Diabetes Mellitus

- A group of metabolic disease characterized by elevated levels of glucose n

the blood (hyperglycemia) resulting from defects of insulin secretion, insulin
action or both
(American Diabetes Association, 2003)
Diabetic Nephropathy
- A renal disease secondary to diabetic microvascular changes in the kidney
(American Diabetes Association, 2003)

Precipitating factors:
80kg 0cm BMI =0
Hypertensive at age
High cholesterol, high sugar
diet
No exercise

Predisposing
factors:
Parents and siblings
are diabetic
Pacific islander
asian

Insulin Resistance or
Impaired Insulin
Secretion

Hyperglycemia
Less nitric oxide
Bp =
Vasoconstriction

Poor tissue perfusion

Slow circulation
of blood
Cellulitis a
left leg and
foot

Increased viscosity of
blood
Increase
intraglomerularic
pressure
Stressed kidney filtration
mechanism

Paleness

Ineffective kidney
function due to poor
perfusion

Increased glomerular
parmeability

Increased afferent
arteriol dilation
Dysfunctional
vasoconstrictive
regulatory response

Scarring and loss of

glomerular filtration
membrane

Proteinuria
Glycosuria
Dyslipidemi
a

Decreased glomerular
filtration rate

Oliguria

Increased filtration of
protein and
macromolecules

Edema grade 2 on
both upper and
lower extremities

Lose of oncotic pressure

on cells

Hyperkalemia due to
decreased excretion in the
distal convoluted tubule

Fluid retention

Pulmonary edema

Dyspnea

Pulmonary congestion

Cardiac arrest

Death