35
lead to multiple genetic deformities such as c-cleft, cleft lip, and neural tube defects.
Genetic factors, weight, and age are also major risk factors for diabetes. Diabetes
can lead to nocturnal hypoglycemia, and brain damage in severe cases [66].
Diabetes can be treated by ingesting a drug that contains an alpha-glucosidase
inhibitor, or by maintaining proper diet and exercise [67]. There is a new mechanism named pressure reflex, which causes an enhanced morbidity and mortality in
patients with diabetes by altering heartbeats [68]. Insulin resistance also interferes
with lipid metabolism, increasing fatty acids leading to obesity, type 2 diabetes, and
cardiovascular disease [69]. Chronic complications of diabetes, due to changes in
minerals and bone metabolism, may cause bone loss [70]. Diabetic patients also
experience macrovascular and microvascular problems. Major vascular complications include coronary heart disease, peripheral vascular disease, and cerebrovascular disease, while the effect on small blood vessels, capillaries, small arteries, and
venules are microvascular complications [64]. Microvascular complications are
more common in adults and the elderly, but rarely in children and adolescents [71].
The classic clinical indicators of diabetes are called three P’s which are polyuria,
polyphagia, and polydipsia. As the level of glucose in the blood rises, the kidney’s
function to reabsorb glucose is compromised, causing glucose spill in the urine and
hence leading to osmotic diuresis. Usually glucose is not detected in the urine, so if
there is any glucose present in the urine, it is an abnormal phenomenon. Weight loss,
fatigue, blurred vision, and thirst may also occur.
Hypoglycemia
Hypoglycemia is a common endocrine disorder related to diabetes. Blood glucose
levels <60 mg/dL (3.3 mmol/L) are referred to as hypoglycemia. Here average
blood level values are mentioned but these levels may vary from individual to individual. In general, when plasma glucose levels fall below 60 mg/dL (3.3 mmol/L),
a rapid and continuous cascade of actions start as follows:
1. The body will reduce insulin secretion to prevent a drop in blood sugar levels.
2. Next, the secretion of counter-regulatory hormones, mainly adrenaline and noradrenaline, is increased.
3. At the end, signs and symptoms, including cognitive decline, become obvious.
When the glucose level drops below 50 mg/dL (2.8 mmol/L), there are significant mental state alterations.
If hypoglycemia is not treated, there will be more morbidity and mortality rate. To
reduce these risks, timely identification of signs and symptoms and quick and affective treatment is required. Hypoglycemia in insulin-dependent diabetes mellitus is
usually results from taking high insulin dose, eating very less, or sometime both.
Central nervous system’s tissues are different from other tissues as they can metabolize protein or fat, usually including sugar, and rely completely on glucose as their
energy source. If the level of glucose in the blood drops sharply, the brain will be
factually starved. Hypoglycemia in patients without a history of diabetes is referred
1 Physiology of Endocrine System and Related Metabolic Disorders
lead to multiple genetic deformities such as c-cleft, cleft lip, and neural tube defects.
Genetic factors, weight, and age are also major risk factors for diabetes. Diabetes
can lead to nocturnal hypoglycemia, and brain damage in severe cases [66].
Diabetes can be treated by ingesting a drug that contains an alpha-glucosidase
inhibitor, or by maintaining proper diet and exercise [67]. There is a new mechanism named pressure reflex, which causes an enhanced morbidity and mortality in
patients with diabetes by altering heartbeats [68]. Insulin resistance also interferes
with lipid metabolism, increasing fatty acids leading to obesity, type 2 diabetes, and
cardiovascular disease [69]. Chronic complications of diabetes, due to changes in
minerals and bone metabolism, may cause bone loss [70]. Diabetic patients also
experience macrovascular and microvascular problems. Major vascular complications include coronary heart disease, peripheral vascular disease, and cerebrovascular disease, while the effect on small blood vessels, capillaries, small arteries, and
venules are microvascular complications [64]. Microvascular complications are
more common in adults and the elderly, but rarely in children and adolescents [71].
The classic clinical indicators of diabetes are called three P’s which are polyuria,
polyphagia, and polydipsia. As the level of glucose in the blood rises, the kidney’s
function to reabsorb glucose is compromised, causing glucose spill in the urine and
hence leading to osmotic diuresis. Usually glucose is not detected in the urine, so if
there is any glucose present in the urine, it is an abnormal phenomenon. Weight loss,
fatigue, blurred vision, and thirst may also occur.
Hypoglycemia
Hypoglycemia is a common endocrine disorder related to diabetes. Blood glucose
levels <60 mg/dL (3.3 mmol/L) are referred to as hypoglycemia. Here average
blood level values are mentioned but these levels may vary from individual to individual. In general, when plasma glucose levels fall below 60 mg/dL (3.3 mmol/L),
a rapid and continuous cascade of actions start as follows:
1. The body will reduce insulin secretion to prevent a drop in blood sugar levels.
2. Next, the secretion of counter-regulatory hormones, mainly adrenaline and noradrenaline, is increased.
3. At the end, signs and symptoms, including cognitive decline, become obvious.
When the glucose level drops below 50 mg/dL (2.8 mmol/L), there are significant mental state alterations.
If hypoglycemia is not treated, there will be more morbidity and mortality rate. To
reduce these risks, timely identification of signs and symptoms and quick and affective treatment is required. Hypoglycemia in insulin-dependent diabetes mellitus is
usually results from taking high insulin dose, eating very less, or sometime both.
Central nervous system’s tissues are different from other tissues as they can metabolize protein or fat, usually including sugar, and rely completely on glucose as their
energy source. If the level of glucose in the blood drops sharply, the brain will be
factually starved. Hypoglycemia in patients without a history of diabetes is referred
1 Physiology of Endocrine System and Related Metabolic Disorders