Hyperglycemia versus Hypoglycemia - Essay Example

Hyperglycemia versus Hypoglycemia The pancreas is an important external secretion that contains digestive enzymes and it also plays an important internal secretion that regulates carbohydrate metabolism known to us as insulin. It is the hormone insulin that determines whether a person is suffering from hyperglycemia or hypoglycemia. To put it simply, hyperglycemia is diagnose as having excessive level of glucose (sugar) in the blood; on the other hand, hypoglycemia is the opposite. It is characterized by having an abnormally low concentration of glucose or sugar in the blood. In understanding hyperglycemia and hypoglycemia, we have to consider the internal condition of the body and this is called homeostasis. Homeostasis is the survival and preservation of a reasonably stable internal setting, such as body temperature. It is the tendency of an organism to establish stability within its internal environment or fluid matrix; and it is through metabolism that an organism maintains homeostasis (Smith p.792). Metabolism is made up of several processes that maintain the structure and molecular composition of a living organism in quasi-stable state, consisting of two interdependent phases – catabolism and anabolism (Nahle, no page number). Anabolism is the term used to describe the total number of chemical reactions involved in a synthesis; while catabolism happens when cells are also constantly involved in the breakdown of larger molecules. Catabolism has two purposes: 1. It releases the energy for anabolism and other work of the cell, and 2. It serves as a source of raw materials for anabolic processes (Curtis p.166). Hyperglycemia versus Hypoglycemia 2 When there is an absolute or relative deficiency of the action of insulin, a simple protein composed of two peptide chains joined by disulfide bridges, at the surface of or within certain body cells, the metabolic disorder known as diabetes mellitus results, which is an inherited disease. In the absence of insulin, glucose is not changed to glycogen and stored within the liver but accumulates in the blood, simply known as hyperglycemia; and when this accumulated blood escapes into the urine, it is called glycosuria (Smith p.733). Insulin also affects the metabolism of fats and proteins. As the disease progresses, the derangements related to these two foodstuffs becomes clear. The biochemical derangements occasioned by the lack of insulin in a diabetic patient are dramatic ones. There are severe fluid and electrolytic disturbances, acidosis develops and death may occur in diabetic coma. Infection is a hazard for the diabetic person. The hardening of the arteries, often a regular feature, leads to cardiovascular complications. In diabetes mellitus, carbohydrate metabolism may be restored to normal, and practically all the manifestations of the disease can be controlled by the administration of insulin. However, insulin must be carefully administered because over dosage triggers a train of events resulting to low blood glucose or hypoglycemia, consisting of weakness, fatigue, profuse sweating, mental disturbance and convulsions. This condition known as hyperinsulinism, may be of gradual or sudden onset. It demands immediate treatment. Manifestation of this health condition usually appears when the blood glucose falls to a level between 45-50 milligrams per 100 milliliter of blood (Smith 744). Hyperglycemia versus Hypoglycemia 3 Feedback mechanism is the mechanism that maintains homeostasis which is of to type: positive or negative. Negative feedback mechanism is directly homeostatic; while the positive feedback mechanism is the opposite (Hicks, Chapter 1 no page number). If positive feedback supports the trend, it works to push the condition away, which is considered to be a far distance, from the set point; negative feedback happens when the trend is being counteracted resulting to the reversal of the trend. When this happens, whenever a change in the condition is distinguished, “a hormone is released which stimulates a return to ‘homeostasis’ because it stimulates the reverse of the noted activity (Hicks, no page number).” If for example, the body’s normal temperature is 37 degrees Celsius and it rises to 39.5 degrees Celsius, naturally, the body starts to sweat as a mechanism to cool it down. As the cooling process happens, body temperature decreases to 35 degrees Celsius which causes the body to shiver, which ironically keeps