Case Study 23 Type 2 Diabetes Mellitus

Insulin allows glucose to enter cell membranes in most tissues (Brown & Edwards 2008).An increased blood glucose level is the main stimulus of insulin synthesis and secretion (Brown & Edwards 2008).The newly diagnosed patient will need to know the importance of making changes to their lifestyle in regards to nutrition, diet and weight control (Farrell 2005).

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This exposure to foods high in fat and sugars, alcohol and nicotine use along with a sedentary lifestyle have placed them in a high risk category of developing diabetes and at an earlier age than non indigenous people (Thomson 2003).

Aboriginal people had the genetic makeup to survive when food was scarce but now this once efficient metabolism, exposed to a western influence is now working against them (Thomson 2003).

The independent actions of both insulin and glucagon control blood glucose levels (Marieb & Hoehn 2007).

Under normal circumstances insulin is the main regulator of the metabolism and storage of carbohydrates, fats and protein.

Long term uncontrolled diabetes mellitus leads to chronic health issues, disability, a poor quality of life and premature death in Australia s worldwide (Thomson 2003) .

In Australia, aboriginal people are more likely to develop Type 2 diabetes than non aboriginal Australians (NATSIHS 2006).

Another important role of insulin is in the peripheral tissues where it facilitates glucose into cells, transport of amino acids across muscle membranes to synthesise into protein and transport of trigylcerides into adipose tissue.

Thus insulin is a storage or anabolic hormone (Brown & Edwards 2008).

Secondly the inability of the pancreas to secrete enough insulin due to Beta cells becoming fatigued from the overproduction created by the resistance of the cells to uptake insulin (Brown & Edwards 2008).

Lastly the liver can not regulate appropriate levels of glucose to match blood glucose levels creating an overflow into the bloodstream as insulin resistance continues and hyperglycaemia develops (Capriotti 2005).