Common Cardiac Alteration

Diabetes occur when there is a combination of inadequate secretion of insulin by the pancreatic beta cells and the peripheral insulin resistance. Insulin resistance leads to a reduced glucose transport into the muscle cells, increases both hepatic glucose production and breaking down of fats because it has been attributed to the elevated level of free fatty acids and proinflamatory cytokines in the plasma.1

The blood glucose level has very limited range for humans to survive and stay healthy. Generally, people are able to remove excess glucose rapidly from the body but this is not the case when they are diagnosed with diabetes and insulin resistant situations. The lack of insulin resistance can also lead to a decrease in glycogen synthesis and storage as it usually converts glucose to energy for cell’s use (Jensen & et al. 2011). When insulin is produced under insulin resistance, the cells are incapable of using them effectively which then leads to high blood sugar level as ketones and ketoacids are produced as an alternative energy source for the body. The rise of ketoacid causes the blood pH acidic and the patient may also be diagnosed with ketoacidosis (Newton & Raskin 2004). There would also be less intake of lipid and more of stored triglycerides as the lipids are effected by the insulin. As the glucose levels increase, the muscle glucose uptake will decrease while the liver glucose production and blood fatty acid concentration will also increase within the body (Lichtenstein & Schwab 2000). Excess glucose within the blood are converted to fat which can lead to Diabetic Dyslipidaemia and furthermore to obesity, hypertension and

R E V I E W S H E E T 30 Anatomy of the Heart

Check BSL. Patient with diabetes is more at the risk of vascular disease. Because when blood vessels are damaged plagque starts to build up and make the vessels narrow, cause impairment of blood flow and affect decreased oxygen delivery. So it is important to keep an eye on blood sugar level.

As previously mentioned, the left ventricle is no longer as compliant and therefore cannot fill with blood without encountering resistance. The use of diuretics decreases overall volume, which as a result decreases overall pressure. This lost pressure may be needed in order for blood to pump with added pressure against the resistance into the ventricle. Once pressure is lost the patient is said to have hypotension and is at risk for blood not being able to perfuse to vital tissues (Burchum et al., 2016, pg.

Uncontrolled diabetes can cause damage to the heart, but does not cause damage to the kidneys or blood vessels.

The aetiology of a disease is the known cause but the aetiology of diabetes is not fully understood. The full title of this condition is diabetes mellitus, (Smith, 2009). Homeostasis is the body 's internal natural regulatory system; it controls the body’s functions and chemical balance, every cell within is involved in maintaining a constant state of equilibrium and prevents a deviation from the norm (Scott, 2011). Hypertension is caused when blood is pumped to the heart at high pressure through a network of arteries and veins, it is thought that high levels of insulin could damage the arteries; this then can cause the arteries to become narrower forcing the blood through a smaller space (NHS Choices 2014)

First the client will weigh himself daily, so that fluctuation in the amount of fluid can be detected quickly. Any major shifts in weight should be reported to the physician and adjustments to the medical regimen can be addressed. Since rapid heart rate is sign of an acute exacerbation, the client should also monitor his blood pressure and heart rate on a daily basis. He should be encouraged to consume a balanced diet that is low in sodium. Adhering to these dietary restrictions will help control his weight and reduce the amount of fluid that may be retained due to sodium

Hyperglycemia is a very serious risk for heart disease and strokes. Complications from hyperglycemic diabetes may include coronary heart disease (CHD), heart failure, stroke, arrhythmias, or even death. High blood glucose (sugar) levels over time can lead to excess fatty deposits on the insides of your blood vessel walls. These deposits often affect blood flow, which increases the possibility of blood vessels clogging and/or hardening. As a result, this leads to heart disease. Furthermore, those with diabetic heart disease (DHD) may have less success with heart disease treatments, such as angioplasty or artery bypass grafting. “The common clustering of these risk factors in a single individual has been called the metabolic syndrome.” (Scott 1134) Uncontrolled diabetes, the biggest contributor to heart disease, is almost four times higher for adults than those without diabetes. The best way to prevent diabetic heart disease is to control it by way of reducing the risk factors through diet and lifestyle changes.

This particular research was driven by the demand of the regulatory guidelines that deals with reduction of risks. The cases of cardiovascular risks among patients are have been reported to increase in the recent days. The regulatory guidance require being presented for the cardiovascular outcomes that can be used in the therapies of type 2 diabetes treatment. However, the

This article goes in detail about the complications of Type 2 Diabetes, on how hyperglycemia damages the vascular system leading to microvascular disease and macrovascular disease. The complications of microvascular disease are diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. On the other hand, with macrovascular disease includes Cardio Vascular Disease (CVD), such as Atherosclerosis. Furthermore, the article gives recommendations of treating Type 2 Diabetes and the prevention of its health related complications with medication, screening, diet, and exercise.

The heart, nerves, blood vessels, kidneys, eyes and other organs can be negatively impacted by uncontrolled diabetes. The goal is to keep the blood sugar normal most of the time to avoid these complications.

Why do we treat diabetes? There are a number of downstream events associated with abnormal blood glucose levels. If glucose levels are managed properly, the complications associated diabetes can be controlled, and sometimes completely prevented. The main problem with having more than the normal amount of glucose circulating in the blood stream is the effect that excess glucose can have on both large and small blood vessels (DTC, 2004). Micro-vascular and macro-vascular problems associated with diabetes can be seen in the heart, eyes, kidney, legs and feet. Diabetic patients are twice as likely to suffer from a mycocardial infaraction, twenty-five times more likely to suffer blindness, and seventeen times more likely to suffer kidney failure compared to a non-diabetic (DTC, 2004). Because of great number of risks associated with abnormal blood glucose levels, diabetes is aggressively treated to improve the quality of life and prevent complications in patients.

Patients with DM1, like Room 40, are at an increased risk for cardiovascular issues such as atherosclerosis. Insufficient use of blood glucose in the body causes the blood vessels to become stiff and smaller in diameter. Because the blood vessels are narrower than a patient without DM1, Room 40 does not have an easy circulation path for his blood cells which carry oxygen and inflammatory response components. (Gerard, 2014, chap. 50). The exact mechanism of DM1 (glucose intolerance) that leads to atherosclerosis and other cardiovascular complications is unknown.

Diabetes is associated with an increased risk of developing primarily vascular complications that contribute to morbidity and mortality of diabetic patients. Poor glycaemic control leads to vascular complications that affect large (macrovascular), small (microvascular) vessels or both. Macrovascular complications include coronary heart disease, peripheral vascular disease and stroke. Microvascular complications contribute to diabetic neuropathy (nerve damage), nephropathy (kidney disease) and retinopathy (eye disease).