Diabetes – Advanced Patho week 9 response 1
Type of document Essay
1 Page Double Spaced
Subject area Nursing
Academic Level Master
Style APA
References 3
Order description:
Please respond to channings post in one of the following ways Share insights on how the factor you selected impacts the pathophysiology of diabetes mellitus and diabetes insipidus.
Offer alternative diagnoses and prescription of treatment options for diabetes mellitus and diabetes insipidus.
Validate an idea with your own experience and additional research. and use the readings and resources for at least 2 references or it will not count
Resources
Learning Resources
Required Readings
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Chapter 18, “Mechanisms of Hormonal Regulation”
This chapter explores mechanisms of hormonal regulation and the structure and function of the endocrine glands. It provides a foundation for examining alterations of the endocrine system, as well as the effects of aging on the endocrine glands.
Chapter 19, “Alterations of Hormonal Regulation”
This chapter begins with an explanation of the mechanisms of hormonal alterations. It then discusses alterations of the hypothalamic-pituitary system, thyroid function, parathyroid function, endocrine pancreas, and adrenal function. It also covers the pathophysiology, clinical manifestations, and evaluation and treatment of type 1 and type 2 diabetes.
Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.
Chapter 17, “Disorders of the Parathyroids & Calcium & Phosphorus Metabolism”
This chapter explores the anatomy, histology, and associated mechanisms of the parathyroid glands, bone, vitamin D, and C cells. It then examines various disorders involving altered regulation of parathyroids, calcium, and phosphorous metabolism.
Chapter 18, “Disorders of the Endocrine Pancreas”
This chapter explores the anatomy, histology, and physiology of the endocrine pancreas. It then covers the clinical presentation, etiology, pathophysiology, and clinical manifestations of endocrine pancreas disorders such as diabetes mellitus.
Chapter 19, “Disorders of the Hypothalamus & Pituitary Gland”
This chapter covers the structure and function of the hypothalamus and pituitary glands. It then explores disorders relating to alterations of the hypothalamus and pituitary glands.
Chapter 20, “Thyroid Disease”
This chapter explains thyroid hormones, including how they are formed and secreted. It then examines thyroid diseases such as hyperthyroidism, hypothyroidism, and goiters.
Optional Resources
American Diabetes Association. (2012). Retrieved from http://www.diabetes.org/
The Endocrine Society. (2012). Retrieved from http://www.endo-society.org/
The Hormone Foundation. (2012). Retrieved from http://www.hormone.org/
Channing Hall
Week 9 Discussion
COLLAPSE
Diabetes insipidus is an insufficiency of ADH activity leading to frequent urination and drinking (Huether and McCance, 2017). It is categorized by two forms, neurogenic and nephrogenic. Neurogenic is caused by the insufficient secretion of ADH; there is an interference with ADH synthesis, transport, and release (Huether and McCance, 2017). It primarily involves the brain. Nephrogenic is caused by the inadequate response of the renal tubules and is usually acquired or genetic (Huether and McCance, 2017). Acquired nephrogenic DI is sometimes related to disorders and drugs. There is also a rare form that is associated with pregnancy. Individuals with DI have a partial to total inability to concentrate urine (Huether and McCance, 2017). In most people, the kidney’s pass about one to two quarts of urine daily but in DI, three to thirty quarts are passed (NIDDK, 2015). The main complication is dehydration when fluid loss is greater than liquid intake. Other symptoms include thirst, dry skin, fatigue, sluggishness, confusion, nausea, and dizziness. Criteria for diagnosis include low urine specific gravity, low urine osmolality, hypernatremia, high serum osmolarity, and continual diuresis. DI is diagnosed through an h&p, urinalysis, blood tests, fluid deprivation tests, or an MRI. Dispogenic DI is a defect in the thirst mechanism (NIDDK, 2015).
Drinking enough fluids to prevent dehydration is key. Acquired Di is treated with desmopressin. It works by replacing the vasopressin that the body normally produces (NIDDK, 2015). There are some cases of nephrogenic DI that resolve after the cause is treated. Diuretics combined with aspirin or ibuprofen aids in reducing urine production and helps that individuals kidney’s concentrate urine (NIDDK, 2015). There is no effective pharmacological treatment for dispogenic DI but desmopressin is given for it. Desmopressin is also given in gestational DI.
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia, resulting from defects in insulin secretion and/or action (Huether and McCance, 2017). The four categories of diabetes mellitus include type 1(insulin-dependent), type 2(non-insulin dependent), other specific types, and gestational diabetes. Type 1 is more prevalent in children and is a chronic autoimmune condition that occurs when the body’s immune system attacks insulin-producing beta cells of the pancreas. Individuals with type 1 diabetes experience increased thirst, frequent urination, blurred vision, fatigue, unintended weight loss, and weakness. Diagnosis is confirmed through an A1C and random/fasting blood sugar tests (Mayo Clinic, 2017). Insulin is required for treatment along with carbohydrate counting, frequent blood sugar monitoring, exercise, and healthy eating. Type 2 is the most common form of DM. In type 2, the body cannot effectively use glucose for energy, causing the cells to become insensitive to insulin. Symptoms include thirst, frequent urination, fatigue, slow healing sores, an unusual odor to urine, and darkening skin under the armpits, neck, and thighs. Diagnosis is confirmed through random/fasting blood sugar tests, A1C, or oral glucose tolerance testing. Type 2 may be reversed with lifestyle changes and diet should match activity level. Insulin therapy and diabetes medications are given for treatment. Dieting and exercising are also encouraged. Other specific types are termed maturity-onset diabetes of youth. These types include genetic defect in beta cell function, genetic defects in insulin action, diseases of the exocrine pancreas, endocrinopathies, drug-chemical induced beta cell dysfunction, infection, or other uncommon autoimmune/inherited disorders (Huether and McCance, 2017). In gestational diabetes, there is a degree of glucose intolerance with onset or first recognition during pregnancy. Screening is recommended after the 24th week of pregnancy. OGTT is used for diagnosis and close monitoring during and after the pregnancy is of grave importance.
In DI, genetics affect the kidney’s ability to concentrate urine and in DM familial history increase the risk. Pregnancy is also a factor that affects both disorders. In DI, placenta enzymes are broken down by the mother’s vasopressin or more prostaglandin is produced and this reduces the kidney’s sensitivity to vasopressin (NIDDK, 2015). It usually goes unnoticed and resolves after delivery. I DM, the placenta produces hormones that impair the action of insulin in the cells and usually resolves after birth. Both may reoccur if the mother gets pregnant again.
Huether, S.E., & McCance, K.L. (2017). Understanding Pathophysiology (6th ed.). St. Louis, MO: Mosby.
Mayo Clinic. (2017). Diabetes Type 1. Retrieved from https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/diagnosis-treatment/drc-20353017.
National Institute of Diabetes and Digestive and Kidney Disease. (2015). Diabetes Incipidus. Retrieved from https://www.niddk.nih.gov/health-information/kidney-disease/diabetes-insipidus
