Adult Health I
NR 324
Deana Fortine
August 2014
Chamberlain College of Nursing

Chapter 15.
1. Describe the pathophysiology of diabetes mellitus and the basis for the resulting abnormalities in carbohydrate, protein, and fat metabolism and utilization.

Type 2 diabetes is caused by either inadequate production of the hormone insulin or the lack of a response to insulin by cells in the body. Glucose is the source of energy in the body. It is mainly obtained from carbohydrates in the diet. Carbohydrates are then broken down into glucose for the cells to use. The level of glucose in your body triggers your liver to either uptake glucose or release insulin to lower it. In addition to that insulin causes the body to uptake and synthesis amino acids, proteins and fat. Most of this is done through the pyruvic acid cycle or Kreb Cycle depending on your reference.

2. Briefly define and summarize the etiologic differences between type 1 and type 2 diabetes mellitus.
Type 1 Diabetes Mellitus - Beta cells in pancreas are being attacked by body's own cells and therefore cannot produce insulin to take sugar out of the blood stream. Insulin is not produced. It is thought to be triggered by autoimmune destruction of the beta cells. Autoimmune attack may occur following a viral infection such as mumps, rubella, or cytomegalovirus. Early diet may also play a role. Type 1 diabetes is less common in people who were breastfed and in those who first ate solid foods at later ages.

Type 2 Diabetes Mellitus - Diet related insulin release is so large and frequent that receptor cells have become less sensitive to the insulin. This insulin resistance results in less sugar being removed from the blood. Type 2 diabetes has a stronger link to family history and lineage than type 1. Appears to be related to aging, inactive lifestyle, genetic influence and obesity. Obesity tends to run in families, and families tend to have similar eating and exercise habits.
3. Compare and contrast the distinguishing features of type 1 and type 2 diabetes mellitus (DM) by completing the chart below and on the next page.
Features Type 1 DM
Synonyms Insulin Blood sugar Diabetes

Age of Onset Type 1 diabetes can occur at any age. It is most often diagnosed in children, Adolescents or young adults.
Incidence Its incidence varies 50–100-fold around the world, with the highest rates in northern Europe and in individuals of European extraction. Both sexes are equally affected in childhood, but men are more commonly affected in early adult life.
Endogenous insulin The cause of diabetes mellitus type 1 is unknown.
Production Type 1 diabetes can be distinguished from type 2 by autoantibody testing. The C-Peptide, which measures endogenous insulin production, can also be used.
Body weight at onset Generally under weight
Ketosis Ketosis-prone diabetes (KPD) comprises a group of atypical diabetes syndromes characterized by severe beta cell dysfunction (manifested by presentation with diabetic ketoacidosis [DKA] or unprovoked ketosis) and a variable clinical course. These syndromes do not fit the traditional categories of diabetes defined by the American Diabetes Association (ADA). To date, attempts to differentiate patients with KPD into clinically distinct subgroups have resulted in four different classification schemes: the ADA system, a modified ADA system, a body mass index (BMI)-based system, and the Aß system. The goal of new classification schemes is to enable clinicians to predict which patients with DKA require temporary insulin treatment versus life-long insulin therapy
Manifestations The classic symptoms of type 1 diabetes are as follows:
Polyuria
Polydipsia
Polyphagia
Unexplained weight loss
Other symptoms may include fatigue, nausea, and blurred vision. The onset of symptomatic disease may be sudden. It is not unusual for patients with type 1 diabetes to present with diabetic