Type 1 vs Type 2 Diabetes (Easy Breakdown!)

In this video, we're breaking down type 1 versus type 2 diabetes. We'll talk about what makes them similar, what makes them different, and we'll go over the key things that you need to know about them for nursing school. Let's dive in. Now, before we dive in, I want to make sure that you have this free critical thinking cheat sheet that I have for you. You know that critical thinking is everything in nursing school. It's what all of your exams are going to test you on, right? So you have to make sure that you know to do it and I'm going to walk you through that in this free cheat sheet. So the link is down below in the description for you to snag it. So be sure to check that out after you watch this video. The first step to understanding the different types of diabetes is to fully understand what is happening in the body, AKA the pathophysiology. This is key to know if you want to pass your exams about diabetes in nursing school. You have to understand the pathophysiology of diabetes for first. Now, the main similarity between type 1 and type 2 diabetes is that in both cases the body isn't able to get glucose into the cells to use for energy and this causes the blood glucose level in the blood to be high. What's supposed to happen is that when there's sugar in the blood, insulin comes in and takes that sugar, that glucose and puts into the cell. Insulin is the key that unlocks the cells. But without insulin, the glucose just stays in the blood and it builds up and builds up. Now, there's two different causes for this for type 1 diabetes and type 2 diabetes. In type 1 diabetes there is a lack of insulin in the first place. The body just doesn't make enough. In type 2 diabetes, it isn't a matter of a lack of insulin like with type 1, but rather the cells stop responding, bonding to that insulin, which is called insulin resistance. Essentially, the blood sugar level has been high for so long and the insulin isn't able to keep up. So this can also lead to the pancreas decreasing its insulin production. Now, when that happens, when the pancreas decreases the insulin production, what's going to happen? Overall, there will be a high glucose level, but the body stops responding to the insulin available. So the cells won't be able to use that glucose for poor energy because the cells aren't responding to that insulin. Now, you know me and you know that I love to put things into simple, step by step processes for you to follow. This is exactly how we teach inside the nursing SOS Membership community too to help you learn things so much faster. So if you are struggling to teach yourself everything in nursing school and you're tired of wasting time reading your textbooks all day long, but you still don't feel prepared for your exams, you have got to join our community, my friend. It will help you so much as you go through nursing school. I'm going to put the link in the description below so you can check out all of the details. So let's break down the pathophysiology of type 1 diabetes and type 2 diabetes into simple steps so you can really understand what's going on here. Let's start with the pathophysiology of type 2 diabetes. Step number one, there is a trigger that causes the cells to become resistant to insulin. Now we aren't exactly sure why type 2 diabete happens in the first place, but there are several factors that have been shown to increase risk. Things like obesity and genetic factors. Now step two is the cells are now resistant to insulin. So step one was that the trigger that causes it? Things like lifestyle and genetics. And now the cells are becoming more and more resistant to that insulin and so the glucose can't get into the cells. And step number three is a lack of insulin production. The pancreas stops making as much insulin because it isn't being used in the first place. So there is a lack of insulin and not enough to give the glucose to the cells. Now step number four is hyperglycemia. Now this happens because of two things, the insulin resistance and that lack of insulin production. And hyperglycemia just means that there is all this extra glucose hanging around in the blood because it can't get into the cel cells. So it's just hanging out there. Now here's where things get a little more sticky. The liver sees that the cells don't have the glucose that they need, so it starts to break down its stored up glucose. It's glycogen stores to give some extra to the cells. The hormone called glucagon, that's the one that tells the liver to make some glucose. So the liver is breaking down its extra glycogen stores into glucose for the cells to use. But there's still not enough insulin to give that glucose to the cells. So this just adds to all of that extra glucose that's floating around in the blood. And the blood sugar level keeps rising and keeps rising. And then step number five of type 2 diabetes pathophysiology is the possible complications There are a lot of complications that can happen with type 2 diabetes. Things like blurry vision because of all of that glucose clogging, scratching the tiny blood vessels in the eyes, infections that won't heal, neuropathy, and damage to the kidneys are all possible. Now, overall, these complications are caused by the excessive amount of glucose in the bloodstream because all of that glucose can't get into the cells to be used for energy, so it's just floating around the blood. Now, a huge question about this is, does type 2 diabetes require insulin? And the answer is sometimes. But it's not usually the first line treatment, because patients with type 2 diabetes still make insulin. The first drug of choice for type 2 diabetes is typically metformin, which increases the cell's sensitivity to insulin and it decreases the amount of glucose the liver makes. So it will help to bring down the blood glucose level that way without more insulin. But if other medications and lifestyle changes don't work, then insulin might be prescribed. So that is TYP2 diabetes. Step by step for you. Now let's walk through what happens with type 1 diabetes. Let's start with the first thing that a lot of nursing students get confused about. When it comes to type 1 diabetes. The pancreas isn't making any insulin at all. None. Type 1 diabetes is actually an autoimmune disorder. With type 1 diabetes, the body itself is destroying the insulin producing cells in the pancreas. These are called the beta cells. Then when the beta cells are destroyed, the pan still can't make any insulin, resulting in type 1 diabetes. So in type 1 diabetes, the body isn't making any insulin. That is going to be the key thing to remember when you are trying to differentiate between type 1 and type 2 diabetes. Now, let's break down the pathophysiology for type 1 diabetes in two steps so