Question

ТООТ А Diabetes Mellitus Type 1 Mr. M. has had type 1 diabetes for 15 ye admitted to the hospital with severe pyelonephritis, infection. as had type 1 diabetes for 15 years. He has just been lonephritis, a kidney 1. Describe the pathophysiology of type 1 diabetes. plain why urinary tract infections are common in people with diabetes. Explain how acute renal failure could develop. Mr. M. has had the infection for a week and has developed mild ketoacidosis because of the infection. Analysis of arterial blood gases indicates that his serum bicarbonate level is low, and his serum pH is just below normal range. 3. Explain why infection may lead to ketoacidosis. 4. Describe the characteristics of Mr. M.'s respirations that you would expect to observe while ketoacidosis is present. Include the rationale for your answer. 5. If Mr. M.'s serum pH continues to decrease below normal, how would that pH affect cell and organ function? 6. Mr. M. is voiding large volumes of urine (polyuria). Explain the reason for this reaction. 7. Describe three signs of excessive fluid loss. 8. Mr. M.'s vision has deteriorated in the past 3 years because of retinopathy. Explain how retinopathy impairs vision. 9. Describe two problems related to diabetes that Mr. M. might encounter because of his reduced vision.

Answer 1

Type 1 diabetes is also known as Juvenile diabetes commonly seen in young people or children.

So type of infection affects insulin producing beta cells in pancreas and destroy cells leads to hyperglycemia due to absence of production of insulin.

1. Due to etiology (genetic factors, viral infection, bacterial infection, Physical factors, dietary factors etc) the beta cells of islets of Langerhans in pancreas which produce insulin get destroyed due to inflammation or autoimmunity. This causes increased blood sugar level and develop type 1 diabetes mellitus.

If left untreated, ketoacidosis develops and following ketonuria and glycosuria. This leads to polyuria and polydypsia leads to diabetic coma.

2. Diabetes can affect the structure and function of the lower urinary tract and bladder become underactive or overactive. Due to low sensation of urinary bladder, urine stays longer time leads to growth of bacteria and urinary tract infection.

High blood glucose level affects glomeruli and leads to kidney cell damage and later kidney failure.

3.body produces hormones like adrenaline and cortisol due to infections like pneumonia and urinary tract infection. These hormones reduce the effects of insulin and leads to increased blood sugar results in ketoacidosis.

4. During respiration, a fruity scented breath can help to identify ketoacidosis.

If body is not converting blood sugar to glucose to meet body's energy requirement, body tries to breakdown fat store from the body. The end product of this cycle is ketone.

Acetone is also a ketone which smells like fruity .so , fruity scented breath indicates increased ketone in blood. And needs immediate attention.