A

↑ Blood Osmolality ↑ Blood Viscosity Blood Sugar Glucose cannot Gluconeogenesis Increased blood
exceeds Renal enter the cells activation glucose can impair
threshold small blood vessels
Fluid shift from
intracellular to Cellular starvation Lipolysis & Protein
↓ Blood flow Favors bacterial
extracellular space Impaired breakdown Micropathy
growth
reabsorption of
↓ Tissue glucose in the urine Sensation of hunger
Intracellular Weight loss,
Perfusion Infection
Dehydration hyperlipidemia
Glycosuria Polyphagia

Stimulation of thirst Atherosclerosis

in the Hypothalamus Osmotic Diuresis Weakness
↓ Wound Gangrene
healing Formation
Thirst sensation
↑ Urine output
Polydipsia Neuropathy Retinopathy Nephropathy
Thrombus Polyuria
formation
Blurred or Dysfunction
Loss of Gastroparesis Loss of vision of
Macropathy sensation, (cataracts) glumerular
tingling, filtration
numbness, ↓ Peristalsis
Cerebrovascular incontinence,
accident, impotence Leakage of
Myocardial erythrocytes,
GI upset
Infarction, leukocytes,
Peripheral and albumin to
Vascular Disease urine
Nausea, vomiting,
abdominal pain,
constipation
 PATHOPHYSIOLOGY

Predisposing Factors:
> Heredity Precipitating Factors:
Etiology: > Weight (Obesity)
> Age (>30)
Unknown > Stress
> Female
> Race (blacks, Hispanics, American > Diet
Indians and Asian-Americans) > Lack of Physical Activity
> Previous Gestational Diabetes

Insulin Resistance

↑ Blood Glucose Level

↑ Insulin Demand

Beta Cell Exhaustion

and Dysfunction

↓ Insulin Secretion

Unregulated
Hyperglycemia