Please enable JavaScript.
Coggle requires JavaScript to display documents.
Type II Diabetes Mellitus, Definition of Type II DM: Cells of the body…
Type II Diabetes Mellitus
Risk Factors: hypertension, rural geography leading to less access to healthcare resources, poor nutrition, dyslipidemia, family history of type 2 diabetes
Hypertension
Condition where the force of blood pushing against the walls of your arteries is too high
Body responds by an increase in cardiac output/total amount of blood the heart pumps or total peripheral resistance/how tightly the blood vessels constrict
Congestive Heart Failure if untreated for too long
Endothelial cells become damaged over time.
The immune system responds by dispatching monocytes and T cells to the injury site, triggering a cascade of inflammation made to destroy the plaques
inflammation causes increased systemic vascular resistance.
Nitric oxide is in endothelium and when endothelial cells get damaged, bioavailability of NO decreases. causing vascontriction and further platelet aggregation
Initial Damage --> LDL sticks to damage and enters the artery wall --> immune activation macrophage --> macrophage breaks down lipids --> macrophage transforms into foam cells --> foam cells attracts more macrophages due to excess lipids --> foam cells form lipid core --> fatty streak forms --> fibrous cap forms with necrotic core (thick vs thin)
Chronic vascular damage decreases blood flow to kindeys.
Kidney damage
RAAS System activated: Renin → angiotensin 2 → vasoconstriction → increase systemic vascular resistance → increase BP
As the lipid plaques/buildups get bigger and calcify, the blood vessels lose their elasticity, become rigid, and blood flow is impaired
High levels of LDL-C (low density lipid cholesterol) move through the vascular endothelium and accumulate on artery walls.
Atherosclerosis
Microvascular
Silently damages vessels over time
Basement Membrane Thickening: capillary walls thicken, reducing flexibility and nutrient exchange
Increased Permeability: fluid and proteins leak into surrounding tissues, disrupting organ microenvironment
1 more item...
Target Organs
Eyes
Microvascular damage causes microaneurysms, capillary dropout, and acellular capillaries, leading to widespread retinal non-perfusion and retinopathy.
1 more item...
Kidneys
Nephropathy
1 more item...
Peripheral Nerves
Neuropathy
1 more item...
Macrovascular
Risk For:
Coronary Artery Disease
Carotid Stroke
Peripheral Arterial Disease
Peripheral arterial disease can contribute to ulcer development in the future and delayed healing due to the decreased blood flow of oxygen and nutrients to the affected limb
Hyperglycemia and dyslipidemia drive rapid plaque formation in coronary, cerebral, and peripheral arteries
Persistent low-grade inflammation destabilizes arterial plaques, increasing the risk of rupture and acute cardiovascular events
This damage decreases blood flow to peripheral tissues
2 more items...
Dyslipidemia
an increased amount of LDL cholesterol and triglyceride
insulin resistance
increased triglyceride breakdown into free fatty acids
free fatty acids circulate to the liver and are then converted into more triglycerides
reduces the activity of lipoprotein lipase that normally breakdown triglycerides
poor nutrition including frequent fatty foods increases the level of LDL in the body
Osteoarthritis is caused by direct damage of joint cartalige connected to systemic inflammation
Body cells become resistant to insulin, causing glucose to build up in the bloodstream
Excessive glucose damages small blood vessels in the kidneys through inflammation and oxidative stress
High blood glucose increases the glomerular pressure, damaging the kidney's filtering system
The glomerular basement membrane thickens and podocytes become damaged, allowing protein to leak into the urine
Chronic inflammation causes scar tissue to form in the glomeruli, reducing their ability to filter blood
Progressive nephron damage decreases GFR, causing waste products to accumulate in the blood
Continued kidney damage leads to permanent loss of kidney function called Chronic Kidney Disease and can eventually progress to kidney failure
Type II DM correlates with an increased risk of BPH
high blood sugar and metabolic dysfunction in DM increase SNS activity, increases muscle tone in the prostate, worsens urinary obstruction, chronic inflammation in DM causes tissue damage and remodeling, microvascular damage from DM also causes tissue damage and changes in the prostate
Benign Prostatic Hypertrophy (BPH)
glandular epithelial cells and stromal cells of the prostate proliferate, and grow forming nodules
development close to urethra leads to compression of the urethra
symptoms of urinary hesitancy, weak urine stream, straining, incomplete emptying d/t obstruction, frequency, urgency, nocturia, dribbling after voiding (George demonstrates hesitancy)
hormones: DHT in the prostate binds to androgen receptors sending signals causing growth of glandular and stromal tissue.
Aging: Changes in hormone signaling and the balance between cell growth and programmed cell death lead to tissue accumulation
Definition of Type II DM: Cells of the body cannot use insulin, leading to increased levels of glucose in the blood
Pathophysiology of DM Type 2
Food in the body breaks down into glucose
glucose is absorbed into the intestine and into the bloodstream, raising blood sugar levels
Glucose sensors in the beta cells of the pancreas recognize the elevated blood sugar in the blood
insulin is produced by beta cells in response
Target tissue fails to respond to insulin
Liver continues releasing glucose because insulin is not signaling to the liver to stop releasing glucose, continuing to elevate blood sugar levels
Beta cells continue to produce insulin d/t blood sugar levels remaining elevated
Eventually, the beta cells cannot produce enough insulin to regulate glucose levels. This is considered exocrine exhaustion.
1 more item...
Alpha cells
Cells in the pancreas that release glucagon, a hormone that raises blood sugar by signaling the liver to release stored glucose into the bloodstream
Insulin resistance: A condition in which the body's cells (muscle, fat, and liver cells) progressively become less responsive to insulin, resulting in decreased glucose uptake and increased blood glucose levels.
Beta cells
Cells in the pancreas that releases insulin and facilitates movement of glucose across cell membranes into cells, decreasing blood glucose
