1. Diabetes mellitus

NUR 325 Week 10

• Diabetes mellitus

Answer

• Diabetes affect multiple systems in the body

• Diabetes involves

• Abnormal insulin production (no insulin or very low insulin) and/or

• Abnormal insulin utilization

Answer insulin not being used (insulin resistance)

• Most common types of diabetes are type 1 and type 2

• Diabetes social and environmental factors

Answer

• Income

lower SES

• Education

decreased access to education

• Employment & working conditions

• Food security

poor access to healthy foods

• Neighbourhood 1 / 3

poorer neighbourhoods

• Insulin

Answer

• Insulin is a hormone produced by the ²cells in the islets of Langerhans of the pancreas

• We need insulin to carry glucose from the blood vessels and into the cells for use
• Insulin is usually released continuously into the blood stream in small increments, but is

increasingly released when there's a rise in blood glucose when we take in energy for food

• The activity of released insulin lowers blood glucose and facilitates a stable, normal glucose

range of 4-6 mmol/L

• Glucagon vs. insulin

Answer

• Glucagon secreted by the alpha cells of the pancreas

• Insulin secreted by beta cells of the pancreas

• Feedback mechanism between glucose and insulin

Answer

• Increased blood glu- cose stimulates increased insulin secretion from the pancreas

• As blood glucose levels decline, insulin secretion decreases

• Rise and fall in insulin

Answer

• The rise in insulin after a meal stimulates storage of glucose as glycogen in liver and muscle,

inhibits gluconeogenesis, enhances fat deposition in adipose tissue and increases protein synthesis

• The fall in insulin level during normal overnight fasting facilitates the release of stored

glucose from the liver, protein from muscle, and fat from adipose tissue

• Counter-regulatory hormones 2 / 3

Answer

• Glucagon, epinephrine, growth hormone & cortisol

• They increase levels of blood glucose by stimulating glucose production by the liver, and

decreasing the movement of glucose into cells

• The actions of insulin and the counter-regulatory hormones ensure that the glucose level is kept

within the normal range, including during eating, and during periods of fasting, for energy

• Need an appropriate level of glucose to manage the level of these 4 hormones

• Normal endogenous insulin secretion

Answer The panceas is always secreting insulin but levels spike during meals (b/c of increased glucose)

• Action of insulin

Answer

• Insulin facilitates glucose transport from the bloodstream across the cell membrane into the

cell

• Release of insulin after a meal

• Stimulates storage of glucose as glycogen in liver and muscle
• Inhibits gluconeogenesis (the production of glucose)
• Enhances fat deposition in adipose tissue
• Increases protein synthesis

• Type 1 diabetes

Answer

• Most often occurs in people under 30 years of age (peak onset at age 12)

• Approximately 5-10% of Canadians with diabetes have type 1 diabetes
• Abrupt onset

• Etiology = genetic predisposition
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