Disorder of endocrine system

DISORDER OF ENDOCRINE SYSTEM
BY: Mr.Ganesh V. Naik
II year MSc(N)
Pediatric Dept
SDM Institute of
Nursing Science’s
Dharawad

INTRODUCTION
 The endocrine system composed of glands that
produce and secrete chemical substance called
hormones which affect multiple organs and tissues.
 The word endocrine is derived from greek word
‘endo’ meaning inside and ‘crine’ meaning secretion
 Endocrine gland secrete their secretions directly
into the blood stream to regulate the body functions

TYPES OF ENDOCRINE DISORDERS
 Endocrine gland hyposecretion
 Endocrine gland hypersecreation

VARIOUS ENDOCRINE DISORDERS
1.Disorders of the pancreatic gland
• Diabetes mellitus
2. Disorders of thyroid gland
• Hypothyroidism
• Hyperthyroidism
3.Disorders of Adrenal gland
• Cushing’s disease
• Addison’s disease

CONT….
4.Disorders of anterior pituitary
• Growth hormone deficiency
5.Disorders of posterior pituitary
• Diabetes insipidus

DISORDERS OF PANCREAS
- Endocrine region of pancreas is known as Islets of
Langerhans
- The Islets of Langerhans have three major types of
cells
o Alpha cells: They produce glucogon that increases
blood glucose level.
o Beta cells: They produce insulin which lowers blood
glucose level by helping cell for metabolism.
o Delta cells: They produce somatostatin which
regulates the release of insulin and glucogon.

INTRODUCTION
 The most common disorder of pancreas is Diabetes
mellitus
 In Diabetes of mellitus the Beta cells of Islets of
Langerhans fail to produce insulin.

DEFINITION
 Diabetes mellitus is defined as genetically
acquired heterogenous group of disorder that
share glucose intolerance. It can also defined as a
disorder of carbohydrate metabolism
characterized by total or partial deficiency of
insulin, resulting in metabolic adjustment or
physiological changes almost all areas of body.

CLASSIFICATION
The American Diabetes Association has classified
Diabetes Mellitus into 3 groups:
1 .Insulin Dependent Diabetes Mellitus(IDDM) or
Type I Diabetes:
-Type I Diabetes Mellitus also referred as juvenile
Diabetes
-It results from destruction of pancreatic beta cells
which produce insulin.

CONT…
-It leads absolute insulin deficiency
-The person becomes completely dependent on
exogenous insulin injections
-Its onset is typically in childhood and adolescence
but can be at any age.

2. NON INSULIN DEPENDENT DIABETES
MELLITUS(NIDDM)
 NIDDM or Type II Diabetes Mellitus
 It results from the insulin resistance
 In this condition cells of the body fails to use insulin
properly
 The onset is usullaly after 40 years of age
 It is also known as “Adult onset Diabetes”

3.GESTATIONAL DIABETES
 When pregnant woman who have never had
Diabetes before have high blood glucose level.

ETIOLOGY
 Idiopathic
 Some of precipitating factors(genetic factors,
autoimmune disease, viral infections

PATHOPHYSIOLOGY
Auto immune destruction of Beta cells
Insulin production declines to less than 10-20%
of normal
Increased blood glucose
level(Hyperglycemia)
Decrease transportation of glucose across cell
membrane(Impaired peripheral glucose uptake)
Less glucose
available and
used for energy
production
Body switches over to
using fat and protein
for energy production
When blood glucose is above
150-180mg/dl
Polyphagia
Hunger center
stimulated
Weight loss

Glucose excreted in
urine(Glucosuria)
Osmotic shift occurs and
additional water is excreted in
urine (Polyuria)
Increased fluid loss
Stimulation of thirst center
Polydipsia
Renal threshold of glucose is
exceeded

CLINICAL FEATURES
 Major symptoms
 Increased Hunger(Polyphagia)
 Increased thirst(Polydipsia)
 Increased Urination(Polyuria)
 Weight loss
 Fatigue

CONT….
o Minor symptoms
• Lethargy
• Weakness
• Irritability
• Abdominal Discomfort
• Dry skin
• Delayed wound healing
• Frequent infections
• Decreased attention span

DIAGNOSTIC EVALUATION
 History collection
 Physical Examination
 Urine test for detecting glycosuria
 Lab test:
 Blood glucose estimation
 Serum electrolytes
 HbA1c level

CONT…..
 Fasting gluose level >126mg/dl
 PPBS level>200mg/dl
 HbA1c level>6.5%

MANAGEMENT
 Diabetes Mellitus is chronic disease which can not
be cured.
 Management concentrates on keeping blood sugar
levels as close to normal
 Controlled by taking proper diet, exercise and use
of appropriate medications (insulin)

INSULIN THEAPY
 The definitive treatment is replacement of insulin
 Available forms of insulin:
 Rapid acting(onset 5-15min, Effect- 5hours)
 Short acting (onset 20-60min, Effect- 5-8hours)
 Intermediate acting (onset 2-4Hours, Effect- 10-
18hours
 Long acting (onset 3-5hours, Effect- 18-24hours)
o The sites of insulin injections are abdomen, arms,
legs and buttocks

CONT…
 Glucose monitoring
 Urine monitoring for sugar and ketones
 Diet, meal planning and nutrition
 Exercise
 Family education( about diet, exercise, insulin
administration)

COMPLICATIONS
 Ischemic Heart disease
 Stroke
 Peripheral vascular disease
Microvascular complications:
 Diabetic retinopathy
 Diabetic nephropathy
 Diabetic neuropathy
 Diabetic foot

NURSING MANAGEMENT
1. Fear and anxiety related to long term illness
2. Imbalanced nutrition related to imbalance of insulin,
food & physical activity.
3. Risk for injury related to hypoglycemia
4. Risk for injury related to insulin deficiency.
5. Risk for infection related to hyperglycemic state

CONT….
6. Risk for fluid volume deficit related to
polyuria & dehydration.
7. Potential self care deficit related to physical
impairments or social factors
8. Knowledge deficit related to care of a child with
newly diagnosed diabetes mellitus.

Disorder of endocrine system

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