Physio seminar 77.pptxxbbxhxhshshshhshdb

Diabetes

1. F e a t u r e s o f D M P o l y u r i a P o l y d i p s i a P o l y p h a g i a H y p e r g l y cemia a n d G l y c o s u r i a U n t r e a t e d D M l e a d s t o k e t o s i s a n d a c i d o s i s

2. P o l y u r i a W h e n p l a s m a g l u c o se c o n c e n tration i n c reases a b o v e 1 8 m g % g l u c o se appear s i n u r i n e . I n c rease d g l u cose c o n c e ntration i n t u b u l a r f l u id c a u s es o s m o t i c diur e s i s t h a t r e s u lt in polyuria . P o l y d i p s i a B e cause of p o l yuria w a t e r l o s t f r o m b o d y . T h i s d e c r e a s e s p l a sma a n d E C F v o l u me . D e h y d r a t i o n s t i m u lates thirst center t h a t c a u ses p o l y d ipsia .

3. P o l y p h a g i a V e n t r o m e d i a l h y p o thalamus d e p ends on i n s u lin f o r g l u c ose uptake V M H i n h i bits t h e lateral h y p o t h a lamus I n s u l i n d e f i ciency in D M d e c r e ases a c t i vity o f V M H D e c r e ase d V M H a c tivity r e m o ves i t s i n h i b i t o ry e f f ect o n l a t e r al h y p o t h a lamus S o L H a c t i v i ty i n c r e ases l e a d s t o p o l y p h a gia

4. W e i g h t l o s s I n s u lin a l s o f a c i lities g r o w th . I n s u l i n d e ficiency c a u s e s w e ight loss a n d g r o wth retardation H y p e r glycemia a n d G l y c o s u r i a I n s u lin d e c reases p l a s m a glucose concentration . Therefore deficiency of i n s u l i n results in hyp e r glycemia . W h e n plasma glucose concentratio n m o r e t h a n r e n a l t h r e s hold g l u cose a p p ears i n u r i n e r e s ults i n Glycosuria .

5. K e t o s i s I n s u lin f a c i lities utilisation o f k e t o ne bodies . T h e r e fore , k e t o sis o c c u rs i n D M Excessive a c e t y l - C o A c o n v e r t e d i n t o a c e t o a c e t a t e i n l i v e r A c i d o s i s T h e h y d r o gen i o n s l i b e r a t e d f r o m k e t o n e bodies a r e b u f f e r e d w h e n k e t o s is b e c o m e s e v e r e , b u f f e r i n g c a p a city d e c r e ases , c a u se p l a s m a a c i d i c

6. D e c r ease d p H s t i mulates k u s s m a u l b r e t h i n g . I n s u lin i n c r e ases N a + , K + a n d p h o s p h a t e r e a b sor p t i o n f r o m k i d ney . T h e r e fore i n D M l o s s o f e l e c t r o l y te a n d w a t e r . T h i s causes d e h ydration , h y p o v o l e m i a , a n d h y p o t e n sion .