Diabetes · Dietetic Internship · Topic of the Week

Topic of the Week: Diabetes-The Disease

My week is already over…what? Well, that’s a lie, my rotations for the week area already over.  Tomorrow is a “didactic day” as we are calling them.  That basically means all 7 of us interns are all together for the day doing various activities.  I’m hoping it goes fast, I’m ready for the weekend! 2 Towns Ciderhouse Harvest Party anyone? That’s where you’ll find me on Saturday evening 🙂

Anyways, on to nutrition.

Diabetes is a VAST subject.  It’s a complicated disease and while many people have a firm grasp on the basics of the disease, I’ve realized lately that it’s not so clear to those who haven’t studied it for the last few years like I have.  On Tuesday night I had the opportunity to attend a diabetes education class with my preceptor and become an emergency glucagon provider.  Basically that just mean that in the case of a diabetic becoming severely hypoglycemic I am trained to administer glucagon using a glucagon pen.

I realize that was probably as clear as Greek to a number of people out there…it’s okay. I will explain.

In the training I was the only person minus my preceptor with a nutrition degree and strong nutrition background.  Our instructor was very well qualified to teach the course and was extremely knowledgeable on the subject of administering glucagon safely and properly, but it was obvious that the biochemistry background that would have allowed her to clearly explain things was missing.  That is totally fine because it wasn’t really her job, but my preceptor had to step in with some of the fundamentals.  Mostly, what is the difference between Type 1 and Type 2?

Although I know quite a bit about the differences between Type 1 and Type 2, I decided to bust out one of my old text books to reference just to make sure I got things right.

003

Can we just talk about how long it’s been since I’ve opened this book?  I still remembered to find “Endocrine Diseases” so not all my nutrition knowledge has slipped away…but it has been a while.  Like 15 or 16 months.  Sheesh!

Also, I am proud to say I DID do something productive in college, my highlighting proves it!

006

Not a total slacker, I obviously did my reading sometimes…

Basically, I love nutrition, I hate textbooks.  End of story.

So diabetes…

Type 1 Diabetes Mellitus

That would be the official name of the disease…  Simply put, in Type 1 Diabetes, the body loses the ability to produce insulin.  Insulin is produced in the pancreas and a diabetic’s pancreas becomes unable to do so.  This change doesn’t happen overnight, it’s gradual, but it causes a noticeable effect early in life.  Type 1 diabetics are usually diagnosed in childhood or early adulthood and from that point they will be dependent on receiving insulin, either through a shot or a pump, for the rest of their life.  Those with Type 1 diabetes typically lead very normal lives and are very in tune with their body.

Type 2 Diabetes Mellitus 

Unlike Type 1 diabetes that is caused by the body not producing insulin, Type 2 diabetes is caused by your body becoming resistant to the insulin it is producing.  The insulin loses it’s ability to do it’s job properly.  For that reason, a Type 2 diabetic has to utilize diet, exercise, and antidiabetes medication to manage their disease.  This is the more common type that accounts for 90% of all diabetes cases.

Insulin and Glucagon 

The last fundamental piece to understanding the basics of diabetes is understanding what insulin and glucagon are.  They are both hormones that are produced by the body and used to control blood sugar.  Insulin is responsible for taking the sugar in the blood and taking it up into the tissues to be used by the cells.  Glucagon does the opposite of that.  Glucagon allows glycogen, the body’s stored for of sugar, to be broken down into glucose (sugar) and released into the blood stream to be used where the body needs it.  If these two hormones are unable to work together then the body can either have high blood sugar (hyperglycemia) or low blood sugar (hypoglycemia).

So to tie this back to my training on Tuesday night!  There is an individual at the preschool who is a Type 1 diabetic.  In the event that they becomes hypoglycemic (has low blood sugar) and it gets to an severely low level, they could lose consciousness, become unresponsive, or have a seizure.  This is an EXTREMELY dangerous state for anyone to be in and requires immediate attention.  If this were to ever happen to them, they have a kit with a glucagon pen in it that someone like myself could administer.  This would give their body a rush of glucagon to breakdown the glycogen and raise their blood sugar, bringing them out of a dangerous state.

Our body is pretty cool, isn’t it?

Source: Nutrition and Diagnosis-Related Care.  Escott-Stump, Sylvia.  7th edition.

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