ENDOCRINE SYSTEM
PREPARED
BY MR. ABHIJIT DAS
DIABETES
DEFINITION
Diabetes is a condition of high blood sugar caused by problems with insulin, a
hormone that helps glucose enter cells for energy.
- Type 1: Immune system destroys insulin-producing cells in the pancreas.
- Type 2: Body becomes resistant to insulin or doesn’t produce enough.
ETIOPATHOGENESIS
- Type 1: Caused by genetic and environmental factors (e.g., viral
infections) leading to immune attacks on insulin cells.
- Type 2: Caused by insulin resistance and reduced insulin production,
often linked to obesity, inactivity, and genetics.
- Other types:
- Gestational diabetes: Hormonal changes during pregnancy cause insulin resistance.
CLINICAL
MANIFESTATIONS
- Thirst, frequent urination
- Weight loss, fatigue, blurred vision
- Slow-healing wounds, frequent infections
- Numbness/tingling in extremities
- Dry, itchy skin, increased hunger
- Mood changes
NON-PHARMACOLOGICAL
MANAGEMENT
1. Diet:
Balanced, high-fiber diet with lean protein; limit sugars and fats.
2. Exercise:
At least 150 minutes/week of moderate activity.
3. Weight Management: Healthy weight through diet and exercise.
4. Blood Glucose Monitoring: Regular checks to manage levels.
5. Stress Management: Techniques like deep breathing or yoga.
6. Quit Smoking:
Reduces risk of complications.
PHARMACOLOGICAL
MANAGEMENT
1. Metformin:
Reduces liver glucose production, improves insulin sensitivity.
2. Insulin:
Needed for Type 1 and sometimes Type 2.
3. Sulfonylureas:
Stimulate insulin production (e.g., glipizide).
4. DPP-4 Inhibitors: Increase GLP-1 to stimulate insulin (e.g., sitagliptin).
5. GLP-1 Agonists:
Mimic GLP-1 to increase insulin and reduce appetite (e.g., exenatide).
6. SGLT2 Inhibitors: Increase glucose excretion in urine (e.g., canagliflozin).
HYPOTHYROIDISM
DEFINITION
Hypothyroidism is a condition where the thyroid gland does not produce enough
thyroid hormones.
ETIOPATHOGENESIS
1. Autoimmune disorders: Hashimoto’s thyroiditis, where the immune system attacks the thyroid.
2. Thyroid surgery:
Removing all or part of the thyroid can cause hypothyroidism.
3. Radiation therapy: Can damage the thyroid, leading to reduced hormone production.
4. Medications:
Drugs like lithium, interferon, and amiodarone can affect thyroid function.
5. Congenital hypothyroidism: Some babies are born with an underactive thyroid.
6. Iodine deficiency: Low iodine intake hinders hormone production.
7. Pituitary disorders: Issues with TSH production from the pituitary gland can lower thyroid
hormones.
CLINICAL
MANIFESTATIONS
- Fatigue, weakness, and weight gain
- Cold intolerance, dry skin, and hair
- Constipation, depression, muscle stiffness
- Joint pain, slow heart rate, and menstrual
irregularities
NON-PHARMACOLOGICAL
MANAGEMENT
1. Diet:
Include iodine (seaweed, dairy) and selenium (brazil nuts, tuna).
2. Exercise:
Helps reduce fatigue and maintain weight.
3. Stress management: Yoga, meditation, or breathing exercises.
4. Supplements:
Omega-3 and L-tyrosine may help but require further research.
5. Avoid certain foods: Limit soy and cruciferous vegetables (e.g., broccoli).
PHARMACOLOGICAL
MANAGEMENT
1. Levothyroxine:
Synthetic thyroid hormone, primary treatment.
2. Combination therapy: Sometimes, levothyroxine and liothyronine (T3) are used together.
HYPERTHYROIDISM
DEFINITION
Hyperthyroidism is a condition where the thyroid gland produces too much
thyroid hormone.
ETIOPATHOGENESIS
1. Graves' disease:
Autoimmune disorder causing excess hormone production.
2. Toxic multinodular goiter: Multiple thyroid nodules produce extra hormones.
3. Thyroiditis:
Thyroid inflammation releases stored hormones temporarily.
4. Excessive iodine: High iodine intake can stimulate overproduction of hormones.
5. Tumors:
Rare tumors in the thyroid or pituitary may cause hormone excess.
6. Medications:
Drugs like amiodarone and lithium can trigger hyperthyroidism.
CLINICAL
MANIFESTATIONS
- Weight loss despite increased appetite
- Heat intolerance, excessive sweating
- Palpitations and rapid heartbeat
- Tremors in hands or fingers
- Anxiety, irritability, and insomnia
- Frequent bowel movements, muscle weakness
NON-PHARMACOLOGICAL
MANAGEMENT
1. Diet:
Balanced diet; avoid excess iodine, caffeine, and alcohol.
2. Stress reduction: Practice meditation, deep breathing, or yoga.
3. Regular exercise: Helps manage anxiety and boosts health.
4. Cooling techniques: Wear breathable clothes, use fans or AC.
5. Adequate rest:
Prioritize sleep to reduce fatigue.
PHARMACOLOGICAL
MANAGEMENT
1. Antithyroid drugs: Medications like methimazole reduce hormone production.
2. Beta blockers:
Drugs like propranolol manage tremors, palpitations, and anxiety.
3. Radioactive iodine therapy: Selectively destroys overactive thyroid cells; used
if other treatments aren’t effective.