DIABETES MELITUS

Precipitating:
- Cushings syndrome
- Pancreatic Ca
- Liver Cirrhosis

Predisposing
- obesity
- age (40 above)
- hereditary

Number of insulin at receptor site

Insulin / zero insulin uptake in the cell

Metabolism

Protein Metabolism

Fat Metabolism
Lipolysis of adipose tissue

Liver is to unable
to store glucose

glycogenolysis

Glucose cannot
enter the cells of
muscle and
adipose tissues

CHON
catabolism

fuel polyphagi

amino acid
converted to
glucose

CHON
synthesis
ketone bodies
-muscle weakness
-failure to grow

hyperlipedimia

incomplete oxidation

deposits lipid
in the lumen

C
D

hyperglycemia

lungs

kidneys secreted
excess glucose to
restore balance

acetone & CO2

retention

kidneys

BP

persisitent

acetone excretion

bursting of small
capillaries in eyes
S/SX: blurring vision

RR
dycosuria

glucose in the urine

acts as osmotic diuretic

ketonuria

Na retention

urine output

osmotic pressure

H2O loss
blood volume

fluid volume deficit

C.O
DEHYDRATION
organ perfusion
SHOCK
severe tissue anorexia

eyes (retinal neuropathy) peripheral neuropathy

blindness

tingling sensation poor

wound healing

paradoxin of lactic acid

kidney neuropathy
ketones in the blood
ketosis
F

BP
CVD

further in the
urine output
H2O loss
polyuria

H+; PH

nausea & vomiting

H+ enters cells

metabolic acidosis
diabetic coma

K+ moves out of the cell

going to the blood

dehydration
hypokalemia

cardiacdysrythmias