Pathophysiology

The pathophysiology of Diabetes Mellitus type II is characterized by the client’s

precipitating and predisposing factors such as body weight(BMI 27) , smoking,

decreased physical activity, genetic heredity and age (49). These factors leads in

alterations from normal levels of the body result into formation of autoantigens on

insulin-producing beta cells which then circulate in the blood stream and

lymphocytes, these changes without medical intervention and modification of

lifestyle proceeds in the activation of T helper lymphocytes 1 and 2, which results in

inflammatory response and the activation of macrophages, B lymphocytes that

produce islet cell antibodies and antiGAD65 antibodies, and autoantigen cytotoxic

(CD8) cells. This leads to beta cell dysfuction, resulting in increase production of

glucose in the liver, decrease uptake of glucose in the adipose tissue and skeletal

muscles and results in hypergylecmia. Client manifest an increase in blood glucose

value of 17.68 mmol/L (from the normal value of 4-5mmol/L), increase in

triglyceride 3.47 (from normal value of 0-1.70mmol/L), increase cholesterol of 6.75,

increase in Low Density Lipoprotein 4.12, decrease inHigh Density Lipoprotein 1.06,

increase urinary frequency, increase in appetite, blurred vision, fruity odor and

orthostatic hypotension.
 PRECIPITATING PREDISPOSING
FACTORS FACTORS

Body weight Genetic heredity

Smoking Age
Decreased physical
activity
Deranged insulin
Autoantigens form on insulin-producing release
beta cells & circulate in the blood stream (PANCREAS)
and lymphocytes
Activation of T helper 1
lymphocytes Activation of T helper 2
lymphocytes

Activation of
Activation of autoantigen Activation of B
macropahges with release
specific T cytotoxic (CD8) lymphocytes to produce
of IL-1 and TNF alpha
cells islet cell autoantibodies
and antiGAD65
antibodies
Beta cell dysfunction and insulin resistance

Insulin-mediated Insulin-mediated Insulin-mediated glucose

glucose production glucose uptake uptake decrease
increase (LIVER) decrease (SKELETAL MUSCLE)
(ADIPOSE TISSUE)

HYPERGLYCEMIA

(+) polyphagia
Manifestations (+) polyuria
UNCONTROLLED DM TYPE 2 of (+) fruity o
sign/symptoms (+) blurred vision
by the client (+) orthostatic
hypotension