PATHO DISCUSSION WK 9: Diabetes

Week 9: Endocrine System

Disorders of the endocrine system have a significant impact on the body. Consider the effects of unmanaged diabetes. Kali Collins, a 10-year-old Colorado girl, helped prevent a potentially fatal accident after her mother, Erin Bolefahr, went into diabetic shock while behind the wheel. After Erin began driving erratically, Kali phoned for help. Police were able to locate the vehicle and provide medical care to an unresponsive Erin (Huffington Post, 2012). If Erin’s diabetes had been properly managed, her daughter would have never been in such immediate danger. This case emphasizes the importance of properly identifying, treating, and managing diabetes. With diabetes and its associated alterations presenting serious medical complications, it is essential for advanced practice nurses to have a strong understanding of this endocrine disorder. In the clinical setting, patients with diabetes and other endocrine disorders will require extensive patient education and supervised care. PATHO DISCUSSION WK 9: Diabetes

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This week you examine the pathophysiology of diabetes. You also explore the impact of patient factors on the disorder.

Reference

Kali Collins, 10-year-old Colo. girl, saves family by calling 911 when mom goes into diabetic shock while driving. (2012, March 6). Retrieved from http://www.huffingtonpost.com/2012/03/06/kali-collins-10-years-old_n_1323056.html

Similarities, Differences, and Effect of Genetics and Behavior (Lifestyle) on Diabetes Mellitus and Diabetes Insipidus

Diabetes Melitus (DM) and Diabetes Insipidus (DI) are both endocrine disorders. DM is defined by high blood sugar (hyperglycemia), while DI is manifested by low levels of the anti-diuretic hormone (ADH). ADH ensures that the kidney tubules reabsorb most of the water in them back into the body. In DI, there is inability to do this, and very dilute urine is produced as a result. Plasma osmolality (concentration) increases and high levels of sodium accumulate (hypernatremia). Dehydration is rapid, and extreme thirst is experienced. DI can be hereditary or caused by mutation. (Huether & McCance, 2017; Hammer & McPhee, 2014, p. 562-564).  DM results from gene-environment interactions which cause insulin insufficiency. It has a strong genetic etiology. Antigens generated attach to the insulin-secreting beta cells of the pancreatic islets of Langerhans. Autoantibodies then destroy these beta cells. The result is a lack of insulin, which allows glucagon hormone uninhibited production of glucose. This glucose then appears in urine causing osmotic diuresis (high volume urine) and thirst (Huether & McCance, 2017; Hammer & McPhee, 2014, p. 525-533).  PATHO DISCUSSION WK 9: Diabetes

The difference between the two is that DI is caused by deficiency of ADH (a posterior pituitary hormone), while DM is caused by deficiency of an endocrine pancreatic hormone, insulin. The absence of regulation of these hormones then causes hypernatremia, serum hyperosmolality, and diuresis in DI. In DM, this causes ketoacidosis and osmotic diuresis. In DI loss of consciousness is due to electrolyte imbalance (N+), while in DM it is due to extreme glucose variation and ketoacidosis (Anonymous, 2012). The similarities are in the genetic aetiology, polyuria (high urine output), extreme thirst, and polydipsia (frequent drinking of water due to thirst).

Genetic etiology means that diagnosis is aided by family history of disease, and treatment does not cure. Behavior/ lifestyle change assists in the management of DM.

References

Anonymous, (2012, June 3). Kali Collins, 10-year- old Colo. Girl, saves family by calling 911 when mom goes into diabetic shock while driving. Huffpost. Retrieved from https://www.huffpost.com/entry/kali-collins-10-years-old_n_1323056

Hammer, D.G., & McPhee, S.J. (Eds). (2014). Pathophysiology of disease: An introduction           to clinical medicine, 7^th ed. New York, NY: McGraw-Hill Education.

Huether, S.E. & McCance, K.L. (2017). Understanding pathophysiology, 6^th ed. St. Louis,            MO: Elsevier, Inc.

PATHO DISCUSSION WK 9: Diabetes