Type 1 Diabetes- (aka Juvenile diabetes mellitus insulin- dependent diabetes mellitus) * Causes by destruction of the beta cells in the islets of Langerhans of the pancreas. When the beta cells are destroyed they are no longer able to produce insulin. Insulin must then be injected so the body can use food for energy. * Only 5-10% of people with diabetes have type 1 diabetes. * It is thought to be caused by vital infections or an autoimmune response. * 90% of pts dx w/ type 1 diabetes have islet cell antibodies in their blood. * The pt w/ type 1 diabetes is most often young and thin and prone to developing ketoacidosis when blood glucose is elevated. * Latent Autoimmune Diabetes of Adulthood
* Is a variation of type 1 diabetes – some pts w/ type 2 diabetes were later found to have cell and insulin antibodies and their blood glucose is not controlled with oral medications Type 2 Diabetes Mellitus
* Tissues are resistant to insulin
* Insulin is still produced by the pancreas but not in inadequate amounts * Sometimes the amount of insulin is normal or even high but bc the tissues are resistant to it, hyperglycemia results * As the disease progresses the pancreas eventually wears out and insulin production decreases. * Heredity -90% cause of type 2 diabetes
* Obesity is a major factor
* Pt with a family hx of type 2 diabetes and have a recent stressors such as the death of a family member, illness, or loss of a job can bring on the disease Chart on pg. 916
Type 1 vs. Type 2
Age at onsetusually younger than 40usually older than 40 Risk FactorsVirus, autoimmune response, heredityHeredity, obesity Usual body type LeanObese
High blood glucose complication KetoacidosisHyperosmolar hyperglycemia; may develop ketoacidosis Treatment Diet, exercise, must have insulin to surviveDiet, exercise; may need oral hypoglycemic or insulin to control blood glucose level
Signs and symptoms
3 P’s of Diabetes
Polydipsia (excessive thirst)
Polyuria (excessive urination)
Polyphagia (excessive hunger)
Large amounts of glucose in the blood causes an increase in serum concentration or osmolality. The renal tubules are unable to reabsorb all the excess glucose that is filtered by the glomeruli and glycosuria results. Large amounts of body water are required to excrete this glucose causing polyuria, nocturia and dehydration. The increased osmolality and dehydration causes polydipsia. Because glucose is unable to enter the cells, the cells starve, causing hunger. High blood glucose may also cause fatigue, blurred vision, abdominal pain, and headaches. Ketones may build up in the blood and urine of patients with type 1 diabetes or late in the course of type 2 diabetes (ketoacidosis).
The only cure is diabetes is a pancreas transplant.
Treatment begins with diet and exercise. Insulin is added in pts w. type 1 diabetes and insulin and oral hypoglycemic medication as needed in those with type 2 diabetes. Blood glucose monitoring and education are needed. * See box 40.2 on pg. 919
* See box 40.6 on pg. 927 for a general summary of diabetes, I explained it in depth. This box shows the basic knowledge of diabetes.