Diabetes Mellitus Case Study

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Diabetes mellitus is a group of metabolic diseases in which the individual has high blood glucose levels as a result of the inability of the pancreas to produce insulin, or as a result of the cells in the body not responding to the insulin produced. The aim of this documentation is to outline the normal regulation of blood glucose levels in the body which includes the role of the hormone producing alpha cells and beta cells in regulating these levels, and the effect that the pathophysiology of diabetes mellitus type one has on this regulation. This documentation further outlines the three main presenting symptoms of diabetes mellitus type one, polyuria, which is characterised by excess urination, polydipsia, which is characterised by extreme thirst, and polyphagia, which is associated with extreme hunger. A further insight is given relating to these symptoms, explaining the metabolic processes behind them. Associated symptoms relating to diabetes mellitus type one are also covered, these include feelings of weakness or fatigue, numbness and tingling of the extremities and a compromised immune system which results in slow healing wounds and injuries. The management of diabetes can often be quite complex, particularly in Anna’s case where she has been been newly diagnosed with diabetes mellitus type one and is a young fourteen year old girl. The five components of diabetes management need to be looked at when developing a care plan for Anna which includes, nutritional management, exercise, monitoring and pharmacologic therapy and education. The pancreas is a mixed gland composed of both endocrine and exocrine gland cells, which plays a major role in controlling blood glucose levels in the body. Distributed throughout the acinar cells are pancreatic islets, which are small cell clusters that produce pancreatic hormones. The islets contain two hormone-producing cells, the glucagon-synthesising alpha cells, and the insulin-producing beta cells. These cells act as fuel sensors, secreting glucagon and insulin when needed during the fasting and fed stages. Stimulis such as increased blood glucose levels prompts the pancreas to release insulin from the beta cells to lower blood glucose levels. Circulating insulin lowers blood glucose levels in three main ways, by increasing membrane transport of glucose into body cells, particularly muscle and fat cells, by inhibiting the breakdown of glycogen to glucose and by inhibiting the conversion of amino acids or fats to glucose. Consequently, this counters any metabolic activity that would increase plasma levels of glucose. On a cellular level, insulin activates a receptor which phosphorylates specific proteins, beginning the process that leads to increased glucose uptake and insulin’s other effects. On the contrary, stimulis such as decreased blood glucose levels prompt the pancreas to release glucogen from the alpha cells to raise blood glucose levels. The major target for glucogen is the liver, where several activities are prompted including the breakdown of glycogen to glucose, also known as glycogenolysis, the synthesis of glucose from lactic acid and from non carbohydrate modules, also known as gluconeogenesis, and the release of glucose to the blood via the liver cells, causing blood glucose levels to rise. Furthermore, a fall in the amino acid concentration in the blood occurs as the liver cells segregate these molecules to make new glucose molecules (Marieb & Hoehn 2010). Type one diabetes mellitus is a genetic disease of the immune system, characterised by pancreatic beta cell destruction which usually leads to absolute insulin deficiency, resulting in the failure of anabolic processes. (Meece 2003, pg.17). When insulin is either absent or deficient in the body, blood glucose levels remain high after a meal because glucose is incapable of entering majority of the tissues cells. Generally, when blood glucose levels rise, hyperglycemic hormones are not released, but when...
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