Endocrine & Metabolism Module

DSL : Diabetes Mellitus

Case History keywords

 10 year 0ld
 Fatigue
 LOW
 Polydypsia
 Polyuria
 Vomitting
 Drowsiness
Laboratory Investigation

 Urine glucose : 4+
 Urine Ketone : 3+
 Plasma ketone : 33mmol/l
Diagnosis

 Type 1 Diabetes Mellitus

with Ketoacidosis
 Treated with insulin
1. Insulin binds to its receptor
2. Activation of cascades
3. translocation of Glut-4 transporter to the plasma membrane and influx of
glucose
4. glycogen synthesis
5. Glycolysis
6. fatty acid synthesis
Definition of DM

 a metabolic disorder of multiple aetiology

characterized by chronic hyperglycaemia
with disturbances of carbohydrate, fat and
protein metabolism resulting from defects in
insulin secretion, insulin action, or both.
Definition of DM

 a metabolic disorder of multiple aetiology

characterized by chronic hyperglycaemia
with disturbances of carbohydrate, fat and
protein metabolism resulting from defects
in insulin secretion, insulin action, or both.
Page 1190, Pathologic Basis of Disease
 HLA-Linked genes
Immune response aga inst
AUTOIMMUNE
normal beta cells
HLA-Linked
and
Immune
ATTACK other
response
AUTOIMMUNE
OR
normal :cells
Beta genes
genetic
aga inst
cells
Immunebeta
response aga inst
and
loci
ATTACK
OR
altered
other
destruction genetic
beta :cells
Beta cells
Immune response aga inst
loci beta cells
destruction
altered

T
Viral infections : y
Molecular mimicry p
AND/OR e
Damage to beta I
cells D
ia
b
e
t
e
s
Complications

 MI
 CCF
 Peripheral Neuropathy
 Diabetic retinopathy
 CRF
 1.
2.
3.
4.

5.
6.
7.
8.
9.

10.

11.
12.

13.
 1. TIA
2. CVA
3. Cataract
4. Diabetic Retinopathy

5. Angina
6. MI
7. CCF
8. microalbuminuria
9. CRF

10. Peripheral neuropathy

11. Hypertension
12. Artherosclerosis

13. Diabetic foot ulcer