1. Diabetes Pathophysiology and Treatment.
1.1. Type 1 Diabetes
1.1.1. Insulin dependant
1.1.2. absolute defiency of insulin
1.1.3. auto-immune disease
1.1.4. initiated by environmental factors:
1.1.4.1. infectious or non-infectious agents.
1.1.5. the acute complications
1.1.5.1. ketoacidosis
1.2. Type 2 Diabetes
1.2.1. non- insulin dependant
1.2.2. environmental factors
1.2.2.1. sedentary lifestyle
1.2.2.2. dietary habits that promote obesity
1.2.3. Excessive triglyceride storage blocks insulin signaling pathway in liver.
1.2.4. insulin resistance
1.2.5. defect in insulin secretion
1.2.6. The acute complications
1.2.6.1. hyperosmolar
1.2.6.2. Infections
1.2.6.2.1. impaired immune function
1.2.6.2.2. impaired wound healing
1.3. Diabetes and Insulin lack
1.3.1. insulin level low, absent or hypoactive
1.3.1.1. insulin resistance- receptor insensitivity
1.3.2. BGL remains high after meal
1.3.3. Hyperglycaemia has 3 effects:
1.3.3.1. high osmotic pressure leads to cellular dehydration, thus thirsty
1.3.3.2. Loss of glucose in urine- glycosuria
1.3.3.3. Glycosuria causes osmotic diuresis- polyuria (often nocturia) and electrolyte depletion.
1.3.3.4. Symptoms of hyperglycemia
1.3.3.4.1. Polydipsia- excessive thirst
1.3.3.4.2. Polyuria- excessive urination, Nocturia: excessive urination at night
1.3.3.4.3. Polyphagia- excessive appetite. frequent yeast infections (in women)
1.3.4. Other effects of insulin lack
1.3.4.1. Alternative energy source (fat & muscle - weight loss
1.3.4.2. tissue protein is depleted - lethargy
1.3.4.3. fatty acids leave adipose cells - hyperlipidemia
1.4. Chronic complications of DM
1.4.1. Micro vascular Complications:
1.4.1.1. Retinopathy -chief cause of new cases of blindness
1.4.1.2. Nephropathy- chronic renal failure
1.4.1.3. Sensory neuropathy - pain and numbness in feet, ulcers prone to infection, may lead to amputation
1.4.2. Macro vascular Complications:
1.4.2.1. Cardiovascular diseas: causes 60-75% of diabetes deaths, accelerated atherosclerosis
1.4.2.2. Peripheral vascular disease: muscle pain/cramp, foot ulcer, amputation
1.4.2.3. Autonomic neuropathy: impotence, constipation, postural hypotension