The Factors That Are Found in Individuals Who Have Diabetes Mellitus - Assignment Example

SCMED2011 Pathophysiology 2 Assignment 2 Name Institution Introduction This essay is based on the factors that are found in individuals who have diabetes mellitus that is mainly caused by the lack insulin production as well as insulin resistance. The essay is mainly covering insulin resistance, Kussmaul respirations, metabolic acidosis, hypovolemia, polydipsia, and polyphagia. The mentioned areas are involved in the occurrence of diabetes mellitus condition. Question 1 Insulin resistance refers to a psychological condition whereby there is a response failure by the cells in a normal action by the insulin. When insulin is being produced by the body during the insulin resistance condition, the cells within the body tend to rests the insulin hence being unable to use the insulin effective thus leading to the condition known as high blood sugar. This leads to the subsequent low production of insulin by the beta cells that further contributes to increasing the blood sugar. Through the increase in the blood sugar concentration within the body, there is an elevated risk of developing type 2 diabetes as well as pre-diabetes state that can easily predispose one to have diabetes (Reaven, 2005). Once an individual has insulin resistance condition, a high blood glucose concentration over time leads to the damaging of the nerves and the blood vessels. Intracellular energy is the energy that is required by the cells to carry out their normal functions. Insulin resistance primarily involves our body cells and mainly cells in the liver and the skeletal muscle tissue. During insulin resistance, the body cannot be able to manufacture the needed energy efficiently from the digested food and from the glucose that is available in the body. The released of insulin into the blood stream activates the special transporter (GLUT4) in the cell membranes that permits the crossing of glucose through the walls of the cells whereby it can be used to produce energy that can enhance intercellular energy utilization. Some of the energy produced in the cells are stored to be utilized later when there is low energy production (Reaven, 2005) If the body develops insulin resistance condition, there is the reduction in the efficiency of intracellular energy production that in turn affects the energy use within the cells. There is no glucose that can be permitted to cross the cell membranes hence causing lack of energy in the cells. Therefore, insulin resistance affects intracellular energy utilization negatively (Reaven, 2005) Figure 1: Insulin resistant Source: (Yuri et al. 2008). From the diagram, insulin resistance is manifested through the excess insulin, increment in glucose production in the liver and the decrease in glucose disposal. In the yellow parts of the diagram indicates that insulin resistance triggers an increase in the release of hormone-sensitive lipase (HSL), hence leading to increasing the rates of triglycerides break down into three fatty acids that are the free fatty acid (FFA). The red part represents the liver where the FFAs are converted to ATP energy in the mitochondria, and they can be converted back to the triglycerides (Yuri et al. 2008). Question 2 Kussmaul respiration is a breathing process that is deep and characterized by labored breathing pattern, and it is always linked to metabolic acidosis. It is specifically associated with diabetic ketoacidosis as well as the kidney failure. It is mainly a form of hyperventilation that reduces carbon dioxide within the body through a deep respiration. It is common in cases characterized with acidosis of diabetes mellitus in situations whereby diabetes two is seriously out of control (Deterding et al. 2006). Metabolic acidosis is referred to as a condition in which the body produces acid quantities in excess or when there is no effective release of acid from the body by the kidneys. In many occasion if the condition is unchecked it always leads to academia. The symptoms of acidosis are not often clear and specific, and this is due to the difficulty in diagnosing it. However, some of the known symptoms include chest pain, headaches, palpitations and altered mental status that is often severe that can include hypoxia. Diabetes leads to acidosis state when it affects the speed at which acid is being released from the body as well as its production (Deterding et al. 2006). The acidosis state causes alterations in breathing through inducing a decreased ventilation that leads to the increase in the concentration levels of carbon dioxide, which in turns leads to the decrease in the PH of the blood. The CO2 is rapidly being produced within the body, which in the end leads to the accumulation in the lungs if not effectively released. The peripheral chemoreceptors are the sensory extensions within the peripheral nervous system that can detect any chemical concentration changes within our body. The peripheral chemoreceptors contribute to the alterations in respirations through detection of the metabolic acidosis state within the body hence creating an onset of the altered respiration. The initial stimulation starts the changes in respiration, and it is often due to the small increment in the brain ISF (H+). Fall in the ventilation often leads to the fall in the arterial pCO2 that in turns inhibit the body ventilator response (Deterding et al. 2006). Question 3 Glycosuria is the process that leads to the excretion of the glucose in urine. In the normal state, urine contains no glucose