Pathophysiology of Diabetes Mellitus
There are three types of diabetes mellitus: type 1, type 2 and gestational diabetes. Type 1 diabetes appears as a result of destruction of beta cells by the immune system. The deficiency of beta cells in the pancreas leads to inadequate insulin and presence of anti-islet cell antibodies in the blood system (Mandal, 2017).
Type 2 diabetes is caused by low levels of insulin and not total deficiency. This means that the body cannot produce sufficient insulin, a condition that leads to deficiency of beta cells and peripheral insulin resistance (Mandal, 2017). Peripheral insulin resistance is a state where there is high levels of insulin and absence of hypoglycemia in the blood.
Gestational diabetes is mainly caused by extreme levels of counter insulin hormones during pregnancy, which leads to high blood sugar and insulin resistance. This condition can damage insulin receptors (Mandal, 2017).
Pathophysiology of Diabetes Insipidus
Diabetes insipidus is caused by unstable antidiuretic hormone (ADH) levels. ADH is produced by the hypothalamus and stored by the pituitary glands. It regulates excretion of fluids from the blood stream by affecting the aquaporins, which control permeability of transmembrane vessels (Mandal, 2017).
Differences between Diabetes Mellitus and Insipidus
Diabetes mellitus is a pancreatic disorder, whereas diabetes insipidus is a hypothalamic disorder (Huether & McCance, 2017). This implies that the two diseases produce different effects on hormonal regulation. In case of diabetes mellitus, the hormone insulin is involved (secreted by the cells located in pancreas). When the condition emerges, it implies that the level of insulin either becomes too low, or the body is incapable of responding to it in a proper way. As for diabetes insipidus, anti-diuretic hormone (or vasopressin) is involved. It is produced by hypothalamus. The disease is characterized by either its deficiency or inability of kidneys to react to it.
There is an occurrence of ketone bodies in the blood of diabetes mellitus patients. These bodies are absent in diabetes insipidus patients. Urine in the case of diabetes mellitus is of normal concentration although it is very dilute in diabetes insipidus. Rise in blood cholesterol and glucose level which result to higher rates of excretion are clear in diabetes mellitus although they do not occur in insipidus (Hammer & McPhee, 2014). Mellitus is also characterized by excessive hunger which is unlike normal eating habits in diabetes insipidus.
Similarities between Diabetes Mellitus and Insipidus
Diabetes mellitus patients often experience excessive fatigue due to high or low levels of blood sugar while fatigue in diabetes insipidus result from inadequate hydration (Hammer & McPhee, 2014). Excessive thirsty in diabetes mellitus is caused by high glucose levels in the body while it is caused by lack of vasopressin in diabetes insipidus. Blurred vision in diabetes mellitus is a result of excess glucose while in diabetes insipidus it results from extreme dehydration (“Diabetes insipidus vs mellitus,” 2015).
Gender and Ethnicity Effects
Generally, men are at a higher risk of being diagnosed with diabetes than women. The major reason is that fat they have is stored in their inner organs (as compared to women whose fat is distributed on the surface). This implies that women can gain more fat before the condition becomes threatening to their health. However, the development of the disease is more complicated for women than for men, which results in higher death rates.
As for the effect of ethnicity, Mexican Americans, African Americans, Asian Americans, Native Hawaiians, American Indians, and Pacific Islanders are at a greater risk of diabetes, partially due to their propensity to be overweight. Treatment differences are not dramatic among genders and ethnicities.
In both females and males of diverse ethnicities and races, the treatment of type 1 diabetes usually includes insulin injections, low-carbon diet and regular physical activity (Mandal, 2017). Patients who are overweight and have high daily doses of insulin can also benefit from the intake of metformin as it helps to control blood sugar level more efficiently by improving glucose metabolism (Viollet et al., 2012).
However, the use of this drug is more common for the treatment of diabetes type 2, whereas the insulin is not used in this form of the disorder. Lifestyle modifications are recommended for the intervention of diabetes type 2 as well. Additionally, since this form of the disease is associated with increased blood pressure, patients can be prescribed with calcium channel blockers and ACE inhibitors that are effective in reducing hypertension and preventing organ damage (Ganesh & Viswanathan, 2011).
References
Diabetes insipidus vs mellitus. (2015). Web.
Ganesh, J., & Viswanathan, V. (2011). Management of diabetic hypertensives. Indian Journal of Endocrinology and Metabolism, 15(Suppl4), S374–S379.
Hammer, G. D., & McPhee, S. J. (2014). Phathophysiology of diseases: An introduction to clinical medicine. (7th ed.). New York: McGraw-Hill Education.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Mandal, A. (2017). Diabetes Pathophysiology. Web.
Viollet, B., Guigas, B., Sanz Garcia, N., Leclerc, J., Foretz, M., & Andreelli, F. (2012). Cellular and molecular mechanisms of metformin: An overview. Clinical Science (London, England : 1979), 122(6), 253–270.