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Clinical Manifestations in Diabetes Mellitus

Lethargy Loss of Weight

Insulin Deficiency/ Insulin Resistance Insulin Deficiency/ Insulin Resistance
↓ ↓
↓ of Uptake of Glucose into Tissue ↑ Lipolysis, Protein Catabolism
↓ ↓
↓ Energy Producon ↑ Appetite → Polyphagia
↓ ↓
Lethargy Intake is Insufficient to Compensate Breakdown
↓
Loss of Weight
Paraesthesia (Numbness)
Hyperglycaemia
↓ Boils, Absce ss, Delayed Wound Healing
↑ Sorbitol, Fructose Relative Deficiency of Insulin/ Insulin Resistance
↓ ↓
Damage to Schwann Cell (Segmental Demyeliniation) ↓ Glucose Utilization by Tissue
↓ ↓
Delayed Nerve Conduction ↑ Gluconeogenesis in Liver
↓ ↓
Numbness Hyperglycaemia
↙ ↘
Glucose as Medium for Growth Impaired Chemotaxis, Phagocytosis
Polyuria, Nocturia
of Bacteria by Polymorphonuclear Cells
Less Entry of Glucose into Peripheral Tissue, ↑ Gluconeogenesis ↓ ↓
↓
↑ Risk of Skin Infection Delayed Wound Healing
Hyperglycaemia
↓ (most common – S. aureus)
↓
Glucose Excretion Exceed Renal Threshold
Boils, Abscess
for glucose reabsorption
↓
Glycosuria Glycosuria
↓ Non-Ins ulin Dependent DM
Osmotic Diuresis ↓
↓ ↓ Insulin Activity
H2O absorbed out of Tubules ↓
↓ Failure to Transfer Glucose from Plasma into Cells
↑ Urine Production ↓
↓ Body response as in the Fasting state
Polyuria, Nocturia ↓
Stimulation of Glycogenolysis, Gluconeogenesis, Lipolysis
↓
Polyuria, Polydipsia
Glucose accu mulate in Blood
Hyperglycaemia ↓
↓
Glucose excreted in Urine
Glycosuria ↓
↓
Glucosuria
Osmotic Diuresis
↓
Polyuria
↓
Loss of H2O, Electrolyte
↓
Dehydration
↓
Stimulate Thirst Centre
↓
Polydipsia