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Homeostasis and Diabetes L2

Homeostasis and Diabetes L2. What is Homeostasis?. Body cells work best if they have the correct Temperature Water levels Glucose concentration Your body has mechanisms to keep the cells in a constant environment. What is Homeostasis?.

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Homeostasis and Diabetes L2

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  1. Homeostasis and Diabetes L2

  2. What is Homeostasis? • Body cells work best if they have the correct • Temperature • Water levels • Glucose concentration • Your body has mechanisms to keep the cells in a constant environment.

  3. What is Homeostasis? The maintenance of a constant environment in the body is called Homeostasis

  4. 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: Insulin Glucagon

  5. 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)

  6. Glucose levels rise after a meal. Insulin is produced and glucose levels fall to normal again. Glucose Concentration Normal Time Meal eaten

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

  8. When blood glucose becomes high • INSULIN allows glucose to enter cells • Liver • Produce & store glycogen • Inhibits glycogen breakdown • Muscles • Promotes protein and glycogen synthesis • Fat cells • Promotes storage of triglycerides

  9. Hyperglycemia= high blood glucose levels • Drowsy • Flushed • Thirsty

  10. 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.

  11. Glucose levels rise after a meal. Glucose Concentration Diabetic Insulin is not produced so glucose levels stay high Time Meal eaten

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

  13. Hypoglycemia= LOW blood sugar • Glucagon: causes release of glucose from liver • breakdown of glycogen to glucose

  14. Hypoglycemia • Weak, sweaty • Confused/irritable/ disoriented

  15. 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.

  16. The glucose in the blood increases, Glycogen but there is no insulin to tell the liver to convert it into glycogen. Insulin Glucose concentration rises to dangerous levels. Glucose in the blood

  17. 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]

  18. Diabetes Mellitus The good news: • Blood glucose control reduces complications of Diabetes!

  19. Diabetes Mellitus • Absence (or ineffectiveness of ) insulin • Cellular resistance • Cells can’t use glucose for energy • Starvation mode • Compensatory breakdown of body fat/protein

  20. 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)

  21. 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

  22. Classifying Diabetes Mellitus • Type I Diabetes: autoimmune • Beta cell destruction in genetically susceptible person • Some viral infections

  23. 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)

  24. 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

  25. Diabetes Mellitus • Prevention of effects: combination approach • Increased exercise • Decreases need for insulin • Reduce calorie intake • Improves insulin sensitivity • Weight reduction • Improves insulin action

  26. Triad of Treatment • Diet • Medication • Oral hypoglycemics • Insulins • Exercise

  27. Diabetes treatment • Exercise • Under physician supervision • Check glucose prior

  28. Diabetes treatment • Diet • Lower calorie • Fewer foods of “high glycemic index” • Spread meals evenly

  29. Diabetes treatment • Anti-Diabetic medications • Oral hypoglycemic agents • Insulins

  30. Stimulate pancreas to secrete insulin • Glyburide • Adverse reactions • Hypoglycemia • Water retention/edema • Photosensitivity • May need to add insulin in times of stress

  31. 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)

  32. Insulin preparations • Rapid acting • Short acting (regular) • Intermediate acting (NPH) • Long acting

  33. Some things to know • Insulin moves potassium into cells • Good for emergency situations • Dangerous if potassium level already low

  34. 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

  35. 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.

  36. Typical diabetic foot ulcer

  37. 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?

  38. .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?

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