Homeostasis and Diabetes L2

What is Homeostasis? Body cells work best if they have the

correct Temperature Water levelsGlucose concentration

Your body has mechanisms to keep the cells in a constant environment.

What is Homeostasis?

The maintenance of a constant

environment in the body is called

Homeostasis

Controlling Glucose levels

Your cells (muscles, brain, etc) need an exact level of glucose in the blood. (normal serum level 65 – 105 mg)

Excess glucose gets turned into glycogen in the liver

Blood glucose levels are regulated by 2 hormones (chemical messengers) from the pancreas called:

InsulinGlucagon

Normal Maintenance of Blood Glucose Levels

Eat a meal: Pancreas detects increased glucose

levels in blood and secretes INSULIN This results in uptake of GLUCOSE by:

Cells that need it for energy (including brain)

Liver and muscle cells to be stored as glycogen

Pancreas stops release of Insulin Glucose levels return to normal (80-

120)

Time

Glucose Concentration

Meal eaten

Insulin is produced and glucose levels fall to normal again.

Glucose levels rise after a meal.

Normal

If there is too much glucose in the blood, Insulin tells the liver to convert some of it to glycogen

Glycogen

Insulin

Glucose in the blood

Hyperglycemia When blood glucose becomes

high INSULIN allows glucose to enter

cellsLiver

Produce & store glycogen Inhibits glycogen breakdown

Muscles Promotes protein and glycogen synthesis

Fat cells Promotes storage of triglycerides

Hyperglycemia= high blood glucose levels

Drowsy Flushed Thirsty

Normal Maintenance of Blood Glucose Levels, cont.

Blood glucose drops due to NOT eating

Pancreas detects and releases glucagon stimulates the release of glycogen

(broken down to glucose) Glucose is released into the blood

and levels return to normal.

Time

Glucose Concentration

Meal eaten

Insulin is not produced so glucose levels stay high

Glucose levels rise after a meal. Diabetic

If there is not enough glucose in the blood, Glucagon tells the liver to convert glycogen into glucose.

Glycogen

Glucagon

Glucose in the blood

Hypoglycemia= LOW blood sugar

Glucagon: causes release of glucose from liverbreakdown of glycogen to glucose

Hypoglycemia

Weak, sweaty Confused/

irritable/ disoriented

Diabetes Some people do not produce enough

insulin. When they eat food, the glucose

levels in their blood cannot be reduced.

This condition is known as DIABETES.

Diabetics sometimes have to inject insulin into their blood. They have to be careful of their diet.

The glucose in the blood increases,

Glycogen

Insulin

Glucose in the blood

but there is no insulin to tell the liver to convert it into glycogen.Glucose concentration rises to dangerous levels.

Diabetes Mellitus(problem with glucose

metabolism) Major health problem US/worldwide Complications [lousy blood vessels]

Blindness Renal failure Amputations [heart attacks and strokes] [OB/neonatal complications]

Diabetes Mellitus

The good news:Blood glucose control reduces complications of Diabetes!

Diabetes MellitusAbsence (or ineffectiveness

of ) insulinCellular resistanceCells can’t use glucose for

energyStarvation mode

Compensatory breakdown of body fat/protein

Diabetes Mellitus HYPERGLYCEMIA: fluid/electrolyte

imbalance. Sodium, chloride, potassium excreted

(frequent urination) Dehydration (thirsty all the time) cells are starving, so person feels

hungry despite eating huge amounts of food. Starvation state remains until insulin is available. (eats too much)

Diabetes Mellitus Complications of chronic

hyperglycemia Macrovascular complications

Cardiovascular disease (heart attack)Cerebrovascular disease (strokes)

Microvascular Blindness (retinal proliferation, macular

degeneration) Amputations Diabetic neuropathy (diffuse, generalized,

or focal) Erectile dysfunction

Classifying Diabetes Mellitus

Type I Diabetes: autoimmune Beta cell destruction in genetically

susceptible person

Some viral infections

Classifying Diabetes Mellitus

Type II Diabetes Reduction in ability of most cells to

respond to insulin Poor control of liver glucose output Decreased beta-cell function (eventual

failure)

Diabetes Mellitus Major risk factors

Family history Obesity Origin (Afro-American, Hispanic, Native

American, Asian-American) Age (older than 45) History of gestational diabetes High cholesterol Hypertension

Diabetes Mellitus Prevention of effects:

combination approach Increased exercise

Decreases need for insulin Reduce calorie intake

Improves insulin sensitivity Weight reduction

Improves insulin action

Triad of Treatment

Diet Medication

Oral hypoglycemics

Insulins Exercise

Diabetes treatment

Exercise Under physician supervision Check glucose prior

Diabetes treatment

Diet Lower calorie Fewer foods of “high glycemic

index” Spread meals evenly

Diabetes treatment Anti-Diabetic medications

Oral hypoglycemic agents

Insulins

Stimulate pancreas to secrete insulin Glyburide

Adverse reactions Hypoglycemia Water retention/edema Photosensitivity

May need to add insulin in times of stress

Insulin

Made in beta cells of the pancreas Moves glucose into cells (thus acts

like growth hormone in a way) Moves potassium into cells (can buy

time in emergencies)

Insulin preparations

Rapid acting Short acting

(regular) Intermediate

acting (NPH) Long acting

Some things to know

Insulin moves potassium into cells Good for emergency situations Dangerous if potassium level already

low

Some things to know…

Dawn Phenomenon vs Somogi’s effect Dawn phenomenon

Blood sugar rises in early morning

Somogi’s (rebound) effect Blood sugar rise in morning as reaction to

hypoglycemic time during the night

Some things to know…

Diabetic foot care Dry, cracked skin + poor circulation

could = loss of a limb

For the most part nurses don’t trim nails of diabetic clients. Refer to Podiatrist.

Typical diabetic foot ulcer

Quick Quiz: 1. Give name of the very important

anabolic hormone that builds up glucose and stores it as glycogen.

2. What is the usable form of sugar in the blood called?

3. What are the cells associated with insulin production called?

4. What is the main problem (physiologically) that exists in people that are diabetic?

.5. Low blood sugar will stimulate what to be released?

6. Describe how someone would look/act if they were hyperglycemic

7.Describe someone who is hypoglycemic

8. List 3 treatments/preventions for diabetes and label if they are for Type 1, 2 or both

9. What is the good news for diabetes?