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Pathophysiology
associated with
diabetes mellitus

16
...
7)
...
7 It is recommended that
people with diabetes mellitus
have a yearly screening test on
their blood lipids (cholesterol
test), blood pressure, kidney
function, eyes and eyesight, feet
and weight
...

Find out more about this and
other physiological observations
in online Chapter 17
...


If left untreated, the patient might eventually become unconscious and
would then need a glucagon injection to raise blood glucose levels
...

Prolonged severe neonatal hypoglycaemia in babies can cause long-term
neurological damage (k Box 16
...


Hyperosmolar hyperglycaemic state
A hyperosmolar hyperglycaemic state (HHS) occurs in people with
diabetes and those with profound beta cell dysfunction (k 11
...
It
can develop over several weeks through a combination of illness and
dehydration
...
9)
...
This is accomplished most effectively within an intensive care
setting
...
8 Risk factors for
neonatal hypoglycaemia
include:
• preterm (less than 37 weeks’
gestation)
• low birthweight (<2
...
5 kg)
• maternal diabetes mellitus (all
types)
...
9 Normally glucose is
filtered by the glomeruli of the
nephrons
in the kidneys and then
completely reabsorbed by
facilitated diffusion into the
bloodstream by cells in the
proximal tubule (k 8
...
2)
...
Since glucose is an
osmotically active molecule,
water tends to follow it, thus the
urine volume increases and the
person becomes exceedingly
dehydrated and thirsty
...
10 Diabetic ketoacidosis (DKA)
is a potentially life-threatening
complication
...
Blood
testing shows low pH (acidosis) due to
ketone bodies, accompanied by
hyperglycaemia
...
If left
untreated, it can be fatal
...
2
...
This means that
glucose cannot be used for energy and so fat or body tissues provide an
alternative energy source
...
Ketones can be detected by urinalysis and a warning sign of DKA is the smell of ketones on breath, usually likened to the smell
of pear drops
...
10)
...
2
...
11 ‘-opathy’ denotes a
disease or disorder
...
12 Peripheral neuropathy can
lead to ‘diabetic holiday foot
syndrome’
...
People with diabetes
are more likely to be admitted to
hospital with a foot ulcer than with any
other complication of diabetes, and
may need to have a limb amputated
later due to gangrene
...
11) is long-term damage to the nerve fibres,
which develops when high blood glucose levels are present over several
years; it affects nerves to different parts of the body:
• peripheral neuropathy is the most common type of diabetic neuropathy
and usually starts with loss of feeling or pain in the feet
...
12)
• proximal neuropathy causes pain in the thighs, hips or buttocks and
leads to weakness in the legs
• focal neuropathy results in the sudden weakness of one nerve or a group
of nerves anywhere in the body, causing muscle weakness or pain
• autonomic neuropathy is due to damage of the autonomic nerves (k 9
...
Autonomic neuropathy can also cause hypoglycaemia
unawareness, a condition in which people no longer experience the
warning symptoms of low blood glucose levels
...
2
...
8
...


16
...
5 Diabetic retinopathy
Long-term diabetes can damage the blood vessels in the eye, leading to
haemorrhage into the retina
...
Diabetes is also associated with increased risk of
glaucoma and cataract
...
3 Other forms of diabetes
16
...
1 Gestational diabetes
Pregnancy changes the way the mother’s body handles nutrients including
glucose and if diabetes develops it can be diagnosed at 20–24 weeks’
gestation

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