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PATHOPYSIOLOGY OF TYPE 1 DM & DKA

Stage I Stage II Stage III


Genetic Predisposition Environmental Trigger Active Auto Immunity
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Stage IV
Acute Illness / Stress Progressive Beta Cell
Destruction

Increased Insulin Consumption Fasting Hyperglycemia Decrease 1st Phase


Insulin Secretion

Honeymoon Period

Mass Destruction of
Alpha & Beta Cells Reached
80% - 90%

Stage IV
Insulin Resistance Insulin Deficiency Proinsulin
Overt Diabetes Mellitus Secretion
Glucagon, Cathecholaines
& Grwoth Hormone Decreased Tissue Response Decreased Glucose Induced
to Insulin Insulin Secretion Protein Wasting

Decreased Cellular Glucose Muscle Wasting


Hyperglycemia Increased Hepatic Glucose
Uptake
Production
Weight Loss &
Peripheral Insulin Post Receptor Weakness
Energy Production Glycolysis Impaired Beta
Resistance Defect
From Fat Stores Gluconeogenesis Cell Function
Fatigue
Lipolysis
Further Increase in Bld.
Glucose Polyphagia
Ketosis
Acid Base DKA Lungs
Imbalace
Glycosuria
Kidney Acetone Breath
Acidosis & Kussmaul’s
Breathing
Ketonuria Osmotic Diuresis Severe K loss
Acid Overload
Na Excretion
Hemoconcentration Polyuria
Diabetic Coma

Tissue Anoxia Fluid Volume Deficit polydipsia

Death

Lactic Acid Hypovolemic Shock Hypotension


Production

Tachycardia