the body warm, returning the temperature back to its “relatively constant internal environment (Hicks, Chapter 1, no page number).” Positive feedbacks push the body farther away from homeostasis as observed during “uterine contractions during childbirth” which begins as a mild contraction then eventually becomes far apart making it strong and intense as labor progresses, to the point when the contractions are “strong and frequent” causing the baby’s delivery (Hicks, Chapter 1, no page number). It should also be noted the human body’s internal state is 99 percent maintained by negative feedback mechanism, making it directly homeostatic. Hyperglycemia versus Hypoglycemia 4 The nature of the metabolic disturbance in diabetes mellitus is an extremely complicated one. The impairment of insulin activity maybe due to the body’s condition when it does not produce enough insulin; or that the action of available insulin is blocked from its primary task of facilitating the entry of glucose into the cells of the body. Various lesions of the pancreas have been found related to diabetes, but no lesion has been called a diabetes mellitus lesion. Although the clinical and physiological disturbances maybe profound the pathologic findings are not specific. The disease is said to be known as a functional disorder. It is used to be assumed that diabetes was caused by the deterioration of the islet of Langerhans in the pancreas, the cell groups which produce insulin. In many cases, this is known to be true. Strangely, however, in some cases there is no such deterioration that can be detected. This observation together with other evidence has persuaded medical scientists that the disease is not always caused by difficulty in the pancreas itself. Other circumstances within the body’s tissues can also interfere with the metabolism of carbohydrate. Diabetes mellitus is not only a serious disease but a common one. The onset might be at any age, especially in the U.S. today, when the country is fighting a war against obesity in children when a report made by the National Institutes of Health in 2002 showed “that type 2 diabetes accounts for at least 30% recent childhood cases in diabetes (Zinczenko p.44).” Parents and health professionals are alarmed because both diabetes type I and II “are powerful Hyperglycemia versus Hypoglycemia 4 independent risk factors for coronary artery disease, stroke, and peripheral arterial disease (Aronson p. 6) The onset may be at any age. Usually, the disease becomes first apparent following some major demand on the body’s resources such as severe injury, a serious infection or stress. Stress is a term that describes the state in which a strong demand is made on the nervous system causing the body to move away from its equilibrium – homeostasis. Accommodation, adaptation, and exhaustion are the three stages which characterize stress. When person’s body deals with a present condition for a short term only, it is called accommodation. If the body feels the need to adjust its metabolism cope up and deal with its present condition on a longer basis, then it is called as adaptation; and if the body finds itself at its threshold and is unable to adjust to the condition any further, it is already acute, which is now known as exhaustion, making it life threatening. In a study on Metabolic Mechanisms of Stress Hyperglycemia conducted by Jeffrey I. Mechanick in 2006 show that the growing increase of encounters of stress hyperglycemia in patients who are critically ill has caught the attention of many physicians “with the coming out of clinical data which supports tight glycemic control and concentrated insulinization for best result (P.157).” Healing from an accident, increasing the body’s workload and childbirth are only a few of the circumstances in man’s life that produces stress. Stress is similar to positive feedback mechanism in a way that it brings the body father away from homeostasis. An evidence of the body’s defense against the consequence of injury is the ability of certain tissues to increase their Hyperglycemia versus Hypoglycemia 5 workload. The muscle provides a good example of this ability to compensate. When it comes to the heart, under favorable conditions, the heart is able to carry a heavier workload than required by the usual pattern of living; but when one of the valves of the heart does not function normally, part of the blood tends to flow backward through the faulty valve, making it inefficient as it