Wednesday, October 14, 2009

Homeostatic Imbalance - Diabetes mellitus - A Trip of Complications

Homeostatic Imbalance - Diabetes Mellitus

Diabetes mellitus results from either hyposecretion or hypoactivity of insulin. After a meal, when insulin is either absent or deficient, blood glucose levels remain high because glucose is unable to enter most tissue cells.

Ordinarily, when blood glucose levels rise, hyperglycemic hormones are not released, but when hyperglycemia becomes excessive, you start to feel nauseated. 

The nausea causes your body to enter the "flight-fright-frolic" response. This is a series of changes brought about by the Autonomic Nervous System and prolonged by certain members of your Endocrine System

The results are inappropriate because they normally occur in the hypoglycemic (fasting state) to make glucose available. The nausea triggers glycogenolysis (breakdown of glycogen), lipolysis (breakdown of fat) and gluconeogenesis.

These cause the already high glucose levels to soar even higher and excess glucose begins to leave the body in the urine (glycosuria).

When simple sugars, such as glucose, cannot be used as cellular fuel, more fats are mobilized and broken down for fuel. The fats produce a high fatty acid level in the blood, a condition called lipidemia or lipemia. The presence of acids in the blood increases a persons free H+ ion count which results in a lower than normal pHThis is referred to as acidosis

When a H+ ion is free, by itself, it contributes to acidity. The purpose of buffering is to combine the free H+ and take it out of body fluids. When that happens the pH of the blood increases (Becomes Basic).

In severe cases of diabetes mellitus, blood levels of fatty acids and their metabolites (acetoacetic acid, acetone and others) rise dramatically. The metabolites, collectively called ketones or ketone bodies are organic acids. They work to push down your pH even more. Your acidosis becomes more severe. Since this is due to ketones the acidosis is renamed ketoacidosis. Excess ketones spill over into the urine from the kidneys. This is called ketonuria.

Severe ketoacidosis is life threatening. One of the very good reasons to see your friendly Diabetologist if you suspect you are starting to lose control of your condition.

The severe ketoacidosis causes the nervous system to initiate rapid deep breathing (hyperpnea) to blow off carbon dioxide from the blood with the net result of temporarily increasing your pH (buffers the blood).

If ketoacidosis continues unchecked it will disrupt heart activity and oxygen transport, severely depress the nervous system which leads to coma and death.

Detection, education and control are the keys to managing diabetes.

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