Diabetes Mellitus Type I and II

Ultimately, all forms are due to the beta cells of the pancreas being unable to produce sufficient insulin to prevent hyperglycemia.

-Type 1 is usually due to autoimmune destruction of the pancreatic beta cells which produce insulin.


-Type 1 diabetes mellitus—formerly known as insulin-dependent diabetes (IDDM), childhood diabetes or also known as juvenile diabetes, is characterized by loss of the insulin-producing beta cells of the islets of Langerhans of the pancreas leading to a deficiency of insulin.


-The main cause of beta cell loss leading to type 1 diabetes is a T-cell mediated autoimmune attack. The principal treatment of type 1 diabetes, even from the earliest stages, is replacement of insulin. Without insulin, ketosis and diabetic ketoacidosis can develop and coma or death will result.

-Type 2 is characterized by tissue-wide insulin resistance and varies widely; it sometimes progresses to loss of beta cell function.

-Type 2 diabetes mellitus—previously known as adult-onset diabetes, maturity-onset diabetes, or non-insulin-dependent diabetes mellitus (NIDDM)—is due to a combination of defective insulin secretion and insulin resistance or reduced insulin sensitivity (defective responsiveness of tissues to insulin), which almost certainly involves the insulin receptor in cell membranes

-There are numerous theories as to the exact cause and mechanism for this resistance, but central obesity (fat concentrated around the waist in relation to abdominal organs, and not subcutaneous fat, it seems) is known to predispose individuals for insulin resistance, possibly due to its secretion of adipokines (a group of hormones) that impair glucose tolerance. Abdominal fat is especially active hormonally. Obesity is found in approximately 55% of patients diagnosed with type 2 diabetes.

Diabetes Insipidus

-Diabetes insipidus is caused by the inability of the kidneys to conserve water, which leads to frequent urination and pronounced thirst.

-DI caused by a lack of ADH is called central diabetes insipidus. When DI is caused by failure of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus. The major symptoms of diabetes insipidus are excessive urination and extreme thirst. The sensation of thirst stimulates patients to drink large amounts of water to compensate for water lost in the urine.

Insulin Pen

Where should I inject the insulin?

Pull back on the plunger to draw insulin into the syringe.

The usual places to inject insulin are the upper arm, the front and side of the thighs, and the abdomen (tummy area).

How do I take insulin?

Insulin is normally injected under the skin with a very small needle. It can also be taken with an insulin pen. Here are some general tips on using insulin:

Clean the injection area using cotton and alcohol. Pinch an area of skin and inject insulin.

1. Wash your hands.
2. Take the plastic cover off of the insulin bottle and wipe the top of the bottle
with a cotton swab that you have dipped in alcohol.


3. Pull back the plunger of the syringe, drawing air into the syringe equal to the
dose of insulin that you are taking (measured in units). Put the syringe needle
through the rubber top of the insulin bottle. Inject air into the bottle by
pushing the syringe plunger forward. Turn the bottle upside down.
4. Make sure that the tip of the needle is in the insulin. Pull back on the
syringe plunger to draw the correct dose of insulin into the syringe .
5. Make sure there are no air bubbles in the syringe before you take the needle
out of the insulin bottle. If there are air bubbles, hold the syringe and the
bottle straight up, tap the syringe with your finger and let the air bubbles
float to the top. Push on the plunger of the syringe to move the air bubbles
back into the insulin bottle. Then withdraw the correct insulin dose by pulling
back on the plunger.


6. Clean your skin with cotton dipped in alcohol. Grab a fold of
skin and inject the insulin at a 90-degree angle. (If you’re thin, you may need
to pinch the skin and inject the insulin at a 45-degree angle.)

Prepared by:
Sri Murniati Rosli

Reference:
MedLine Plus
http://www.nlm.nih.gov/medlineplus/ency/article/000377.htm