Prediposing factors:

Family history
Obesity
Race/Ethnicity
Age below 40

intracellular hypoglycemia

fats breakdown(lypolysis)

increase liposis ketones formation

triacyglycerol DKA

hyperlipidemia COMA

macrovascular:

cerebral atherosclerosis (plaque)

coronary blood perfusion

peripheral retinal ischemia cell compensates by

artery disease fluid intake (polydipsia)
retinopathy

blood viscosity

peripheral resistance

HPN
 Precipitating Factors:
Viruses (mumps, Coxsackie,
Rubella, CMV)
Autoimmune response (HLA,
DR3, DR4 and other diseases)

production of autoantibodies that work against beta cells

decline in andeventually lack in insulin

reduce tissues' uptake of glucose

r hypoglycemia neurons deprived of enrgy

down(lypolysis) CHON Breakdown

motor
gluconeogenesis (-)nitrogen bal.
Weakness
use of glucose muscle wasting
Atrophy
extracellular weight loss
hyperglycemia Deformity
polyphagia
osmotic diuresis Abnormal stress

polyuria glycosuria high plantar

pressure
cell dehydration
Callus formation
ke (polydipsia)
hyperosmolality
hemoconcentration

ACIDOSIS
 neuropathy

sensory Autonomic

loss of Anhidrosis
protective dry skin
sensation Fissures
Decreased
Sympathetic tone
( Altered blood flow
regulation)

Osteoarthropy

imapired response to
infection

diabetic foot ulceration