Case Based Learning: Topic T1 Diabetes Mellitus (T1DM)

Case Study Topic: T1 Diabetes Mellitus (T1DM)
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Introduction
Type 1 diabetes mellitus (T1DM) is among the most common chronic disorders among children, adolescents, and older adults (Lontchi-Yimagou et al., 2017). The risks of cardiovascular diseases (CVDs) are increased among patients with T1DM. Wang et al (2018 p, 141) have evaluated the differences in major CVD risks among patients with T1DM from healthy subjects and found an elevated CVD burden among patients with T1DM and confirmed the use of markers of subclinical atherosclerosis in T1DM patients. While the increased risks of CVD among individuals with TIDM has been documented, there is scanty knowledge about the relationships between CVD risk factors, events, and T1DM (de Ferranti et al, 2014, p.2843). McCall and Farhy 2013, p.145) asserts that besides the cardiovascular system, T1DM affects the endocrine function and the general body metabolism. The endocrine system consists of different types of glands that secret hormones controlling how various organs and cells function. T1DM affects the body’s mechanism of regulating blood glucose, and at the same time, the role of glucagon hormone is to increase the levels of glucose in blood. Among healthy individuals, both glucagon and insulin function to balance the glucose levels in blood. However, in T1DM patients, the body becomes incapacitated to produce sufficient insulin leading to increased levels of blood glucose unless insulin is administered (McCall & Farhy 2013, p.151). Lastly, T1DM has a significant impact on the general body metabolism. A study conducted by Lontchi-Yimagou et al (2017) have found a significant improvement in glycaemic control and relieve of diabetes complications among patients provided with diabetes care treatments, this denoting a correlation between diabetes and metabolism. This paper discusses the aetiology of type 1 diabetes mellitus (T1DM), how the disease causes a disruption in endocrine, circulation, and metabolic functions and focuses on the normal anatomy and physiology, homeostatic mechanisms in each body systems, and anatomical and physiological adaptations likely to occur among acutely and chronically ill patients with the disease.
Relevant Body Anatomical and Physiological Components
Three major systems are involved in T1DM are the endocrine system, the metabolic function, and the circulatory system. While the pathophysiology of the disease is complex and often difficult to understand, disease state emerges as an abnormal metabolism associated with vascular bed systematic damage (Alrefai et al 2002, p.105). An increasing number of studies have shown that the endocrine system is not stable among patients with T1DM, and it is not clear if the observed changes in the endocrine system would represent a primary defect or display effects of impaired action of insulin and abnormal lipid and carbohydrate metabolism on the endocrine milieu. Alrefai et al (2002, p.105) have reviewed the literature revealing that the function of the general endocrine system such as the hormonal functions from the pituitary, hypothalamus, parathyroid, thyroid, adrenal, vitamin D system, adipose tissue, and the gonadal system among T1DM is usually impaired. The authors suggest that appropriate control of metabolism and insulin administration may potentially reverse some of the abnormalities associated with T1DM. however, Alrefai et al (2002, p.105) note that it has not been clear to what extent such changes in the endocrine system will contribute to vascular derangements observed among individuals with T1DM and if part of the abnormalities seen in the endocrine system point to the basic cellular defect in diabetes.
The endocrine system comprises of glands, which secrete hormones or chemical messengers that regulate the activities of cells and organs (Chrousos 2007, p.125). The hormones are responsible for metabolism, growth, sexual development, and a myriad of other functions. The endocrine system and associated glands and structures such as the hypothalamus, pituitary glands, thyroid glands, parathyroid glands, and adrenal glands serve to maintain the normal body functions and homeostasis. The hypothalamus, which is located in the middle lower part of the brain, is critical in the regulation of metabolism, satiety, and body temperature. This structure also secretes hormones stimulating or suppressing the release of pituitary glands hormones. The pituitary gland is at the base of the brain below the hypothalamus whose role is to control a number of functions of other glands of the endocrine system. Insufficient production of hormones associated with the pituitary glands is known as hypopituitarism. The thyroid gland produces thyroid hormone, which regulates the general body metabolism, and plays a significant role in the development of the nervous system and the brain among children (Kemp, 2019). It is also responsible for the maintenance of heart rate, blood pressure, muscle tone, digestion, and reproductive functions. The parathyroid glands release parathyroid hormone that serve to regulate the levels of calcium in the blood.
Other important systems that take part in the regulation of body functions include the circulatory system and the general metabolic functioning. A complex network of arteries, veins, and capillaries make up the vascular of system that aids in the maintenance of cellular homeostasis (Pugsley & Tabrizch 2000, p.333). The circulatory system is made of the heart and the general vascular system that helps in the transportation of blood throughout the body. The blood will carry a number of essential substances needed by the body to function. Therefore, an understanding of the functions of the cardiovascular system as well as the various pathways such as arteries, veins, and capillaries is critical in the management of diseases such as T1DM. While related to the endocrine system, metabolic syndrome has been classified to a constellation of biochemical, physiological, clinical, and other metabolic factors that are directly related to the increase of type 2 diabetes mellitus (T2DM) and cardiovascular diseases leading to increased chances of mortality (Kaur, 2014). Type 2 diabetes mellitus is one of the several factors, including visceral adiposity, insulin resistance, dyslipidaemia, endothelial dysfunction, atherogenic dyslipidaemia, and chronic stress that constitute metabolic syndrome.
Relevant feedback loops to maintain homeostasis
The body makes use of homeostatic function in resisting changes and maintain a relatively constant and stable internal environment. This function usually involves negative feedback loops, which counteract alterations of various properties from their targeted values, referred to as set points. Contrary to the n...