Absolute insulin deficiency

Absolute insulin deficiency

1. No insulin production

   • Increased Counter regulatory horones
     • Proteolysis
       • amino acid production
     • Lipolysis
       • Creation of acety COA
         • Ketogensis
           • Increased B-Hydroxybutyrate
             • Increased acetone levels
               • acetone smeling breaths
           • METABOLIC ACIDOSIS
             • Respiratory compensation
               • Kussmauls Breathing
                 • decreased co2
                   • Decreased 02 to brain
                     • Ischaemia to brain
                 • DECREASED GCS
                   • Cerebral swelling
                     • Seizure
                   • DEHYDRATION
                     • osmotic diuresis
                       • polyuria
                       • Polydipsia
                       • Orthostatic hypotension
                         • Tachycardia
             • Decreased ph on ABG
             • abdominal pain, nausea and vomiting
       • decreased tryglycerides
         • Impart to free fatty acids
           • glycerol
           • ketones

2. Stress, infection, reduced insulin production

   • Increased CRP & WCC

3. Pancreatic beta cell defecit

   • reduced ATP
   • HYPERGLYCAEMIA
     • excretion of glucose & Ketones
       • Glomerular filtrate unable to absorb excess ketones
         • Glucosuria
           • Increased sodium excretion
             • Increased fluid loss
               • increased potassium and calcium excretion
                 • electrolyte imbalance
             • hyponatremia
     • Increased Osmolarity
       • Water and sodium move from ICF to ECF