Diabetes Mellitus Notes PDF

gelisimed igugelisi u m  Mehmet Köroğlu MD. Internal Medicine igugelisim gelisimedu Definitions Endocrinology- the study of hormone and glandular abnormalities- diabetes, thyroid problems, and circus performers Hormones-bi...

gelisimed igugelisi u m  Mehmet Köroğlu MD. Internal Medicine igugelisim gelisimedu Definitions Endocrinology- the study of hormone and glandular abnormalities- diabetes, thyroid problems, and circus performers Hormones-biologically active substances secreted by glands. Endocrine- hormones that have a biological effect far away. Paracrine- hormones that have a biological effect nearby. Autocrine- hormones that have a local effect Hormone Classification Proteins-thyroid stimulating hormone, insulin, parathyroid hormone Amino acids-thyroid hormone, epinephrine Steroids-cortisol, aldosterone, testosterone Mechanism of Action of Hormones Circulate in blood stream bound to transporter proteins or free Free hormone is the active hormone Enter cells to alter biological activity Endocrine Hypofunction Congenital defects in hormone biosynthesis Autoimmune destruction of glands Surgery or trauma to glands Infiltration by tumors, infection  Coordination of Body Functions 1) nervous system (neurotransmitters into the synaptic junctions – locally) 2) endocrine system (hormones into blood) 3) neuroendocrine (neurohormones into blood) 4) paracrines (secreted into extracellular fluid and affect neighboring different target cells) 5) autocrines (affect same cells) 6) cytokines (peptides - 5,4 or 2 - interleukins, lymphokines, adipokines (leptin)) When blood sugar is high, body cells must be stimulated to take up sugar. This is accomplished by___ communication. 25% 25% 25% 25% 1. Direct. 2. Synaptic. 3. Paracrine. 4. Endocrine. 1 2 3 4 Hormone Functions Growth and development: Thyroid, GH, Sex Steroids, Cortisol Reproduction: Estrogen, Testosterone, FSH, LH, Thyroid Homeostasis: Thyroid, Cortisol, Insulin Changes in environment: Cortisol, Thyroid Aldosterone Endocrine Hormones Gland Hormones Functions Thyroid Thyroxine Regulates metabolism Calcitonin Inhibits release of calcium from the bones Parathyroids Parathyroid hormone Stimulates the release of calcium from the bones. Islet cells (in Insulin Decreases blood sugar by promoting uptake of glucose by cells. the pancreas) Glucagon Increases blood sugar by stimulating breakdown of glycogen in the liver. Testes Testosterone Regulates sperm cell production and secondary sex characteristics. Ovaries Estrogen Stimulates egg maturation, controls secondary sex characteristics. Progesterone Prepares the uterus to receive a fertilized egg. Adrenal cortex Epinephrine Stimulates “fight or flight” response. Adrenal Glucocorticoids Part of stress response, increase blood glucose levels and decrease medulla immune response. Aldosterone Regulates sodium content in the blood. Testosterone (in both Adult body form (greater muscle mass), libido. sexes) Pineal gland Melatonin Sleep cycles, reproductive cycles in many mammals. Homeostasis and Hormones Examples: Thyroid and temperature control Thyroid, Parathyroid, and calcium Pancreas and glucose control  W Knowing that: O Insulin from the pancreas lowers blood glucose by R stimulating body cells to take up glucose. K Glucagon from the pancreas increases blood sugar by stimulating the liver to break down glycogen into glucose. T Sketch a negative feedback loop that controls O blood sugar. G E T H E R Pancreas Combination Organ Exocrine tissues called acini secrete digestive enzymes into the small intestine. Endocrine tissues secrete hormones. Glycogenolysis. Gluconeogenesis. Pancreas Disorders of the Pancreas Diabetes Mellitus Glucose Metabolism Metabolism Anabolism & catabolism Disorders of the Pancreas Insulin is required for glucose metabolism Presence of enough insulin to meet cellular needs. Ability to bind in a manner to stimulate the cells adequately. When unable to obtain energy from glucose, the body begins to use fatty stores. Ketones and ketosis. Regulation of Blood Glucose Hypoglycemia and hyperglycemia Role of pancreas, liver, and kidneys Osmotic diuresis and glycosuria Blood Sugar Control Diabetes Mellitus Type I Diabetes Mellitus Also called juvenile or insulin-dependent diabetes mellitus (IDDM). Characterized by low production of insulin. Closely related to heredity. Results in pronounced hyperglycemia. Symptoms of untreated Type I DM include polydipsia, polyuria, polyphagia, weight loss, and weakness. Untreated or noncompliant patients may progress to ketosis and diabetic ketoacidosis. Diabetes Mellitus Type II Diabetes Mellitus Also called adult-onset or non-insulin-dependent diabetes mellitus (NIDDM). Results from decreased binding of insulin to cells. Related to heredity and obesity. Accounts for 90% of all diagnosed diabetes patients. Less risk of fat-based metabolism. Results in less-pronounced hyperglycemia. Hyperglycemic hyperosmolar nonketotic acidosis. Managed with dietary changes and oral drugs to stimulate insulin production and increase receptor effectiveness. Diabetic Emergencies Conclusions Hormones are essential for normal growth, development, metabolism, energy, reproduction etc. Hormones are tightly regulated by multiple systems Both over and underproduction of hormones leads to clinical disease