Advanced pathophysiology of type 2 diabetes mellitus

¶ … Pathophysiology of Diabetes Mellitus II

The patient is a male 45 years of age who has been diagnosed with Metabolic Syndrome many years ago but most recently has been diagnosed with Type 2 Diabetes Mellitus. The patient presents expressing concerns that he may have had high blood sugars prior to the recent diagnosis. It is necessary to explain to the patient that Type 2 Diabetes Mellitus is comprised by a range of dysfunctions "characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion and excessive or inappropriate glucagon secretion." (Khardoni, 2014, p. 1)

Type 2 Diabetes Mellitus is reported to be a "heterogeneous disorder with varying prevalence among different ethnic groups." (Death to Diabetes, 2014, p. 1) The primary events of DM are held to be "an initial insensitivity of insulin resulting in peripheral insulin resistance; and later on, relative insulin deficiency." (Death to Diabetes, 2014, p. 1) The primary message to relate to the patient is that the primary cellular dysfunction occurring in Type 2 diabetes "is not due to the B cells" but rather the "muscle, liver and fat cells, and also damage to the red blood cells" caused due to glycation. (Death to Diabetes, 2014, p. 1) However, across the years it is reported that "beta cell dysfunction can occur with Type 2 diabetes" particularly when it is not treated. (Death to Diabetes, 2014, p. 1)

Sugar that is appended to the outside of the red blood cell is compared to the way that sand sticks to an object that is moist and the result is that a "crystalline crust which is very coarse is created." (Death to Diabetes, 2014, p. 1) With the millions of red blood cells in the body all becoming very coarse the circulatory system is greatly affected and the arteries that are destroyed are reported to be "sealed off by cholesterol and this can result in strokes and heart attacks" in individuals with Type 2 diabetes.

In addition, the course red blood cells cause damage to the capillary beds which are very fragile in nature and this is important to note since the capillaries are the very small blood vessels in the human body that supplies the eyes, feet and kidneys. For patients with poor control of their blood sugar the result can be a large amount of damage in areas that are dense with capillaries including the hands and feet.

Additionally, damaged capillary beds result in the blood flow being very poor and infections resulting and even more serious problems resulting in amputations in individuals with Type 2 diabetes. Finally, the red blood cells that are so coarse can result in damage to the capillaries that supply the kidneys and retina because they are so very fragile and this can result in the development of blindness, failure of the kidneys or even cataracts. Failure of the kidneys can result in the individual requiring kidney dialysis.