QUESTIONS FOR THE ARTICLE ON DIABETES MELLITUS AND HYPOGLYCEMIA What observation led to more research in diabetes? None of the dogs developed diabetes. …
UNIT 7 - ENDOCRINE SYSTEM
ACTIVITY - Reading On Diabetes Mellitus
Name __________________________________________ Period __________
QUESTIONS FOR THE ARTICLE ON DIABETES MELLITUS AND HYPOGLYCEMIA
1 Why did Von Mering and Minkowksi remove the pancreases of dogs?
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2 Scientists often discover things that they had not set out to find Such
discoveries can be said to happen by chance What observation led to more
research in diabetes? Why can this observation be called a chance
observations
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3 What observation led researchers to infer that two functionally
different tissue types were present in the
pancreas?
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4 Suggest a reason why dogs that showed the symptoms of diabetes did not
improve after being fed bits of pancreatic tissue
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5 Differentiate between the Type I and the Type II diabetes Be sure to
Include the forms, the causes and the treatments
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6 Suggest ways that a diabetic could prevent or decrease his risk of the
following:
a
Burning himself on the stove
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b Kidney damage
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c Amputation of a toe, foot or leg
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d Blindness
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e hypoglycemic
reaction
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HISTORY - DIABETES MELLITUS AND HYPOGLYCEMIA
INTRODUCTION: Diabetes mellitus is a disorder caused by the low levels
of or the absence of the hormone insulin which is necessary to take glucose
into the cells where they can be converted into energy or stored as
glycogen for later use The use of glucose in the body to provide energy is
important as the Central Nervous System, the brain and spinal cord require
glucose in order to make their energy or ATP Hypoglycemia is the
overproduction of or the hypersensitivity to the insulin produced Insulin
is produced in the pancreas Without insulin, the body cannot maintain
proper blood sugar levels
DISCOVERY OF THE FUNCTION OF THE PANCREAS: In the late 1800s, two German
biologists, Joseph Von Mering and Oskar Minkowski, were studying the role
of the pancreas in digestion They surgically removed the pancreas from a
number of dogs The dogs showed an increase in urine output
and died within
a period of 10 to 30 days The researchers noticed that ants were attracted
to the urine these dogs produced before they died A Urine analysis showed
that there was a high level of sugar in the urine Increased urine output
and high levels of sugar in the urine were known to be symptoms of diabetes
mellitus in human beings To make sure that the dogs symptoms were not due
to the operation alone, the scientist operated on other dogs but did not
remove their pancreases None of the dogs developed diabetes They
concluded that the diabetic symptoms were due to the removal of the
pancreas
Study of the pancreas showed that it is made of two different tissue
types One type of tissue produces digestive enzymes The other type of
tissue is called the islet of Langerhans Researchers tried to find out
which of the two tissue types produced a substance that prevented diabetes
In one experiment, the pancreatic ducts of experimental dogs were tied off
Tying off these ducts caused the enzyme-producing tissue in the pancreas to
atrophy; that is the tissue stopped functioning and began to disintegrate
These dogs did not develop the symptoms of diabetes Researchers
hypothesized
that damage or removal of the islets of Langerhans caused the
symptoms of diabetes
Researchers had difficulty finding the substance produced by the
islets They thought that the substance might be found in pancreatic
tissue Researchers fed bits of pancreatic tissue to dogs whose pancreases
had been removed, but the symptoms of diabetes did not disappear
The substance was finally isolated in 1922 by two Canadians, Frederick
Banting and Charles Best They tied off the pancreatic ducts of many dogs
After the enzyme-producing tissue had atrophied, they removed the pancreas
They then froze the tissue, ground it into a solution and injected the
solution into diabetic dogs The dogs showed
immediate improvement
Banting and Best received the Nobel Prize in 1923 for their important
work The substance they discovered was the hormone insulin Research in
the 1950s by Frederick Sanger showed that insulin is a protein
FACT SHEET - DIABETES MELLITUS
FORMS OF DIABETES MELLITUS: There are two forms of the disorder diabetes
mellitus They are Type I, or insulin dependent diabetes mellitus, which
was formerly known as the juvenile onset diabetes, and Type II, or non-
insulin
dependent diabetes mellitus, which was formerly known as the
mature or adult onset diabetes Type I usually occurs before the age of 30
and requires regular insulin injections in order to regulate the blood
sugar Type II usually occurs in obese adults after the age of 40 and is
often treated with diet, exercise and occasional pills to lower the blood
sugar
CAUSES: Diabetes mellitus is caused by obesity, prolonged periods of
mental, emotional or physical stress, pregnancy, or various disease
processes as well as known causes Stress affects the blood sugar as it
helps to release hormones that in turn aid in the production and release
of glucose to provide the body with sufficient energy to meet its increased
needs
INCIDENCE: Diabetes mellitus affects 5 of the population in the United
States approximately 10-12 million persons It is estimated that only
half of those diabetics are actually diagnosed and receiving medical
attention Is occurs equally in males and females The risk increases with
age
SYMPTOMS: The observable symptoms are more pronounced with the Type I
