Predisposing Factors

Heredity

Age

Precipitating Factors

Ethnicity: South Asian

Sedentary lifestyle

High carbohydrate, fat, calorie diet

Presence of gene
TCF7L2 in metabolic
Increased
intake of carbohydrates,
fatmetabolism of carbohydrates, fat, proteins
Decreased
Decrease
processes
Increased amount of fat, calories in d

uses a decrease in the function of B cells

Increase in storage of adipose tissue

Irregular insulin production

Increased circulating fatty acids interfere with insulin signaling

Cells dont use insulin effectively or cells are insulin resistant

Glucose cannot enter the cell and collect in the ECF

Cellular starvation

Fatigue
polyphag

B cells produce more insulin to override the insulin resistance

Over time, the B cells will not be able to produce enough insulin to override Death
the insulin
of B cells
resistance
in the pancre
Hepatic gluconeogenesis begins, resulting to over production of glucose

Hyperglycemia

Uncontrollable blood sugar levels

Glucotoxicity

BUN
Serum creatinine
GFR

Sodium reabsorption in tubules

ate increase matrix formation (fibrin/collagen)

Hypertrophy of remaining nephrons

Dilute polyuria and loss of sodium in urine
Glomerular damage

Water Retention

Edema or Fluid Shifting

Inability to concentrate urine
Glomerulosclerosis
Dehydration
Hyponatremia

the tubules through efferent arterioles is interrupted

Ischemic tubules

Scarring of kidney

Pulmonary Congestion
Further loss of nephron function

Hematuria

Complications:
Death
Treatment:
ACE inhibitors or Angiotensin II Receptor Blockers
Diuretic
Calcium antagonist
- or -blocker
Insulin
Early start of statins
Stop smoking
Wight loss and regular exercise
Antioxidant vitamins (C and E)
Diet changes (low protein)