Insulin and Diabetes Mellitus Overview

Insulin and Diabetes Mellitus

• Insulin: A polypeptide hormone, crucial for regulating blood glucose levels.
• Organs Not Secreting Hormones: Stomach
• Blood Sugar Control:
  • Liver stores glucose as glycogen
  • Beta cells of the pancreas secrete insulin, not glucagon
  • Rising blood glucose increases insulin, not glucagon secretion
  • Liver breaks down glycogen and releases glucose
  • Muscle stores glucose
• Fast-Acting Insulin: Regular insulin

Insulin Effects

• Insulin Effects:
  • Decreases catabolism
  • Increases adipose tissue
  • Promotes growth
  • Decreases gluconeogenesis (glucose production)
  • Increases DNA transcription

Diabetes Pathophysiology

• Underlying Defects in Diabetes:
  • Peripheral insulin resistance
  • Increased glucose production by the liver
  • Beta cell disorders in the pancreas
  • Insulin receptor defects
• Not a Pathophysiologic Defect: Glut-2 defect in intestinal cells

Diabetic Symptoms and Complications

• Hypoglycemia Symptoms: Headache, sweating, confusion, dizziness, vomiting
• Polydipsia: Excessive thirst, a common symptom of diabetes
• Non-Modifiable Risk Factor: Diabetic parent
• Clinical Presentation of Diabetes: Can be asymptomatic, can present with weight loss, polydipsia, palpitations, fatigue.
• Type 1 DM Treatment: Education, insulin (e.g., glargine), glycemic control monitoring, prevention/early detection of complications
• Type 1 DM Characteristics:
  • Mostly occurs in childhood
  • Usually not obese
  • Oral antidiabetic drugs can not be used
  • Partly inherited
  • False: Oral antidiabetic drugs can be used
  • Absent in Type 1 DM, usually present in Type 2: Diabetic ketoacidosis, Obesity, high genetic concordance, Immunologic reactions
• Diabetic Ketoacidosis (DKA) Indicators: Increased respiration, decreased pH, decreased bicarbonate, increased plasma pH, elevated blood glucose level, decreased urine output,
• Type 2 DM Reasons: Defects in insulin secretion, decreased cellular response to insulin, and defects in insulin production ( all correct)
• Diagnosis based on Fasting Blood Glucose and HbA1c:
  • Fasting blood glucose 127-128 mg/dL, HbA1c 5.8: Prediabetes
  • Fasting blood glucose 127-128 mg/dL, HbA1c 6.2: Type 2 diabetes
• Hypoglycemia Causes: Change in insulin dose, missed meals, strenuous exercise, anorexia/reduced food intake
• DKA Treatment Elements: Volume repletion, insulin therapy, metabolic corrections, treating underlying diseases
• Hyperosmolar Coma: Plasma osmolarity >350 mOsm/L, life threatening, neurologic deficits, ketone production often absent

Complications and Treatment of Diabetes

• Microvascular Complication of Diabetes: Nephropathy
• Insulin Therapy Use; Not a Therapy: Hyperosmolar coma
• Gestational Diabetes Screening: 50-gram glucose screening test
  • 75-gram glucose screening test
  • Fasting blood glucose and HbA1c
• Effects of Diabetes on Pregnancy: Abortion, pre-eclampsia, polyhydramnios, infection
• Modifiable Risk Factors: Hypertension, high triglycerides, polycystic ovary syndrome, obesity
• Insulin Therapy Adverse Effects: Lipodystrophy, insulin antibodies, Dawn phenomenon, Somogyi effect, Diabetic Ketoacidosis

This quiz covers the essential aspects of insulin and its role in diabetes mellitus. It discusses insulin secretion, effects, and the underlying defects associated with diabetes. Test your knowledge on blood sugar control mechanisms and the pathophysiology of diabetes.