Diabetes 1 Flashcards
urination is a consequence of osmotic diuresis secondary to sustained hyperglycemia. This results in a loss of glucose as well as free water and electrolytes in the urine.
polyuria
is a consequence of the hyperosmolar state, as is blurred vision, which often develops as the lenses are exposed to hyperosmolar fluids.
polydipsia
The weight loss is initially due to depletion
water , triglycerides, glycogen
produces symptoms of postural hypotension. Total body potassium loss and the general catabolism of muscle protein contribute to the weakness.
lowered plasma volume
may be present at the time of diagnosis, particularly when the onset is sub acute. They reflect a temporary dysfunction of peripheral sensory nerves, which clears as insulin replacement restores glycemic levels closer to normal, suggesting neurotoxicity from sustained hyperglycemia. When absolute insulin deficiency is of acute onset, the above symptoms develop abruptly.
paresthesias
exacerbates the dehydration and hyperosmolality by producing anorexia, nausea and vomiting, interfering with oral fluid replacement.
o The patient’s level of consciousness can vary depending on the degree of hyperosmolality.
ketoacidosis
•When insulin deficiency develops relatively slowly and sufficient water intake is maintained, patients remain relatively alert and physical findings may be minimal.
•When vomiting occurs in response to worsening ketoacidosis, dehydration progresses and compensatory mechanisms become inadequate to keep serum osmolality below 320-330 mOsm/L.
•Under these circumstances, stupor or even coma may occur.
oThe fruity breath odor of acetone further suggests the diagnosis of
diabetic ketoacidosis
the recumbent position is a serious prognostic sign.
Hypotension
are features of more slowly developing insulin deficiency. In occasional patients with slow, insidious onset of insulin deficiency, subcutaneous fat may be considerably depleted.
• Loss of subcutaneous fat and muscle wasting
