Patofisiologi Diabetes Melitus

Summary

This video script discusses the pathophysiology of Type 1 and Type 2 Diabetes Mellitus (DM). It explains that Type 1 DM is an autoimmune disease that damages the pancreas' beta cells, reducing insulin production, leading to high blood glucose (hyperglycemia). In contrast, Type 2 DM involves insulin resistance, where cells cannot effectively use insulin, also resulting in high blood glucose. The script details the body's compensatory mechanisms such as lipolysis (fat breakdown), gluconeogenesis (glucose production), and increased hunger and thirst. The script also covers complications like diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic states (HHS), emphasizing the body's attempts to maintain balance despite the condition.

Takeaways

• 😀 Type 1 Diabetes (DM) is an autoimmune condition where the immune system destroys pancreatic beta cells, leading to reduced insulin production and high blood glucose levels.
• 😀 Type 2 Diabetes (DM) occurs due to insulin resistance, where the body's cells are unable to respond to insulin, resulting in high blood glucose levels.
• 😀 In Type 1 DM, high blood glucose levels (hyperglycemia) occur because insulin cannot help glucose enter cells.
• 😀 In Type 2 DM, insulin resistance prevents glucose from entering cells, leading to hyperglycemia, similar to Type 1 DM but through a different mechanism.
• 😀 Hyperglycemia triggers lipolysis, the breakdown of fat into fatty acids, providing an alternative energy source for cells.
• 😀 Fatty acids, produced from lipolysis, can enter cells without insulin but lead to the production of ketones, which can cause ketoacidosis (KD).
• 😀 Hyperglycemia also stimulates gluconeogenesis, the production of glucose, which exacerbates high blood sugar levels.
• 😀 Severe hyperglycemia can lead to hyperosmolarity and hyperosmolar hyperglycemic state (HHS), which are life-threatening complications.
• 😀 Dehydration occurs due to polyuria (excessive urination), which is triggered by hyperglycemia. This leads to thirst (polydipsia).
• 😀 Insulin deficiency and low leptin levels stimulate hunger by activating neuropeptide Y (NPY), leading to an increased appetite.
• 😀 The thirst mechanism in the body is triggered when cells experience dehydration due to the high glucose concentrations in the blood.

Q & A

What are the primary causes of Diabetes Mellitus (DM) type 1 and type 2?

DM type 1 is primarily caused by autoimmune responses that damage the beta cells in the pancreas, reducing insulin production. DM type 2, on the other hand, is characterized by insulin resistance, where the body's cells fail to respond properly to insulin.

At what age do DM type 1 and type 2 typically manifest?

DM type 1 usually occurs at a young age, while DM type 2 tends to manifest in older individuals.

What happens to the body when insulin production is insufficient in DM type 1?

When insulin production is low in DM type 1, glucose cannot enter the cells, leading to high blood glucose levels, or hyperglycemia.

What is the main difference between DM type 1 and DM type 2?

The main difference is that in DM type 1, there is an autoimmune attack on the beta cells of the pancreas, while in DM type 2, the body’s cells develop resistance to insulin, preventing proper glucose absorption.

How does the body compensate for hyperglycemia?

To compensate for high blood glucose, the body initiates lipolysis, breaking down fat into fatty acids that can enter cells without insulin, providing an alternative energy source.

What is the role of ketone bodies in DM complications?

During lipolysis, ketone bodies are produced as byproducts. These are acidic and can lead to ketoacidosis, a potentially dangerous complication of uncontrolled diabetes.

What is gluconeogenesis, and how does it contribute to hyperglycemia?

Gluconeogenesis is the process by which the body generates glucose from non-carbohydrate sources. In DM, the body mistakenly activates this process even when blood glucose is high, exacerbating hyperglycemia.

What is the connection between hyperglycemia and polyphagia (increased hunger)?

In hyperglycemia, cells are deprived of glucose because it cannot enter them due to insulin resistance or insufficiency. This causes the body to signal hunger, leading to increased food intake.

What is the effect of hyperglycemia on urine production?

Hyperglycemia leads to osmotic diuresis, where excess glucose in the blood draws water into the urine, causing increased urine output, which can lead to dehydration.

How does the body respond to dehydration caused by high urine volume in diabetes?

Dehydration due to excessive urine production triggers polydipsia, or excessive thirst, as the body attempts to restore lost fluids.