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Ideal Pathophysiology of Diabetes Mellitus Type II

Precipitating factors: Predisposing factors:


1. frequent or chronic infections 1. family history of DM
2. eating too much sweets 2. obesity
3. development of glucose 3. Age above 40
intolerance during drug
Insulin resistance
therapy
4. delivery of over 9 lbs infants
5. diet
6. sedentary lifestyle 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

Kidney filtration mechanism impaired


Nerve Demyelinization Capillary basement
membrane thickening
GLYCOSURIA

NEUROPATHY  Acidity of urine


Diffuse glomerular
sclerosis
 Urethral flora
Paresthesias &
numbness NEPHROPATHY

Impaired pain
sensation UTI Vaginitis Renal failure

NON-HEALING End-Stage Renal


Delayed wound  Circulating POLYURIA &
ULCERS Disease
healing blood volume ALBUMINURIA

Gangrene Hypovolemia

HYPOTENSION &
TACHYCARDIA
F & E imbalance

 Number of solute relative to water

Potassium ion retention Sodium ions lost

Cardiac arrythmias Tissue dehydration

DEATH POLYDIPSIA

Increase viscosity of
blood

Capillary basement Thickening of blood Musculoskeletal effects


membrane thickening vessel walls

Abnormal retinal vascular Occlusion of plaque Impaired glucose absorption in


permeability the muscle tissue

Blood flow blocked


Scarring Joint contractures

RETINOPATHY  Blood pressure Myocardial Diminished


ischemia peripheral FATIGUE
pulse
HYPERTENSION
Blurring of vision Myocardial
infarction
Stroke
Blindness
blindness Heart Failure
 Breakdown of fat  Fatty acids &  Fat content of the
glycerol blood

Weight Loss  ketone bodies in Hyperlipidemia


the general circulation
• hydroxybutyric
acid Formation of fatty
• acetoacetic deposits on the
acid walls of the blood
vessels
Convulsions Metabolic acidosis Acetone breath
Atherosclerosis

Nausea and vomiting Abdominal pain ↓ Cellular Potassium Body attempts to prevent Depressed central
further decrease in pH nervous system
Poor appetite Cardiac arrhythmias Kussmaul’s respirations

Headache Coma
 Amino acid in the  Mobilization /
general circulation degradation of proteins

Hyperaminoacidemia

Decreased urinary
nitrogen

Further sodium ion loss Potassium ion retention

Dehydration Cardiac arrhythmias

DEATH
hunger