Describe the metabolic events that led to Matias's symptoms and subsequent admission to the ER (polyuria, polydipsia, polyphagia, fatigue, and weight loss), integrating the pathophysiology of T1DM into your discussion

Question

What will be an ideal response?

Answer 1

• With type 1 diabetes, insulin is not being produced because of the autoimmune destruction of beta cells within the pancreas.
• Without insulin, hepatic gluconeogenesis is not suppressed properly, leading to an increase in gluconeogenesis along with glycogenolysis. This causes hyperglycemia, a hyperosmolar condition.
• Without insulin, glucose cannot be transported into the cell, also resulting in hyperglycemia. Lack of nutrients results in polyphagia, or excessive hunger.
• Since hyperglycemia is a hyperosmolar condition, water is drawn from the cells into the blood in an attempt to compensate for the serum hyperosmolality. The cells become dehydrated, which contributes to polydipsia, or excessive thirst.
• The increase in urinary glucose excretion occurs due to a blood glucose concentration of 180 mg/dL or higher and water follows it (due to the osmotic gradient). This increases urination and manifests itself as polyuria.
• Because the cells are not getting the nutrients they need due to a lack of insulin, unintentional weight loss typically occurs in type