Groups 8

Diabetes Melitus type 1

SCENARIO
A 21 year old noncompliant male with a history of type 1
(insulin-dependent) diabetes melitus was found in a coma. His
blood glucose was high, as well as his urine glucose, urine
ketones, and serum ketones. His serum bicarbonate was < 12
mEq/L. His respiration was exaggerated and his breath had an
acetone odor. His blood pressure was 90/60 and his pulse weak
and rapid.
STEP I
Difficult words :
Acetone odor
Exaggerated
Diabetes type 1

Key words :
The patient had an ilness (diabetes melitus type 1)
The Blood pressure 90/60
The pulse weak and rapid
Serum bicarbonate
The patient was found in a coma
The blood glucose was high
STEP II
1. How does the normal regulation of blood glucose?
2. How does the mechanism of pancreas to secreted insulin hormone?
3. Whats the relation between the age and that ilness?
4. Whats the relation between diabetes and the patient had an acetone
odor?
5. Whats the function of keton bodies with the scenario?
6. Whats the relation of that case with syntesis of trigliserida and lipolisis.

STEP III
1. Normally, blood glucose in a our bodies : 80- 90 mg/L. 2 hours after eat the
blood glucose increase to be 120-180 mg/L.
2. Insulin hormone works in metabolism of carbohidrate process, therefore
carbohidrate food has an impact to pancreas to secreted the insulin
hormone.pancreas (langerhans island) consists of : cell that producing
glucagon, cell producing insulin hormone, and cell producing
somatostatine.
3. The patient of that ilness (D.M type 1) from 20 year old and more than that
age. It happen because of the decrease of insulin hormone secretion, as well
as the sensitivity of the tissue.
4. Ketogenesis is an process that producing ketone bodies. Ketone bodies
consists of : aseto asetat, beta hidroksi butirat, aseton. The syntesis process
happen in liver. Theres no enzym in liver that can change the ketone bodies
to be acetil koA, therefore :
- ketone bodies has transport to the extrahepatic tissue.
- Aseton : couldnt transport to the extrahepatic tissue and it must
give off with via-lungs.



5. LO
6. The different between D.M. type 1 and 2 are;
- D.M type 1 has a sign with the decrease of insulin hormone
secretion.
- conversely with D.M type 1, D.M. type 2 has a sign with the secrtion
of insulin hormone is normal or high but the sensitivity of the tissue
has decrease.
7. LO
STEP IV
MIND MAPPING

A man, 21
year old
Anatomi
and
Histologi
Ketogenesis
Syntesis
process
happen in
livers
Give off
asetone with
via-lungs
D.M type 1
Defisiensi
insulin
Acidosis metabolic
Coma of
diabetes
Physiology of
insulin hormone
secretion, etc.
Syntesis of
trigliserida
lipolisis
Fatty
acid in
blood
STEP V
Learning Objective
1. The regulation of blood glucose process in normally.
2. The organ involve with that case
3. The hormones involve with that case
4. Explaination about the mechanism ; coma of diabetes, breath had an
acetone odor, hiperventilation, etc.
5. the function of insulin hormone and the controll in Center System Nervous .
6. The insulin hormone works in metabolism of carbohidrate.
Hormon hormon terkait pada kasus
Hormon insulin

Hormon glukagon
Sekresi hormon insulin
Kelebihan
karbohidrat
Sekresi
insulin
Menyimpan kelebihan
energi (glikogen)
dibawa ke otot dan
hati
Kelebihan yang lain
diubah menjadi
lemak (disimpan
dalam jaringan
adiposa)
Kadar glukosa
darah turun
Sekresi glukagon
Peningkatan glukosa
darah
Peningkatan energi
Kadar glukosa darah turun

Sekresi
glukagon