BIOH12012 Pathophysiology And Pharmacology

Question:

Define the pathophysiology, pharmacological treatment and management of type 2 diabetes in a client/person.

Please demonstrate your understanding by clearly describing the relationships between pathophysiology clinical manifestations, and pharmacological treatment of your client’s/person’s disease.

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These questions will be used for grading the ‘coverage’ and accuracy information’ sections of your assignment.

Following the criteria, you will need to create a client/person for yourself.

The following 4 questions must be answered:

Question 1

For blood glucose control, the following physiological processes are essential:

Insulin synthesis, release

Insulin binding to target tissues explains why they are different in your client/person than in a healthy person.

Question 2

Here are some of the long-term consequences of uncontrolled hyperglycaemia

Renal disease: Explain why they might be present in your client/person.

Question 3

Type II diabetes mellitus can be managed with the following drugs:

Metformin

Insulin

Select the appropriate one for your client/person.

Its mechanism of action can be discussed with your client or person.

Question 4

Answer both the a/b and c parts. Insulin resistance can be caused by an increase in abdominal adiposity.

Explain the pathophysiological reasoning behind this.

(b) Describe why HbA1c has been used to measure long-term BGL control and how this measure can be applied in the management of your client’s/person’s disease.

Answer:

Question 1

Insulin Synthesis and Rejection

The beta cells of the pancreas contain significant amounts of insulin that are synthesized.

The insulin mRNA is translated into the single peptide through insertion in endoplasmicreticulum. This creates the proinsulin.

Fu, Gilbert, & Liu (2013) noted that proinsulin is mostly derived from the exposure to C peptide-exercising endopeptidases.

This is what allows you to make mature insulin.

Insulin binding to target tissue

Insulin resistance is a result of insulin alternation. It occurs at the hepatic insulin levels.

Post binding is a process that occurs in the peripheral targeted tissue (Berry, et al. 2013,).

The primary lesion in type 2 diabetes is the post binding defect.

Question 2

Retinopathy can be caused by type 2 diabetics and causes vision loss or vision impairment.

Mr. Brown may experience total blindness due to his type 2 diabetes.

The type 2 diabetes must be treated.

High levels of sugar can cause abnormal blood vessels to grow in the retina (Lovshin, Shah, 2017).

Mr. Brown has a greater chance of developing kidney disease.

Insufficient insulin production can cause problems in blood glucose regulation.

High-risk kidney disease can result (Coresh and co., 2014).

This condition requires that the patient be aware of their weight, healthy eating, lifestyle, medication, and other measures to decrease the impact of diabetes mellitus.

Question 3

Insulin and its Mechanism Of Action

Insulin is one example of a peptidehormone.

It is made from the beta cell in the pancreas.

Insulin activates GLUT4, which allows glucose to be uptaken in the fat cells.

If insulin production is reduced in the body, glucose uptake decreases and symptoms of type 2 diabetes appear.

The insulin is composed of the single peptide which directs the nascent peptide chain to the endoplasmicreticulum.

The transport of proinsulin through the trans-Golgi system causes the formation of mature granules.

Question 4

A. Pathophysiology And Insulin Resistance

Type 2 diabetes mellitus, as well as metabolic syndrome, are both caused by insulin resistance.

The insulin resistance in skeletal muscles is manifested primarily by a reduction in insulin stimulated glycogen synthes (Blazquez, et al. 2014).

This is due to decreased glucose transportation.

Measurement of HbA1c

Red blood cells in the human body can survive for 8-12 weeks before being replaced.

According to Strack et. al. (2014), it is possible to measure the glycated haglobin which indicates the average blood glucose level.

This can have a long-term affect on blood glucose control.

HbA1c, however, is the biochemical marker that aids in the management and prevention of type 2 diabetes mellitus.

Refer to

The STRA6 receptor plays an essential role in the retinol binding protein-induced insulin resistance, but it is not necessary for maintaining vitamin A homeostasis elsewhere than the eyes.

Journal of Biological Chemistry. 288(34), 235228-24539.

The brain’s insulin: the pathophysiological implications of central insulin resistance, type-2 diabetes, and Alzheimer’s disease for States.

The decline in estimated glomerularfiltration rate and the subsequent risk of end stage renal disease and death.

Fu, Z.R Gilbert, E. and Liu D. (2013).

Regulation of insulin secretion and synthesis as well as pancreatic Beta-cell dysfunction during diabetes.

A population-based study reveals inadequacies in screening for retinopathy among type 2 diabetics.

Journal of Diabetes & Its Complications 31(4), 666-668.

Metformin [mdash]: mechanism of action and clinical implications.

Nature Reviews Endocrinology 10, 143-156

Analyse of 70,000 records from the clinical database: Impact of HbA1c measurement upon hospital readmission rates

BioMed research international 2014