Cash4Coursework has been rebranded ‘FreeCoursework.info’ - Visit us to download coursework for free and to earn money from your old coursework!
View this page at Freecoursework.info
Type 2 Diabetes Case Study - page 4
Keywords: Daibetes, case study, Diabetes Melltitus, NIDDM patient history
By Einstein10 on 30/12/2009
Level: Foundation Degree
Page Number: 4 of 6 pages: 1 2 3 4 5 6Patients are usually obese and afro-carribean/asian populations are genetically predisposed due to low HLD levels and high triglycerides. Treatment includes oral hyperglycaemic agents and insulin in severe cases
Tests to differentiate between type 1 and 2
Table 8. 11 7 Test to differentiate between type 1 and type 2 Diabetes
Test Explanation
C Peptide A C-peptide test can be performed to determine the amount of endogenous insulin is present and therefore can differentiate between a type 1 and type 2 patient. During the synthesis of insulin, a precursor molecule called proinsulin is cleaved proteolytically to form euquimolar amounts of mature insulin and C-Peptide, which has no know physiological function, are released into the portal vein. C-peptide is removed from the bloodstream via the kidneys in half an hour and insulin by the liver within 5 minutes, therefore high concentrations of C-peptide persist in the peripheral circulation. If at the time of testing, there is no C-peptide present, then this suggests a diagnosis of type 1 because there has been total beta cell destruction. If C-peptide is present, then you have two possible results. Firstly, the patient is in the early stages of type 1 diabetes where there is clear beta-cell destruction with some insulin secretion or, the patient is a type 2 diabetic who is still producing endogenous insulin but has impaired glucose tolerance. 5
Autoantibody Furthermore, in type 1 diabetes, specific autoantibodies to insulin, islet cells and glutamic acid decarboxylase help in identifying type 1 patients. Glutamic acid decarboxylase 65 (GAD65) antibodies are the most specific antibodies constituting to 70-80% GAD antibodies found in type 1 patients before or at the onset of the disease. If GAD autoantibody assays are added to the ICA (islet cell antibodies) found in the serum of type 1 diabetic then it increases the chances of detecting the disease to greater than 90%. This test must be done prior to exogenous insulin exposure.
The major short-term complication of type 1 diabetes is ketoacidosis which is a life-threatening condition. A total lack of insulin in the body results in decreased glucose absorption into bodily cells initiating the process of gluconeogenisis. This results in ketone bodies like aceotacetate and β-hydroxybutyrate being formed which lower blood pH (metabolic acidosis). Excess glucose spills into urine which takes along with it water, potassium and sodium (osmotic diuresis) causing dehydration. Treatment includes fluid, intravenous insulin, potassium and mannitol in the case of cerebral oedema.
Last 5 comments…
There have been no comments posted for this article, but you need to register if you want to be the first!