Pancreas Answer 2022

Answer 1
Sarah was diagnosed with Type 1 Diabetes (T1D) in which the insulin producing cells in the
pancreas are destroyed by CD4+ and CD8+ T cells and macrophages infiltrating the islets.
The autoimmune destruction of pancreatic beta-cells, leads to a deficiency of insulin
secretion. In addition to the loss of insulin secretion, the function of pancreatic α-cells is also
abnormal and there is excessive secretion of glucagons in T1DM patients. In patients with
T1DM, glucagons secretion is not suppressed by hyperglycemia. The resultant
inappropriately elevated glucagons levels exacerbate the metabolic defects due to insulin
deficiency (Baynest, 2015). So, to reverse these metabolic derangements occurring in the
body of Sarah because of deficiency of insulin, insulin is prescribed to Sarah. In Sarah’s
body, insulin will begin acting by joining with a glycoprotein receptor on the cell surface.
The alpha subunit of the receptor which binds the hormone while the beta-subunit is a
tyrosine-specific protein kinase. When this kinase is activated, a signal is generated which
ultimately leads to action of insulin on glucose, lipid, and protein metabolism.
Answer 2
a) The onset of action of NovoRapid occurs within 10-20 minutes of subcutaneous
injection. The peak effect is exerted between 1 and 3 hours after injection. The
duration of action is 3 to 5 hours (Bullock & Manias, 2017).
b) Since NovoRapid is a fast acting insulin with a shorter duration of action, it should be
given immediately prior to a meal so that complications such as hypoglycaemia can
be avoided.
Answer 3
a) Hypoglycemia is a condition in which the blood glucose level of a human reaches below 4
mmol/L (72mg/dL).
b) Causes of hypoglycemia in people without diabetes include certain medications such as
quinine, excessive alcohol intake, critical illnesses like severe hepatitis, anorexia nervosa,
tumor of the pancreas and hormonal deficiencies. Causes of hypoglycemia in people with
diabetes overdose or diabetes medications like insulin, less intake of food or excessive
exercise.
c) Common symptoms of hypoglycemia are sweating, dizziness, fatigue, irritability, pale
skin, hunger, weakness, increased heart rate and confusion. If hypoglycemia is severe, the
symptoms may include blurred vision, loss of consciousness and convulsions.
d) Treatment of hypoglycemia includes immediate initial treatment to raise the blood sugar
level and management of the underlying condition that led to hypoglycemia to prevent its
recurrence. Hypoglycemia can be immediately treated by consuming 15-20g of fast acting
carbohydrate such as glucose tablets, sweets, sugary fizzy drinks or fruit juice.
Answer 4
a) The most suitable insulin pen needle length for Sarah is 4mm.