Share insights on how the factor you selected impacts the pathophysiology of diabetes mellitus and diabetes insipidus

Many people may confuse diabetes mellitus with diabetes insipidus because both of the diseases contain the word diabetes, but the pathophysiology of the two are completely different. Diabetes insipidus (DI) occurs when there is too much antidiuretic hormone, or ADH, in the body. DI can be neurogenic or renal, meaning it develops in the nervous system or as a result of decreased response in the kidneys. Normally, the human body has a balanced amount of ADH. ADH helps with water reabsorption. If water levels begin to rise or decline, ADH will send a signal to the body to release pores in the distal tubular system that allows for reabsorption. However, if there is a dysfunction in this system causing the antidiuretic hormone to increase too much, the body will try to get rid of the excess solute through the urine, putting the person in a diuretic state (Hammer & McPhee, 2019). If a person is excreting large amounts of urine, he can become dehydrated and suffer from worse complications such as hyperosmolarity, loss of consciousness, shock, and damage to the central nervous system. According to Mortini, Barzaghi, Albano, Panni, and Losa (2018), there are several causes of diabetes insipidus. It can be familial, idiopathic, or occur secondary to a brain injury that affects the pituitary gland. Some other causes include stroke, aneurysm, cancer, and infection. In many familial cases, defects of the vasopressin receptor or water channel were identified. DI is uncommon. It is typically diagnosed through urine, blood, and serum osmolality testing and treated with fluids and medications, such as vasopressin, that works as a supplement for ADH. Diabetes mellitus (DM), on the other hand, is an illness where there is a problem with the amount of insulin production in the body. It involves carbohydrates, protein, and fat metabolism. Beta cells in the pancreas produce insulin, but in Type 1 DM, the body has an autoimmune response and attacks these beta cells leading to their destruction and insulin dependency. In Type 2 DM, insulin resistance occurs due to issues such as high levels of fatty acids in the blood, decreased glucose transport within muscle cells, or increased hepatic glucose production (Huether & McCance, 2017). DM is not limited to age or gender, but Type 1 DM usually develops before the age of 20 and has a higher incidence among Caucasian and African American ethnicities. Type 2 DM usually develops after 30 and has a higher incidence in Native Americans, Hispanics, and African Americans. It can be diagnosed through urine and blood glucose testing and is most commonly treated with medications that replace the absent or low levels of insulin. Risk factors like obesity, lack of physical activity, and consumption of an unhealthy diet can lead to a higher risk of developing Type 2 diabetes. In Type 1, many adolescents and young adults may suffer from issues like depression and altered body image. Peer support groups have been shown to help young adults struggling with diabetes manage their illness (Khodneva et al., 2016). References Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education. Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby. Khodneva, Y., Safford, M., Richman, J., Gamboa, C., Andreae, S., & Cherrington, A. (2016). Volunteer peer support, diabetes, and depressive symptoms: Results from the Encourage trial. Journal of Clinical & Translational Endocrinology, 4, 38-44. Mortini, P., Barzaghi, L., Albano, L., Panni, P., & Losa, M. (2018). Microsurgical therapy of pituitary adenomas. Endocrine Surgery, 59(1), 72-81. According to Huether & McCance, 2017, diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia and in 2012 29.1 million people had diabetes. Types of diabetes include type 1, type 2, and gestational. More than 90% of diabetes are classified as either type 1 or type 2 diabetes mellitus (Hammer & McPhee, 2019). Type 1 diabetes also known as juvenile diabetes is an autoimmune disease that is abrupt, affects children, insulin replacement is mandatory, and levels fluctuate in response to infection, exercise, and changes in caloric intake (Rosenthal & Burchum, 2018). Type 1 diabetes destroy beta cells of the pancreas. Gestational diabetes occurs in pregnant women. Gestational diabetes usually occurs in the second half of gestation when hormone levels increase (Hammer & McPhee, 2019. Type 2 diabetes is the most prevalent form of diabetes (Rosenthal & Burchum, 2018). Type 2 diabetes is non-insulin dependent diabetes mellitus and obesity is a contributing factor. Diabetes insipidus is a rare disorder that occurs when a person's kidneys pass an abnormally large volume of urine that is insipid. This causes a lack of vasopressin action in the kidneys. According to Hammer and McPhee, 2019, the initial clinical presentation is diminished output accompanied by thirst. Diabetes insipidus result from central diabetes insipidus, nephrogenic diabetic insipidus, and pregnancy. Urine is hypotonic in central and nephrogenic (Hammer & McPhee, 2019). Common causes of central diabetes insipidus may include renal damage from drugs and familial risk factors for nephrogenic diabetes insipidus. Hypernatremia can result from both types. Diabetes mellitus and insipidus are unrelated even though both cause frequent urination and excessive thirst. Diabetes mellitus causes high blood glucose levels resulting from the body's inability to use blood glucose for energy. People with diabetes insipidus have normal blood glucose levels, however their kidneys cannot balance fluid in the body (National Institute of Diabetes and Digestive and Kidney Diseases, 2015). The initial treatment for type 2 diabetes would include lifestyle changes and the administration of metformin. Metformin is given orally and is taken twice a day. Dietary considerations would include avoiding simple carbohydrates such as sugar, bread, flour, cookies. A diet should include complex carbohydrates such as whole grains, brown rice, fruits, and vegetables. Exercise should also be incorporated to help reduce insulin levels. Metformin can decrease absorption of vitamin B12, and folic acid causing a deficiency of both (Rosenthal & Burchum, 2018). These labs will need to be monitored. Patients with renal impairment should not take metformin due to metabolic acidosis. According to Hammer & McPhee, 2019, diabetes damage multiple organ systems. Vascular disease, neuropathy, diabetic retinopathy, and infection can happen due to diabetes. According to Huether & McCance, 2017, the major acute complication of diabetes includes hypoglycemia, diabetic ketoacidosis, and hyperosmolar hyperglycemic nonketotic syndrome. Treatment for diabetes insipidus depends on which type you have. For central diabetes insipidus a hormone called desmopressin is given. This drug works by replacing the vasopressin that a patient’s body normally produces (National Institute of Diabetes and Digestive and Kidney Diseases, 2015). For neurogenic diabetes insipidus there are times it will go away with medication changes. Other treatment includes diuretics and aspirin. Diuretics can reduce urine production and help patients’ kidneys concentrate urine. Adding Aspirin can reduce urine volume. References Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education. Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby. Diabetes Insipidus. (2015). Retrieved from https://www.niddk.nih.gov/health-information/kidney-disease/diabetes-insipidus Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier. please respone to each separately Respond to at least two of your colleagues on two different days who selected different factors than you, in one or more of the following ways: Share insights on how the factor you selected impacts the pathophysiology of diabetes mellitus and diabetes insipidus. Offer alternative diagnoses and prescription of treatment options for diabetes mellitus and diabetes insipidus. Validate an idea with your own experience and additional research.

ANSWER. PAPER DETAILS
Academic Level	Masters
Subject Area	Nursing
Paper Type	Case Study
Number of Pages	2 Page(s)/550 words
Sources	0
Format	APA
Spacing	Double Spacing

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