1. Pancreas A&P + Diabetes Pathophysiology
Dan Judkins, RN, MS, MPH
SEAHEC
Santa Cruz County
Community Integrated Paramedicine Program
Rio Rico Medical & Fire District

6. Islets of Langerhans: (endocrine)
Alpha cells  glucagon
Beta cells  insulin & amylin
Delta cells  somatostatin
PP (F) cells  pancreatatic polypeptide
Acini: (exocrine)
Digestive juices to duodenum

12. Glucose  sugar used by body for energy
Hyperglycemic  high blood sugar level
Hypoglycemic  low blood sugar level
Glycogen  storage form of glucose
Gluconeogenesis  make glucose from fats
Glycogenolysis  break down glycogen to glucose
Glycogenesis  making glycogen from glucose
Glycolysis  glucose converted to energy

13. Polydipsia Polyphagia Polyuria
3 Polys
Polydipsia Polyphagia Polyuria

17. Polydipsia Polyphagia Polyuria
3 Polys
Polydipsia Polyphagia Polyuria

18. Hyperglycemic Hyperosmolar Nonketotic Coma (HHNC)
Hyperglycemic Hyperosmotic Non-ketoacidosis (HHNK)
Very high glucose levels
No increased serum ketones
Some insulin produced but not enough
Loss of more water than sodium

20. is a property of a solution involving the concentration of solutes.
OSMOLALITY
is a property of a solution involving
the concentration of solutes.
TONICITY
is a property of a solution in reference
to a particular membrane.

21. Signs of HHNK… No ketonuria No fruity breath No significant acidosis
Extremely dehydrated
BG > 600 ( )

22. Diabetic Ketoacidosis (DKA)
High glucose
Acidosis
Ketosis

23. Signs of DKA… Excessive thirst Fruity-scented breath
Frequent urination
Nausea and vomiting
Abdominal pain
Weakness or fatigue
Fruity-scented breath
Confusion
Hyperglycemia
High urine ketones
Acidosis

24. Hyperglycemia
DKA
Ketosis
Acidosis

26. DKA Gluconeogenesis  make glucose from fats Fat breakdown  ketones
↓ Insulin  glucose ↓ in cell (starvation)
Gluconeogenesis  make glucose from fats
Fat breakdown  ketones
Ketones are acid  acidosis
DKA

27. Metabolic Syndrome…

28. Take-home messages:
Insulin
DKA
HHNK