Ideal Pathophysiology of Diabetes Mellitus Type II

1. 2. 3. 4. 5. 6.

Precipitating factors: frequent or chronic infections eating too much sweets development of glucose intolerance during drug therapy delivery of over 9 lbs infants diet sedentary lifestyle

Predisposing factors: 1. family history of DM 2. obesity 3. Age above 40 Insulin resistance

Exhaustion of beta cells

Insulin production/ decrease secretion of insulin Degradation of proteins

Absorption of glucose by the cell

Breakdown of fat

Cell starvation

Stimulation of hunger mechanism via hypothalamus

Hunger

POLYPHAGIA

FBS 140 mg/dL

HYPERGLYCEMIA

FBS to 180 mg/dL

Nerve Demyelinization

Kidney filtration mechanism impaired

Capillary basement membrane thickening

GLYCOSURIA

NEUROPATHY

Acidity of urine Diffuse glomerular sclerosis Urethral flora NEPHROPATHY

Paresthesias & numbness Impaired pain sensation NON-HEALING ULCERS Delayed wound healing

UTI

Vaginitis

Renal failure End-Stage Renal Disease

Circulating blood volume Hypovolemia

POLYURIA & ALBUMINURIA

Gangrene

HYPOTENSION & TACHYCARDIA

F & E imbalance

Number of solute relative to water

Potassium ion retention

Sodium ions lost

Cardiac arrythmias DEATH

Tissue dehydration

POLYDIPSIA

Increase viscosity of blood

Capillary basement membrane thickening Abnormal retinal vascular permeability Scarring RETINOPATHY

Thickening of blood vessel walls Occlusion of plaque

Musculoskeletal effects

Impaired glucose absorption in the muscle tissue Joint contractures Myocardial ischemia Myocardial infarction Diminished peripheral pulse

Blood flow blocked

Blood pressure HYPERTENSION

FATIGUE

Blurring of vision Stroke

Blindness blindness

Heart Failure

 Breakdown of fat

Fatty acids & glycerol ketone bodies in the general circulation hydroxybutyric acid acetoacetic acid Convulsions Metabolic acidosis Acetone breath

Fat content of the blood Hyperlipidemia

Weight Loss

Formation of fatty deposits on the walls of the blood vessels Atherosclerosis

Nausea and vomiting

Abdominal pain

Cellular Potassium

Body attempts to prevent further decrease in pH

Depressed central nervous system

Poor appetite

Cardiac arrhythmias

Kussmauls respirations

Headache

Coma

 Amino acid in the general circulation Hyperaminoacidemia

Mobilization / degradation of proteins

Decreased urinary nitrogen

Further sodium ion loss

Potassium ion retention

Dehydration

Cardiac arrhythmias DEATH

hunger