Pathophysiology of the Endocrine
System, MSN 570 Advance Patho, MSN
570 HESI, HESI Exit Pathophysiology,
Alterations of Cardiovascular Function,
Pathophysiology (HESI), MSN 570 Exam
Diabetes Mellitus
Diabetes mellitus is a syndrome of impaired carbohydrate, fat, and protein metabolism
caused by either lack of insulin secretion or decreased sensitivity of the tissues to insulin.
insulin
causes rapid uptake, storage, and use of glucose by almost all tissues of the body (with
exception to the brain).
Insulin plays an important role in storing the excess energy.
In the case of excess carbohydrates, insulin causes them to be stored as ______________
mainly in the _________________ and _______________.
In the case of excess carbohydrates, insulin causes them to be stored as glycogen mainly in
the liver and muscle.
Excess carbohydrates that cannot be stored as glycogen are converted under the stimulus of
insulin into _____________ and stored in ___________________.
fats, adipose tissue
,When insulin binds to the membrane receptor, it increases transportation of what into the
cells?
glucose
Additionally, the cell membrane becomes more permeable to many of the amino acids,
potassium ions, and phosphate ions, causing increased transport of these substances into the
cell.
glucagon
hormone secreted when the blood glucose concentration falls, most important of these is to
increase the blood glucose concentration, an effect that is exactly the opposite of insulin.
Glucagon can elevate the blood glucose concentration by 25% in about 20 minutes and
therefore is called the hyperglycemic hormone.
what are the major effects of glucagon on glucose metabolism?
Major effects of glucagon on glucose metabolism are
(1) glycogenolysis (breakdown of liver glycogen) and
(2) increased gluconeogenesis (generation of glucose from non-carbohydrate substrates).
glycogenolysis
breakdown of liver glycogen
gluconeogenesis
,generation of glucose from non-carbohydrate substrates
A fasting blood glucose above this value often indicates diabetes mellitus or at least marked
insulin resistance.
A fasting blood glucose (early morning) >110 mg/100 mL is the upper limit of normal.
islets of Langerhans
cell clusters in the pancreas that form the endocrine part of that organ
what are the 3 major cells types of the islets of Langerhans and what do they secrete?
Somatostatin depresses the secretion of both insulin and glucagon,
decreases the motility of the stomach, duodenum, and gallbladder,
and decreases both secretion and absorption in the gastrointestinal
tract.
The principal role is to extend the period over which the food
nutrients are assimilated into the blood and decrease the utilization
of the absorbed nutrients by the tissues, thus preventing rapid
exhaustion of the food.
Type 1 Diabetes
, Deficiency of Insulin Production by Beta Cells of the Pancreas
Also called insulin-dependent diabetes mellitus (IDDM) is caused by lack of insulin secretion
injury to the beta cells of the pancreas (viral infection / autoimmune disorders) impair insulin
production. The cause of T cell-mediated autoimmune destruction of beta cells in the
pancreas is unknown, although environmental triggers such as viruses, drugs, or chemicals
may initiate the autoimmune process in genetically susceptible hosts. Production of
antibodies to beta cell antigens with loss of beta cell function precedes the onset of clinical
diabetes
The lack of insulin decreases the efficiency of peripheral glucose utilization and augments
glucose production, raising plasma glucose to 300-1200 mg/100 mL. The increased plasma
glucose has multiple effects.
3 principle sequelae of type 1 DM
(1) increase blood glucose.
(2) increased utilization of fats for energy for formation of cholesterol by the liver.
(3) depletion of the body's proteins.
what are the consequences of increased plasma glucose levels?
Loss of Glucose in the Urine
Dehydration
The increased osmotic pressure in the extracellular fluids causes osmotic transfer of water
out of the cells.
Additionally, the loss of glucose in the urine causes osmotic diuresis.
Thus polyuria (excessive urine excretion), and increased thirst are classic symptoms of
diabetes
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