PATHOPHYSIOLOGY OF DIABETES MELLITUS

Modifiable factors: Smoking Alcohol Obesity Diet Non-modifiable factors: age gender hereditary socio-economic status Decreased special receptors on cell surfaces for insulin Diminished intracellular reactions to insulin insulin resistance less effective insulin for glucose uptake by the cell and tissues glucagon elevated blood glucose level (RBS of 191mg/dl) Diabet Kidney excrete Glucose glucosuria dehydration increased amount of excretion of water Weight loss increased thirst (Polydipsia) Viscous blood Hardening and thickening Of the arterial walls atherosclerosis increased pressure on the arterial wall decreased circulation decreased renal perfusion released of renin increased angiotensin I and II increased aldosterone decreased Na and water excreted by the kidneys grade II non-pitting edema numbness and tingling of extremities gangrenous diabetic foot L diabetic foot care (third solution) Clindamycin ceftriaxone decreased perfusion to the different part of the body including the extremities symmetrical loss of protective sensation decresed cerebral perfusion transient ischemic attack increased BP solute diuresis polyuria hyperosmolality wasting of lean body mass cellular starvation polyphagia production of excess glucagon

production of glucose from protein and fat stores

Weight loss (from 135 to 85 kls) Creatinine= 1.44mg/dl

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Clinical Manifestation Nursing Management Medical Management Laboratory Results