Question

Choose an endocrine disorder and describe its pathophysiology, clinical manifestation and appropriate treatment.

Answer 1

Endocrine glands are tissues or entire organs that excrete chemical substances called as hormone directly into the blood rather than through a system of ducts. From the bloodstream, the hormones will be able to travel through the body's circulatory system to reach distant targets.

One of the leading cause of death in the U.S are due to diabetes where the pancreas makes insulin, but it either does not produce enough, or the insulin does not work properly.

Pathophysiology:

Type 1 diabetes occurs due to the pancreatic islet B-cell destruction predominantly by an autoimmune process that may have a higher risk of developing ketoacidosis or it is a disorder involving the complete destruction of insulin-producing beta cells in the pancreas

Type 2 diabetes is caused by either inadequate production of the hormone insulin or a lack of response to insulin by various cells of the body/insulin resistance.

Here the insulin resistance refers to :

Due to lack of physical activity and obesity $\rightarrow$ When cells of the body such as the muscle, liver and fat cells fail to respond to insulin even when the levels are high.

*In fat cells, triglycerides are instead broken down to produce free fatty acids for energy.

*Muscle cells are deprived of an energy source

*Liver cells fail to build up glycogen stores

This all will leads to an overall rise in the level of glucose in the blood $\rightarrow$ Glycogen stores become markedly reduced  $\rightarrow$ less glucose available for release when it may be needed.

Clinical Manifestations :

*Frequent Urination/Polyuria

*Intense Thirst/Polydipsia

* Increased Hunger/Polyphagia

*Dry mouth

*Loss of body weight

*Unexplained muscle loss

*Fatigue

* Tiredness

*Blurred vision

*Frequent skin infections

*Numbness or tingling in the hands/feet

*Slow healing of the wound

*Frequent urinary tract infection

Appropriate Management:

In type 1 diabetes there is the complete destruction of the insulin-producing beta cells in the pancreas and resulting in a life-long need for daily insulin replacement therapy

Type 2 Diabetes Mellitus is a disorder involving insulin resistance and impaired insulin secretion and resulting in the need for a therapy that includes diet, exercise, oral medications, and injectable medications and regular blood sugar monitoring

Oral medications include:

*Metformin

*Sulfonylureas

*Meglitinides

*Thiazolidinediones

*DPP-4 inhibitors

*SGLT2 inhibitors Injectable medications include :

Insulin therapy such as -

*Apidra

*Humalog

*Novolog

*Lantus

*Levemir

*Humulin N

*Novolin N

Diet Modification:

A healthy eating diet is important to control the higher level of glucose that includes a high fiber and low-fat foods and as well as eat food less in refined carbohydrates and sweets.

Exercise:

Participate in regular aerobic exercise like walking, swimming, biking and as well as engage in stretching and strengthening exercise helps to control blood sugar.