should because some of its force in expended in pumping blood twice. In such a case, the heart responds by enlarging and by increasing its force of contraction, producing stress. In hypoglycemiya, the amount of glucose drops below the level of 50 milligrams of glucose per 100 milliliters of blood. Hypoglycemia is not a separate disease, but many stem from any one of several causes. The symptoms may follow two patterns. First, certain symptoms relate o the nervous system and result from the brain’s being deprived of sufficient glucose, which is an energy food, to maintain the normal activity of its cells. These symptoms may include metal confusion and anxiety, hallucinations, aimless activity, convulsions and eventual coma. Second, other symptoms result from the body’s attempt to compensate for lack of blood sugar by producing an emergency supply of epinephrine – a hormone occurring naturally and also known as adrenaline (Scott no page number). These include sweating, pallor, chilliness, trembling, hunger, weakness, and palpitation. Hypoglycemia is caused by many factors. It may result from an overdose of insulin. Insulin accelerates the body’s use of blood sugar. An over dosage, therefore, reduces the amount Hyperglycemia versus Hypoglycemia 6 of sugar in the blood. Hypoglycemia may result from excessive use of hypoglycemic agents such as insulin substitutes. Failure to eat the usual amount of food after taking insulin may also cause hypoglycemia in diabetic patients to whom insulin must be carefully balanced against the amount of food eaten in order to maintain the right amount of sugar level. Otherwise, the effect is like that of an overdose of insulin wherein blood sugar is reduced. Hypoglycemia may also develop in cases of liver disease in which the blood sugar is not stored by the liver in a normal manner. Giving of insulin or hypoglycemic agents are important factors in the treatment of diabetes. People might think that for as long as you are given these drugs, everything goes well and health condition will eventually go back to normal. However, unlike hyperglycemia where it is usually cause by poor eating habits and unhealthy lifestyle, hypoglycemia is caused not just by unhealthy eating habits and lifestyles, but also as a consequence of a disease, even the close monitoring of diabetic patients. According to Mathur et al, despite the medical advances made to treat diabetes, episodes of hypoglycemia are the frequent limiting aspect in attaining the best blood sugar control. Maintaining sufficient level of sugar in the blood is necessary because amongst all the organs in the body, it is the human brain that depends largely on sugar in the form of glucose for proper functioning; and with the fact that the brain is not able to produce its own glucose, making it 100 percent dependent on the human body. Such characteristic makes hypoglycemia more dangerous than hyperglycemia. Works Cited Nahle, N. S..  “Metabolism”.  Biology Cabinet. New Braunfels, TX, 2007. Viewed on 10 November 2008 from http://biocab.org/Metabolism.html. Hicks, R. “Introduction to Anatomy and Physiology.” Biol2404 Online. 27 May 2008. 2000- 2004 byTemple College. All Rights Reserved. 10 November 2008. http http://www.templejc.edu/dept/biology/RHicks/biol2404Int/biol2404onl_ch1.htm. Aronson, D.“Hyperglycemia and the Pathobiology of Diabetic Complications”. Fisman EZ, Tenenbaum A (eds): Cardiovascular Diabetology: Clinical, Metabolic and Inflammatory Facets. Adv Cardiol. Basel, Karger, 2008, vol 45, pp 1-16(DOI: 10.1159/000115118). Mechanik, J.I. “Metabolic Mechanisms of Stress Hyperglycemia.” Journal of Parenteral and Enteral Nutrition. Vol. 30, No. 2, 157-163 (2006) DOI: 10.1177/0148607106030002157. Curtis, H. and Anderson, S. (ed).“Metabolism.” Biology. Worth Publishers, Inc.: New York, 1986. Smith, A.L. “Special Pathology of Major Organ Systems.” Microbiology and Pathology. The CV Mosby Company: Missouri, 1980. Zinczenko, D. “Don’t Blame the Eater.” The New York Times. 23 November 2002 Scott, E. “The Definition of Epinephrine.” About.com: Stress Management. Reviewed by the Medical Review Board. 22 December 2007. About.com. viewed 10 November 2008 From http://stress.about.com/od/stressmanagementglossary/g/Epinephrine.htm. Mathur, R., M.D., Shiel, W.C. Jr. and Stoppler, M.C. (eds). “Hypoglycemia.” MedicineNet.com. 1996-2008. Media Net Inc. All Rights Reserved. Viewed 10 November 2008, from http://www.medicinenet.com/hypoglycemia/article.htm. Read More