” and 210lbs, which is very much over weight for his height. The pathophysiology of NIDDM, which is a non-insulin dependent diabetes mellitus and the body stops producing enough insulin for the body. The body does not have any ketones and occurs more frequently in people over the age of 30. The signs and symptoms of NIDDM are a delay in the secretion of insulin, it gets worse with age, Muscle and adipose tissue are most resistant, you will have high blood sugar levels, and the liver will initiate gluconeogenesis. The basic defect in this type of diabetes is genetics and obesity. 2. The significance of B.Z.’s report of Polydipsia and Polyuria are that the signs and symptoms are very similar to the signs and symptoms of diabetes. The 3 P’s in diabetes are polyuria, polydipsia and polyphagia. Polyuria is increased urine output. Polydipsia is increased thirst. Polyphagia is increased eating or hunger. The water is pulled intracellular causing dehydration. - The recent weight loss of B.Z. is due to the fluid in the osmolarity levels and the loss of body tissue. - Orthostatic Hypotention is an abnormal decrease in blood pressure when a person stands up. B.Z. has orthostatic hypotension because he is not getting enough blood flow to the brain. 3. Hyperosmotic hyperglycemic nonketotic coma is diabetes characterized by high blood levels of glucose but without...
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...Retired LIVING SITUATION/WITH WHOM: (home, assisted living, LTC, etc) Lives with daughter. SOCIAL HISTORY: (tobacco, ETOH, illicit drugs, family dynamics) Quit smoking many years ago, no history of ETOH or drug use. NURSING CARE PLAN ADMITTING MEDICAL DIAGNOSIS: Client's principal admitting diagnosis was leukocytosis. Definition: (from Taber’s) “An increase in the number of leukocytes (usually above 10,000/mm3) in the blood. It occurs most commonly in disease processes involving infection, inflammation, trauma, or stress, but it also can result from the use of some medications” (Venes, 2009, p. 1327). Etiology/pathophysiology: ( NOT from Taber’s or Wikipedia) Etiology: Causes of leukocytosis are infection, inflammation, tissue damage, immune reaction, bone marrow problems, medications, and stress (Drug Information Online, 2011). Pathophysiology: “Leukocytosis can be a reaction to various infectious, inflammatory, and, in certain instances, physiologic processes (eg, stress, exercise). This reaction is mediated by several molecules, which are released or regulated in response to stimulatory events that include growth or survival factors (eg, granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, c-kit ligand), adhesion molecules (eg, CD11b/CD18), and various cytokines (eg, interleukin-1, interleukin-3, interleukin-6, interleukin-8, tumor necrosis factor)” (Medscape, 2010). Common signs/symptoms: Fever, bleeding, bruising, lethargic...
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...Type 1 Diabetes Definition: Diabetes Mellitus is a metabolic disease in which the pancreas no longer produces a sufficient amount of insulin or the cells do not respond to the insulin that is being produced. This causes the glucose in the body to not be a absorbed by the cells. Type 1 Diabetes or Insulin Dependent Diabetes Mellitus (IDDM) happens when the body does not produce insulin, requiring the individual to inject insulin. Epidemiology: Type 1 Diabetes is prevalent among children and adolescents. Studies have shown that children receiving oral antibodies and insulin has increased eight times between 1998 and 2005.( Hindmarsh et al., 2009) The current global increase in incidence of 3% per year is well reported, and it is predicted that the incidence of type 1 diabetes will be 40% higher in 2010 than in 1998. (Gillespie 2006) The Search for Diabetes in Youth found that type 1 diabetes is the primarily in children 10 years and younger.(Aanstoot et al., 2007) High rates of type 1 diabetes were found in non-Hispanic white youth.(Dabelea et al., 2011) While most cases of type 1 diabetes are found in children and adolescents there is an increasing rate in older adults. Etiology: Type 1 DM is linked to a genetic component. Antibodies to the islet cell and to insulin are can be positive for several years before diabetes occurs. Non-genetic factors may also contribute. Viruse such as mumps, rubella, coxsackievirus B4 can be potential triggers for immunologic...
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...year since 1900, cardiovascular disease has been the number one cause of death in the United States. Nearly 2300 Americans die of CVD each day, and average of one death every 38 seconds. This disease kills more people than the next four causes of death combined, including cancer, chronic lower respiratory diseases, accidents and diabetes. Of particular concern is that CVD is the leading cause of death for women (Ignatavicius and Workman, 2013). Risk Factors Gender According to, Huether and McCance (2012) more women in the United States die from coronary artery disease and stroke than from all cancers combined. Women have a higher rate of CAD related mortality than men, in part because of under diagnosis and treatment. Menopause is associated with increased exposure to risk factors and poor endothelial healing. Endogenous estrogen is said to be protective of vascular function and when this is reduced after menopause hits the risk of CAD increases. Postmenopausal women are two to three times more likely than premenopausal woman to have CAD. Diabetes Diabetes mellitus is an extremely important risk factor for CAD. Insulin resistance and diabetes have multiple effects on the cardiovascular system including endothelial damage, thickening of the vessel wall, increased inflammation, increased thrombosis, glycation of vascular proteins, and decreased production of endothelial derived vasodilators such as nitric oxide (Huether and McCance, 2012). CARDIOVASCULAR PAPER ...
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...Pathophysiology for G,L ESRD: renal failure is progressive, from acute to chronic, then end stage. In ESRD, the kidneys fail to function. Once in chronic renal failure, damage to kidneys is progressive and irreversible. The nephrons are damaged, can't function and don't recover. Surviving nephrons then hypertrophy and increase their rate of filtration, reabsorption, and secretion. Compensatory excretion continues as GFR decreases. This leads to retention of water, waste products, oliguria, and even hypertension because the kidneys cannot excrete. Also due to ESRD, BUN, creatinine, are high, GFR decreases, resulting anemia, metabolic acidosis. Hypertension: progressive damage to major organs like the kidneys, brain or heart, lead to hypertension. The kidneys, through the renin-angiotensin system help control blood pressure, by releasing angiotensin II a vasoconstrictor, and aldosterone, which leads to sodium and water retention. Impairment in this system affects blood pressure. Also changes in blood vessels cause hypertension, if their force of contractility is increased due to blockage or structural changes. Diabetes mellitus: it is known as type 2 diabetes mellitus, and is as a result of relative insulin deficiency. The pancreas produces either normal or excessive amounts of insulin but the body s unable to use it effectively, so glucose levels remain elevated, thus know as insulin resistance. Also, failure of the pancreas to produce enough insulin to overcome this insulin...
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