Type II Diabetes Mellitus

Relevant Physiology

Physiology

• Insulin

Etiology

• Insulin Resistance with multi-faceted causes
  • Obesity - visceral adiposity (Central Obesity )
  • Physiological
    • Adolescents (Puberty)
    • Pregnancy
    • Older Adult > 65 (RF)
  • Genetic Predisposition
  • Medications
    • SGA - Atypical antipsychotics, Lithium (0.8-1.2 mmol/L)
    • Oral Corticosteroid (OCS)
    • AVT (NRTI, PI-lipodystrophy)

Pathogenesis

• Insulin Resistance → compensatory hyperinsulinemia → beta cell failure (Hyperglycaemia)

Natural history

Presentation

Signs and Symptoms

Clinical presentation (HPI):

• Polyuria
• Psychogenic Polydipsia
• Blurry Vision
• Lethargic (GCS 13–15)

Complications

• !HONK/HHS (Emergency)
• Diabetes Complications

Physical Exam Findings

• Acanthosis
• !Hypovolemia ↓

Risk factors