Pathophysiology of Diabetes Mellitus Type II References: Black, J. and Jacobs, 2004. Medical-Surgical Nursing, .

Brunner and Suddarths Medical and Surgical Nursing

Precipitating factors: 1. eating too much sweets 2. diet Insulin resistance

Predisposing factors: 1. family history of DM 2. Male

Exhaustion of beta cells

Impaired insulin secretion

Absorption of glucose by the cell

Breakdown of fat

UNCONTROLLED HYPERGLYCEMIA

Fatty acids & glycerol ketone bodies in the general circulation Metabolic acidosis

Increase viscosity of blood

Microvascular vasoconstriction Thickening of blood vessel walls Occlusion of plaque Blood flow blocked Capillary basement membrane thickening

Glomerular hemodynamic changes Glomerular hyperfiltration and hyperperfusion

Nausea and vomiting

Circulating blood volume

Endothelial hyperplasia Bp HPN Neural hypoperfusion and ischemia

Dysfunction of autoregulatory response Increased extracellular matrix deposition

Poor appetite

Possible delayed wound healing

Weight loss

Glomerulosclerosis

Risk for impaired skin integrity

Nerve dysfunction PERIPHERAL NEUROPATHY Tubulointerstitial fibrosis

Decreased glomerular filtration

Imbalance nutrition less than body requirement

Kidney excrete glucose

Numbness Impaired sensation on lower extremities

BUN and creatinine

GLYCOSURIA

Nephropathy
POLYURIA and albuminuria

Acidity of urine

Capillary basement membrane thickening Abnormal retinal vascular permeability Scarring

Urethral flora UTI

F & E imbalance

Number of solute relative to water

Blurring of vision

Sodium ions lost

Tissue dehydration POLYURIA

Fluid volume deficit

POLYDIPSIA

Musculoskeletal effects

Inhibit both protein synthesis and protein degradation in skeletal muscles

Risk for injury

Body weakness

Fatigue

hunger