that you can really make sure that you understand what is happening inside the body. So step number one of type 1 diabetes is that there is an autoimmune response. Now, we're not sure exactly why this happens, but in the vast majority of cases of type 1 diabetes, the cause is autoimmune related. So step one, the autoimmune response is triggered. Now, this leads to step number two, where that autoimmune response continues and the person's own immune system destroys the beta cells in the pancreas. These beta cells are the cells that produce insulin. So without them, insulin can't be produced. Which leads us to step number three, a lack of insulin production. Now, with all those beta Cell attacked, they can't make as much insulin as they should. And this leads to hyperglycemia, which is now step number four of type 1 diabetes. Insulin's job, like we talked about previously, is to move glucose into the body cells so that the cells can use it for energy. But without enough insulin, glucose just hangs out, floats around the blood, and it can't move into the cells. Think of insulin as the key that unlocks the body cells. So without it, the glucose cannot get into the cells. Now, here's where things get really tricky and cross into diabetic ketoacidosis. When the cells can't use glucose for energy, they use fat instead. The body needs energy to survive. So if the body can't use glucose, it moves on to the next best thing, fat. And when fat is broken down for energy, ketones are produced, and ketones are acids. So let's call this step number five and six. Step number five is when the cells use 5 fat as energy instead of glucose. And step number six is when ketones are produced because of that fat breakdown. This leads us into some of the key symptoms of type 1 diabetes that you may see in your patients. And pay close attention here because the NCLEX loves to test you on this. Type 1 diabetes can often lead to diabetic ketoacidosis if it's not treated properly. Don't freak out. I know that can be a big scary word. But here's all that ketoacidosis means. There's a buildup of ketosis ketones in the blood that's making the blood acidic. And this is not a good thing. Remember, there's no insulin to get the glucose inside the cells, so the cells use fat for energy instead. Then when that fat is broken down for energy, ketones are produced and ketones are acids. Now, the body always wants to stay in balance, meaning that it doesn't want to swing too far any which way, especially, especially when it comes to the ph. So when all of that fat is broken down, more and more ketones are made, which are acids, and the blood becomes acidic. Now, the more acidic the blood gets, the lower and lower the ph becomes. When the blood becomes acidic and that ph is lower, so this is ketoacidosis. Now, there's two things about ketoacidosis that nursing exams love to test you on. So let's make sure you understand what is happening inside the body that is causing these symptoms to occur. Now, the first one is fruity breath. Literally, when ketoacidosis Makes the breath smell fruity. Fruity breath is caused by those ketones being broken down into acetone, because acetone actually smells fruity. So that fruity breath is a pretty telltale sign that those ketones are being broken down into acetone, because that's the acetone smelling fruity. So if the patient's breath smells fruity, they may be in acidosis. The second one you must know about is kuzmal respirations, which is a pattern of breathing that is fast and deep. When the breathing is faster and deeper, more carbon dioxide is released. And carbon dioxide is an acid. The lungs try to compensate for the buildup of acidic ketones that they breathe deeper and faster to try to get rid of that excess acid. Remember, carbon dioxide is an acid too. That's why those Kussmaul respirations may occur. They are fast and deep respirations. And that's the body's way of trying to get rid of as much acid as possible by getting rid of as much carbon dioxide, AKA acid, as they can. So now that we understand what is happening with type 1 diabetes and type 2 diabetes, and some of the major symptoms you will see on your nursing school exams about type 1 diabetes, now let's touch on the main symptoms that all all have to do with high blood glucose. Now, we know that with both type 1 and type 2, high blood glucose will occur. So when you think of diabetes, I want you to think of the three Ps, polyuria, polydipsia and polyphasia. So let's go through what each of those means. We'll break it down for you. So poly, the first part of the word means a lot or many. Urea refers to urine, dipsia refers to being thirsty, and phasia refers to eating. So putting those all together, polyuria means excessive urination, like the patient is really urinating frequently and a lot. Polydipsia means excessive thirst. Now, I mean excessive, the patient is really thirsty just all of the time. And then polyphagia means excessive hunger, so the patient is hungry all the time. Now, in patients with diabetes, there is an increase in the amount of sugar in the blood. So the blood is just filled with sugar, right, because of that insulin resistance with type 2 diabetes or a lack of insulin production with type 1 diabetes. Now remember from the pathophysiology back in the beginning of this video, so these three symptoms really make sense when you think about it. I mean, what are the kidneys going to do when the blood is filled with sugar? They're going to try to get rid of it, right? So they're going to urinate a lot and that is what leads to polyuria. The patient will also be extremely thirsty because their blood is telling their, the brain, hello, I'm drowning in sugar here, help. So the brain will then tell them to drink more fluids to help dilute that sugar. That's what causes that polydipsia. They will also be really, really hungry because their body cells are deprived of their best energy source, that glucose. Even though there is glucose in the blood, with diabetes, the cells can't use it for energy, right? So their brain just thinks that they need more energy, more glucose. So they tell them to eat and eat, and that's what causes that polyphagia. Now we talked a lot about the key things that you need to know for diabetes for your nursing exam and the nclex. But there's some really important NCLEX test taking strategies that you need to know about as well if you want to pass. So click on this video here. I'm going to walk you through the best tricks to use to get NCLEX questions right and pass your nursing school exams. And if you love this video and want to see more full breakdowns like this on our channel, write love in the comments comments below and go become the nurse that God created only you to be. And I will see you over there in that next video.