What Is Diabetes Pathophysiology?
“Pathophysiology” is defined as “the functional changes that accompany a particular syndrome or disease.” The pathophysiology of diabetes mellitus defines the changes which occur in a person who has been diagnosed with diabetes, given that those changes would be considered abnormal in a healthy body.
Diabetes Mellitus occurs when the human pancreas no longer functions correctly, or when the insulin that it releases is not properly absorbed by the cells of the body.
Type 2 Diabetes
Type 2 diabetes is by far the most commonly diagnosed type of the disease, accounting for around 90% of all cases of diabetes. It normally does not show up until later in life, often after the sufferer has turned 40 and is moderated by several environmental factors. In type 2 diabetes, either the pancreas has become damaged from spikes in insulin over the life of the patient, or the body has developed a resistance to insulin from repeated and high levels of exposure over a long period of time.
The obese and the overweight are by far at greatest risk of developing this more common form of diabetes. There are a couple of reasons for this:
- First, type 2 diabetes is primarily caused by diet. Eating lots of sugary foods, or diets extremely high in simple carbohydrates leads to repeated spikes in insulin levels in the blood stream. Eating too much candy is not worse than eating lots of potatoes – both flood the bloodstream with glucose and also with insulin. So, having a poor diet tends to produce both obesity and diabetes, though for two completely different reasons.
- Secondly, obesity itself is tied to diabetes. Especially for those with a lot of visceral fat, the kind of fat that builds up around the belly, the body produces hormones as a result of this that interfere with the proper distribution of glucose and can impair pancreas function if the body is subjected to this too frequently or too extremely.
Complications Of Diabetes
Diabetes brings with it a number of complications, which may impact on the quality of life for the patient. These include the following:
- Polydipsia: this is the increased thirst that occurs in diabetics as a result of increased glucose levels, which make the blood thicker, telling the body to urinate.
- Polyuria: excessive urination has two root causes: glucose in the blood needs to be flushed and polydipsia leads to excessive consumption of fluid.
- Weight loss: frequent urination can lead to weight loss as fluids are urinated away.
- Polyphagia: the body is consistently dumping the glucose that you are putting into it, so it constantly thinks that it needs to eat again.
- Heart disease: damage to the blood vessels resulting from constant exposure to glucose can lead to heart problems.
- Eye damage: otherwise known as “diabetic retinopathy” , the small blood vessels in the eyes are damaged by constant exposure to extreme levels of glucose.
Approaches to the Prevention of Diabetic Complications
There are a number of elements, which should form part of every diabetic’s healthcare plan. Included among these, are the following strategies for keeping the complications of diabetes in check:
- Check Hb1Ac level every 3 to 6 months.
- Dilated eye examination, annually.
- Microalbumin checks, at least once a year.
- Foot examination by a Podiatrist, every year.
- Regular blood pressure checks, to ensure that blood pressure is below 130/80 mm Hg.
- Statin therapy to reduce low-density lipoprotein cholesterol.
A non-diabetic body needing energy simply converts food into energy through a simple process. This process is digestion: the food is broken down and the nutrients and energy are absorbed from it. That energy is converted by the body’s metabolic processes into glucose, which is the sugar that we use for energy – it maintains your body temperature, keeps your heart pumping and powers all the systems that keep your body running and growing properly.
Glucose is not the only component to nutrient absorption and energy production. The hormone insulin, created and distributed by the pancreas, floods the bloodstream whenever you eat. This insulin is the primary factor in the absorption of nutrients. When insulin levels are high, the cells absorb energy and nutrients from the bloodstream. When they are low, the cells close up, to prevent losing those nutrients. It’s a finely-tuned system, until something goes wrong.
When a person contracts diabetes, either the pancreas quits and no longer produces insulin, or the body has developed such a tolerance for insulin from repeated and extreme exposure, that it no longer performs its function adequately. Either way, glucose doesn’t make it into the cells where it needs to go.
Glucose just sits in the blood until the body flushes it out. This is why one of the early signs of high glucose – how diabetes is diagnosed – is frequent urination. You may also experience excessive hunger, as the body doesn’t realize that you’re pushing nutrients through it, since they’re all going down the waste tubes.
Pathophysiology of Diabetes Mellitus
There are actually three types of diabetes, though the third is a relatively special case (and rare, as well). Each one differs slightly in its pathophysiology. We have talked a lot, in this article, about the pathophysiology of type 2 diabetes. Allow me, now, to briefly touch on the other types of the disease.
Type 1 diabetes is “early-onset” diabetes. It occurs relatively early in life, normally showing up while the patient is still a teenager. This type of diabetes results from problems in the pancreas that have nothing to do with diet – the pancreas simply shuts down or produces so little insulin that the body cannot get enough energy. Only about ten percent of diabetics suffer from type 1. If you have this, it’s almost certain you’ll know about it before you’re 40. It has no known cure, though you can most definitely treat it effectively with a few simple steps.
People who have type 1 diabetes can normally expect to have to take insulin shots or insulin tablets for their entire lives. They will also need to constantly monitor their blood sugar levels to ensure that they don’t over- or under-do it with the insulin, as imbalance in this hormone – too much or too little – can both result in very serious complications.
Gestational diabetes is specific to pregnant women. It has a very specific cause, not related to diet. It is a complication of pregnancy and so has nothing to do with pancreas function.
When a woman is pregnant, her body releases counter-insulin hormones, which, if they are released too much, or if she already has problems getting enough insulin around the bloodstream, can lead to the elevated glucose levels and lack of glucose absorption associated with diabetes. This can lead to insulin tolerance by the cells, and so it is important that this issue be taken care of before it leads to worse complications, such as type 2 diabetes from that insulin tolerance crossing the threshold and becoming permanent.
Filed under: Diabetes Mellitus Symptoms