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Diabetes

FYI: Types of Diabetes
This text on diabetes has been provided to you to supplement Intravenous Therapy for Prehospital Providers. Problems resulting from diabetes may require IV treatment. Understanding diabetes and problems related to it will help you treat them in the clinical setting.

Table of Contents
Diabetes Mellitus
Diabetes Mellitus Type 1
Diabetes Mellitus Type 2
Diabetes Insipidus


A Brief Discussion on Diabetes

Diabetes Mellitus
Diabetes Mellitus (Sweet Diabetes) is an endocrine disease involving the use of glucose as an energy source for the cells of the body. Diabetes Mellitus can be broken down into two categories depending on its onset and the degree of insulin insufficiency.

Diabetes Mellitus Type 1
Diabetes Mellitus Type 1 is also called Juvenile Onset Diabetes because it first appears in children. Type I is characterized by a complete absence of insulin production, resulting in life-long dependence on injectable insulin. Dependence on insulin arises from the inability to create insulin, the hormone that transports glucose across the cell membrane. Normally, insulin is created in the beta cells of the Islets of Langerhans in the pancreas. People suffering from Type 1 are particularly prone to the development of diabetic ketoacidosis (DKA). Type 1 can also be categorized further into Type 1a - an autoimmune disorder that destroys the beta cells of the pancreas - and Type 1b - an idiopathic form.

Diabetes Mellitus Type 2
Diabetes Mellitus Type 2 is also called Adult Onset Diabetes. Type 2 is characterized by reduced insulin production by the pancreas or desensitization of the cells to the presence of insulin. Type 2 patients are usually overweight and have dietary habits that predispose the pancreas to wear out. Often, Type 2 is managed with medication or diet modification.

Diabetes Insipidus
Diabetes Insipidus (Tasteless Diabetes) is another form of diabetes that is not related to insulin production. Insipidus is a problem of water regulation in the body due to the absence of the Anti-Diuretic Hormone (ADH) secreted by the pituitary gland. Without ADH, the kidneys will not retain water, allowing huge amounts to be released into the urine. Insipidus patients experience polyuria and polydipsia in order to balance out the water losses. Problems occur as the water losses lead to acid/base shifts.



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