Prompt 1: Explain in detail the pathogenesis of DM Type 1 & 2 and DKA.
Prompt 3: Describe treatments that would be used for DM and DKA.
The exact pathogenesis of diabetes mellitus type one is still unknown, but it is believed that an
individual’s immune system is the cause. “T1D results from the destruction of the insulinproducing cells in the pancreas called beta cells by the adaptive immune system. This process is
promoted by an incompletely understood interaction between a person’s genetics and their
environment” (Giwa et al., 2020). This is usually detected in children but there are cases where
adults get diabetes mellitus type one. People with this disease must inject insulin to keep their
glucose levels under control.
“In type 2 diabetes, there are primarily two problems. The pancreas does not produce enough
insulin — a hormone that regulates the movement of sugar into the cells. And cells respond
poorly to insulin and take in less sugar” (Mayo Clinic, 2023). Diabetes mellitus type two is
usually seen in obese adults and children. This can usually be managed by a healthy lifestyle.
Eating healthy, exercising, and losing weight can help reduce the amount of glucose in the blood.
The insulin produced by the body is usually enough when an individual is healthy.
Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes. “DKA develops
when your body doesn’t have enough insulin to allow blood sugar into your cells for use as
energy. Instead, your liver breaks down fat for fuel, a process that produces acids called ketones.
When too many ketones are produced too fast, they can build up to dangerous levels in your
body” (CDC, 2021). This usually occurs to people who have undiagnosed diabetes when their
glucose levels are at 300 mg/dL or higher for a long period of time. Frequent urination and
insatiable thirst are the most common symptoms. In this week’s episode Mrs. Fernandez was
experiencing extreme nausea, weakness in left leg and foot, frequent urination, and memory loss
due to DKA. Since her glucose levels were at 368 mg/dL an insulin drip was administered, and
no food or water were given to her until her full metabolic panel results were improved.
Reference:
CDC. (2021, March 25). Diabetic Ketoacidosis. Centers for Disease Control and Prevention.
https://www.cdc.gov/diabetes/basics/diabeticketoacidosis.html#:~:text=DKA%20develops%20when%20your%20body
Giwa, A. M., Ahmed, R., Omidian, Z., Majety, N., Karakus, K. E., Omer, S. M., Donner, T., &
Hamad, A. R. A. (2020). Current understandings of the pathogenesis of type 1 diabetes:
Genetics to environment. World Journal of Diabetes, 11(1), 13–25.
https://doi.org/10.4239/wjd.v11.i1.13
Mayo Clinic. (2023, March 14). Type 2 Diabetes. Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc20351193