since the kidneys reclaim all the glucose that has been filtered back into the blood stream. The condition is almost entirely caused by the elevation of the glucose levels, and it is mainly due to the untreated diabetes mellitus. The condition is also due to the intrinsic reabsorption of the glucose within the kidneys themselves, and it is known as the glycosuria renal condition. It often leads to the excessive loss of water into the urine, which in turn leads to dehydration within the body through osmosis diuresis. Glycosuria leads to hypovolemia by having more glucose into the blood that in turn decreases the amount of blood that is flowing (Agabegi and Steven, 2008). Polydipsia refers to the excess feeling thirst, and it is among the first symptoms of diabetes mellitus. The condition is often accompanied by temporary and sometimes prolonged dryness state of the mouth. The condition can occur during the Hypovolemia conditions, Hypovolemia is a condition in which there is the decrease in the volume of blood. It is specifically due to the reduced blood plasma. Hence, it is a primary component of the volume contraction that is sometimes referred to as dehydration. When it comes to polydipsia that is a common case among people with diabetes and specifically among those who fail to take their routine medications. Hypovolemia reduces the blood volume that in turn affects the osmolality of the extracellular fluids. In the Hypovolemia, condition there is the activation of the renin-angiotensin (RAS) which is then detected by the kidney cells (Agabegi and Steven, 2008). When the kidney cells detect the reduction in the blood, flow due to the low volume, there is the secretion of the renin enzyme. Renin then enters the blood stream and catalyzes the angiotensinogen to angiotensin I proteins. The process continues to occur up to the point when Angiotensin II travels within the blood up to the posterior pituitary gland, hence leading to the changes in the hormones of the kidney to cause water and sodium retaining effects of the body. Thus, increasing the blood pressure. In the end, there is the inducement of the drinking behavior by initiating thirst (Agabegi and Steven, 2008). Figure 2: Acidosis Source: (Davenport, 1974).  From the diagram, any changes in the metabolic composition of the blood lead to the changes in the pH of the blood. The diagram also indicates that acidity of the blood increases with the increase in the HC03-, below a pH of 7.4 respiratory acidosis occurs and increases with increase in the HC03-. When the pH is above 7.4, there is the reduction in the respiratory alkalosis (Davenport, 1974). Question 4 Polyphagia is a condition that is characterized by excessive hunger or an increment in the appetite, and it is among the three primary symptoms of diabetes. Leptin is a hormone that comprise of body fat cells, and it is known as the hunger hormone. It is a chemical messenger, and it mainly sends the message about the hunger status. The hormone travels through the bloodstream and plays the role of appetite facilities of the brain through signaling the emotions of fullness when the levels of leptin are low, there is a feeling of hunger and hence motivated to seek food. Leptin binds to the neuropeptide neurons, hence decreasing their activities. Leptin during polyphagia signals hypothalamus that in the end creates the feeling of satiety (Elliott, Jane and Wisoff, 2011). The activation of the leptin receptors leads to the inhabitation of the neuropeptide. The NPY neurons are the primary factor when it comes to hunger regulation. The combination of both leptin and insulin resistance can induce hunger among people who are suffering from diabetes. Insulin resistance often leads to low levels of glucose absorption in the body, insulin resistance and leptin can dampen the appetite of an individual through the inhibition of the NPY/AgRP secreting neurons as well as through the activation of the POMC releasing neurons. Besides, the combination of insulin resistance and leptin can stimulate hunger by dampening the stimulatory hormone as well as stimulating the inhibitory fibers. The release of leptin is stimulated by insulin. Hence, insulin resistance can cause low levels of leptin in the body that in turn leads to the stimulation of hunger (Elliott, Jane and Wisoff, 2011). Conclusion The essay has been able to cover areas of great concern related to diabetes mellitus, the essay has explained the aspects in detail, and diagrams have been used to boost the understanding of the concepts. Therefore, in conclusion, diabetes mellitus involves various conditions and process within the body that makes it one of the unique diseases that affects the body. References Agabegi, E., & Steven, S. (2008). Step-Up to Medicine (Step-Up Series). Hagerstown, MD: Lippincott Williams & Wilkins.  Davenport, H.W. (1974). The ABC of Acid-Base Chemistry: The Elements of Physiological Blood-Gas Chemistry for Medical Students and Physicians. Chicago: The University of Chicago Press. Deterding, R. et al. (2006). Current Diagnosis and Treatment in Pediatrics (Current Pediatric Diagnosis and Treatment). New York: McGraw-Hill Elliott, R.E., Jane, J.A., & Wisoff J.H. (2011). Surgical management of craniopharyngiomas in children: meta-analysis and comparison of transcranial and transsphenoidal approaches. PubMed Health p.1-4 Reaven, G.M. (2005). The insulin resistance syndrome: definition and dietary approaches to treatment. Research Gate 25(1):391-406 Yuri, E. et al. (2008). 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