Disturbance Insulin hormone
1-Hypersecretion( Hypoglycemia ):-
Cause :
– Overdose of insulin in diabetes
– Insulinoma (tumor of the pancreas)
– Kidney failure
Symptoms:– Palpitation, sweating, nervousness, hanger, and confusion.
– At very low plasma glucose level: coma and convulsion Death.
2- Hyposecretion (hyperglycemia)
Diabetes Mellitus
Cause :
– Pancreas doesn’t produce enough insulin
or cells don’t respond to the insulin that
is produced.
Symptoms:
– Polyuria, polydipsia, polyphagia.
Types :
Type I- Insulin-dependent DM
Type II- Non–insulin-dependent DM 
TYPE1 (INSULIN DEFICIENCY)
Risk factors:
1- genetics
2- dietary factor
– Low vit.D consumption.
– Early exposure to cow’s milk (before 4 months)
3- Race
– More common in white
Type2 insulin resistance
Mainly decrease tissue sensitivity to insulin (usually after 40 years)
Risk factors :
– Overweight
– Inactivity
– Age
– Gestational diabetes
– Polycystic ovary syndrome
– High blood pressure
– Abnormal cholesterol level
GESTATIONAL DIABETES
– lifestyle modification.
Type I: insulin therapy 
Type II: oral anti-diabetic & some ppl need insulin gestational: Insulin therapy only.
Patient counseling:-
1. Eat healthily.
No foods are strictly off-limits.
Get plenty of vegetables, fruits, and whole grains
Choose nonfat dairy.
Limit foods that are high in sugar and fat.
Remember that carbohydrates turn into sugar, so watch your carb. intake.
2. Exercise.
Just walk, ride a bike, or play active video games.
30 minutes of activity that makes you sweat and breath a little harder
An active lifestyle helps you control your diabetes by bringing down your blood sugar.
It also lowers your chances of getting heart disease.
3. Get checkups.
See your doctor at least twice a year.
Diabetes raises your odds of heart disease.
So learn your numbers: cholesterol, blood pressure, and A1C (average blood sugar over 3 months).
Get a full eye exam every year.
Visit a foot doctor to check for foot ulcers and nerve damage problems.
Random blood glucose
Fasting blood glucose and postprandial
Hb A1C
Cholesterol & Triglycerides
Kidney Function Test
4. Manage stress.
When you’re stressed, your blood sugar levels go up.
And when you’re anxious, you may not manage your diabetes well.
5- wear weight socks
6- follow up on your vaginal infection
Basal insulin and bolus insulin:
Insulin preparation:
A- short-acting insulins BOLUS only not basal ( half an hour before meals )
Only one type can be used in an emergency (water-soluble)
C- intermediate-acting insulin ( Natural
protamine Hagedrn NPH )
* Protamine + zinc insulin = susp. ( cloudy milky )
Onset : 1 – 2 hr
Duration : 14 – 24 hr
– Basal
short acting ( bolus )
+ NPH ( basal ) = premixed
D- premixed insulin
– Humulin 70/30 : 70% NPH + 30 % Regular
– Mixtard 50/50 : 50 % NPH + 50 % Regular
– Humalog mix 75/25 : 75% protamine lispro
+ 25 % lispro.
E- Long-acting insulin ( basal insulin )
Onset: 1 – 1.5 hr
Duration: 24 hr
Once-daily
