endocrine

• Secretions of Exocrine Glands

  • Lubricating
  • Digesting
• Functions of Endocrine System

  • Regulating growth & development, metabolism and stress adaptation
• Endocrine Gland Diseases


  • Pancreas
  • Thyroid Gland
  • Adrenal Glands
  • Pituitary Gland
• Pancreas


  Islets of Langertans: clusters of cells that produce hormones
• Cells in Islets of Langerhans

  • Alpha cells: glucagon
  • Beta cells: Insulin
  • Delta cells: somatostatin
• Glucagon


  • Compensatory hormone, Increases blood sugar
• Insulin


  • Released all day but only in low value, it only increase after eating, Decreases blood sugar
• Somatostatin


  • Compensatory hormone, Decreases growth hormone, increases blood sugar which is stimulated after sleep
• Glucose Transport


  1. INSULIN: Transport glucose to the cells, Converts excess glucose to the glycogen (glycogenesis), Maintains blood sugar to 80-120 mg/dL

  2. GLUCAGON: Reconverts glycogen to glucose during hypoglycemia (glycogenolysis)
• Diabetes Mellitus


  Hyperglycemia for at least a month, Most common metabolic disorder
• Classification of Diabetes Mellitus

  • Acquired/ Primary: Type 1 (Hereditary related DM), Type 2 (Dietary related DM)
  • Secondary Type/ Secondary to hormonal type: Gestational (pregnancy related)
• Type 1 Diabetes


  • Juvenile onset (<30 y/o), Zero Insulin (absolute insulin deficiency)
• Type 2 Diabetes


  • Adult onset, High blood sugar/ insulin resistant
• Symptoms of Diabetes Mellitus

  • Hallmark: Hyperglycemia
  • Triad: Polyuria (urination), Polydipsia (thirst), Polyphagia (hunger)
• Diabetic Ketoacidosis


  1. Cause: cellular starvation

  2. Signs & Symptoms: weak/ thread pulse, Abdominal pain, 3 P's, Kussmaul's Breathing - fast and deep breathing, Acetone/ fruity breath, Altered LOC - ketotic coma

  3. Management: IV insulin: regular insulin, Watch out for: Hypoglycemia, Hyperglycemia
• Chronic Complications of Diabetes

  • Hypertension
  • Atherosclerosis
  • Nephropathy
  • Diabetic impotence
  • Foot ulcers
  • Retinopathy
  • Neuropathy
• Diabetic Impotence


  • There's sluggish blood supply
• Diabetic Retinopathy


  • Retina have small blood vessel and have high risk for damage/ rupture and may lead to blindness
• Triad of Diabetes Management

  • Diet
  • Activity
  • Medications
• Oral Hypoglycemic Agents


  Stimulates islets of langerhans, Stimulates B-cells: increase insulin, Stimulates a-cells: lowers glucagon, Corrects insulin resistance
• Oral Hypoglycemic Medications


  • Glucophage (Metformin)
  • Glucotrol
  • Glucobay
  • Diabinese
  • Orinase/ Tolinase
• Types of Insulin


  • Rapid-Acting
  • Regular Short-acting
  • Intermediate
  • Long acting
• Rapid-Acting Insulin


  • Onset: 5-10 mins, Peak: 30 mins, May experience hypoglycemia
• Regular Short-acting Insulin


  • Onset: 30-60 mins, Peak: 2-4 hours
• Intermediate Insulin


  • Onset: 1-2 hours, Peak: 6-10 hours
• Long-acting Insulin


  • Onset: 3-4 hours, Peak: 12-16 hours, Cannot be mixed
• Insulin Administration


  1. Route: Subcutaneous

  2. Refrigerate unused insulin but never administer cold insulin

  3. Never shake

  4. Don't massage the site

  5. Prevent lipodystrophy - 1 inch/ 2.5 cm apart, rotate insulin sites
• Symptoms of Hypoglycemia


  • Gait disturbances
  • Unusual perspirations
  • Tachycardia
  • Obvious tremors
  • Moody/ irritability
• Side Effects of Insulin

  • Induration/ Redness, Hypoglycemia
• Foot Care for Diabetics

  1. Inspect daily

  2. Warm water and mild soap

  3. Proper fitted pair of shoes

  4. Break in new pair – wear 1-2 hours @ foot first, hinuhulma shoes foot

  5. Wear socks

  6. Apply lotion on feet; not on interdigital space

  7. Exercise/ massage the feet
• Rationale for best time to fit shoes at night: feet tends to be bigger at night because feet was used all day therefore all the fluids flowed down due to gravity
• Things to Avoid for Diabetic Feet

  • Going barefooted
  • Trim toenails
  • Knee-high stockings
• Thyroid Gland


  Butterfly-shaped organ
• Parathyroid Gland


  Releases parathyroid hormone - Calcium
• Thyroid Hormones


  • T3: Triiodothyronine (Overall metabolism)
  • T4: Thyroxine (Heat production)
• Thyrocalcitonin


  Parathyroid hormone antagonist, Lowers PTH
• Parathyroid Hormone (PTH)


  Calcium Regulation, Calcium from the bone to the blood
• Vitamin D


  Calcium from the blood to the bones
• Hyperthyroidism


  Exact Cause: Unknown, Common to females
• Effects of Hyperthyroidism


  • Increased metabolism, Heat intolerance, Hypocalcemia