insulin secretion from the beta cells of the pancreas. Table 21-3 illustrates hypo-
glycemic and hyperglycemic reactions caused by a deficient glucose metabolism.
There are two types of diabetes mellitus: Type I and Type II.Type 1 diabetes mellitus
Type 1 diabetes mellitus is referred to as insulin-dependent diabetes mellitus
(IDDM) or juvenile-onset diabetes because Type 1 diabetes mellitus usually
begins in childhood or adolescence. In Type 1 diabetes mellitus, the pancreas
produces little or no insulin.
Type 1 diabetes mellitus is characterized by a sudden onset that occurs more
frequently in populations descended from Northern European countries
(Finland, Scotland, Scandinavia) than in those from Southern European coun-
tries, the Middle East, or Asia.
Approximately 3 in 1000 people in the United States develop Type 1 diabetes
and are dependent on regular insulin injections.Type 2 diabetes mellitus
Type 2 diabetes mellitus, sometimes called age-onset or adult-onset diabetes,
is the common form of diabetes mellitus that effects approximately 5% of
Americans under the age of 50 and 15% of those 50 and older. More than 90%
of the diabetics in the United States have Type 2 diabetes mellitus.
Patients with Type 2 diabetes mellitus are often overweight and don’t exer-
cise. They can produce insulin but are unable to use it effectively. Type 2(^392) CHAPTER 21 Endocrine Medications
Reaction Signs and Symptoms
Hypoglycemic reaction Headache, lightheadedness, nervousness, apprehension,
(insulin shock) tremor, excess perspiration; cold, clammy skin, tachycardia,
slurred speech, memory lapse, confusion, seizures
Blood sugar <60 mg/dL
Diabetic ketoacidosis Extreme thirst, polyuria, fruity breath odor, Kussmaul
(hyperglycemic reaction) breathing (deep, rapid, labored, distressing, dyspnea), rapid,
thready pulse, dry mucous membranes, poor skin turgor
Blood sugar level >250 mg/dL
Table 21-3. Hypoglycemic reactions and diabetic ketoacidosis.