diabetes over the Type II These include fatigue polyuria increased urine
production, polyphagia increased hunger and
polydipsia increased
thirst Other symptoms include dehydration, even though they are usually
drinking large amounts of fluids and weight loss, even though they have a
ravenous appetite Symptoms in Type II usually include fatigue and
increased hunger
DIAGNOSIS: Diagnosis is based on blood sugar levels and the presence of
glucose in the urine The normal values for blood glucose are 70-120 mg per
deciliter after a period of fasting Two consecutive readings of 140 mg or
above indicates diabetes A person may also undergo a glucose tolerance
test in which the subject fasts, has a blood sugar level drawn for a
baseline, and then will drink a sweet sugar or glucose drink Every hour
thereafter, the blood will be drawn to test the blood sugar The body, if
it was producing sufficient amounts of insulin, should be able to remove
the sugar from the blood and the levels should drop In a patient with
diabetes, the blood sugar levels remain higher than normal during the first
two hours of so
Glucose is a compound that is not normally found in the urine as the
kidneys are responsible for reabsorbing and conserving the glucose If
glucose is found in the urine it indicates that the levels of
glucose are
too high for the kidneys to take care of properly, and consequently, some
leaks out in the urine This test is done by the patient producing a urine
sample and the medical care given dipping a stick into the urine to see if
there is a color change indicating the presence of glucose
TREATMENT: Type I diabetics, as they have a deficiency of insulin, require
regular insulin injections at regular intervals The insulin once came from
beef and pork sources, but is now being made with advances in genetic
engineering, specifically, recombinant DNA There are two major types of
insulin, the Regular brand which is a rapid, short acting form and NPH,
which is an intermediate, longer acting form The patient will usually be
required to test his/her blood sugar at intervals throughout the day,
usually before meals and adjust his/her insulin injections accordingly
Insulin injections are given into the subcutaneous layer of the skin
The Type I diabetic should be on a strict diet to regulate glucose
levels The well-known diet is the American Diabetic Association diet or
the ADA diet The diet is controlled with exchanges of the various food
groups and organic compounds of fat,
carbohydrates and protein Simple
sugars or monosaccharides, should be avoided and the person should increase
his amount of polysaccharides
The Type II diabetic usually benefits from a diet that is high in
polysaccharides, low in monosaccharides, as well as one that is low in
calories to facilitate weight reduction The diet should also be
accompanied by an exercise program The Type II diabetic may also take oral
hypoglycemics, medications which stimulate their own insulin production and
increase their sensitivity to the insulin present
COMPLICATIONS: Diabetics are prone to many long range complications Out of
all the heart attacks that occur, 50 of them are attributed to
complications of diabetes During a heart attack, blood flow is reduced to
an area of the heart which causes tissue death As a result, the pumping
mechanism of the heart is interfered with, and a heart attack, or
myocardial infarction, results One of those complications is
atherosclerosis, fatty deposits on the lining of the arteries, which make
them narrow The heart has to pump harder to push the blood through It
also accounts for 50 of all strokes that occur A stroke is when blood
flow is reduced to an area of
the brain, resulting in the death of brain
tissue They are susceptible to blindness due to interference with the
blood supply in the eye This is known as diabetic retinopathy They
develop neuropathy, which affects the nerves causing numbness and decreased
sensitivity They have a decreased resistance of infections as the glucose
content in the epidermis and urine encourages the growth of bacteria They
are also in line for kidney damage, known as nephropathy They may require
dialysis or a kidney transplant Dialysis includes the removal of blood
from the patient to be filtered by a machine This would remove excess
water and waste products A transplant involves a person who donates an
organ which is implanted into the patient You may remember this from the
movie Steel Magnolias However, the risks are considerably decreased
when the patient is able to care for himself, maintain his diet and his
blood sugar levels Hypoglycemia is another disorder
HYPOGLYCEMIA: Hypoglycemia is the abnormally low glucose level in the blood
stream
CAUSES: The major causes are when the use of glucose exceeds the supply,
overproduction of insulin or the excessive injection of insulin such as
with a
diabetic
TYPES: There are two major forms of hypoglycemia One is known as reactive,
which responds to
insulin administration or production The other is known as fasting, which
is due to the lack of food,
such as before breakfast
SYMPTOMS: The symptoms are many but usually include such symptoms as
fatigue, nervousness, irritability, trembling, hunger, sweats, headache,
and rapid heart beat in extreme cases, such as with a diabetic and
excessive insulin injections, a coma may also be seen Remember that the
central nervous system disorders are common as it need glucose to make its
ATP
DIAGNOSIS: Diagnosis is on the basis of a fasting blood sugar test which is
usually less than
45 to 60 mg
TREATMENT: Treatment involves in the maintenance of a constant, normal
blood sugar level This would include smaller, more frequent feedings
throughout the day The diet should avoid the monosaccharides as is
stimulates insulin production, which of course, would drop the blood sugar
level If the patient is a diabetic, hard candy, frosting or jam would be
indicated If the person is in a coma EMS should be contacted immediately
Source:uhmc.sunysb.edu
