Scenario 3: Type II DM A 55-year-old male presents with complaints of polyuria, polydipsia, polyphagia, and weight loss. He also noted that his feet on the bottom are feeling “strange” “like ants crawling on them” and noted his vision is blurry sometimes. He has increased an increased appetite, but still losing weight. He also complains of “swelling” and enlargement of his abdomen.

Scenario 3: Type II DM

A 55-year-old male presents with complaints of polyuria, polydipsia, polyphagia, and weight loss. He also noted that his feet on the bottom are feeling “strange” “like ants crawling on them” and noted his vision is blurry sometimes. He has increased an increased appetite, but still losing weight. He also complains of “swelling” and enlargement of his abdomen.

PMH: HTN – well controlled with medications. He has mixed hyperlipidemia, and central abdominal obesity. Physical exam unremarkable except for decreased filament test both feet. Random glucose in office 333 mg/dl.

Diagnosis: Type II DM and prescribes oral medication to control the glucose level and also referred the patient to a dietician for dietary teaching.

Question:

1.     How would you describe the pathophysiology of Type II DM?  

Selected Answer:

Type 2 diabetes is a chronic medical condition regarding how the body metabolizes glucose in the body. Two situations cause type 2 diabetes: the body develops insulin resistance, or the pancreas does not produce enough insulin. The cause of type 2 diabetes is unknown, although genetics and environmental factors, such as being overweight and inactive, seem to be contributing factors.

Type 2 diabetes can be managed with diet and exercise in some cases. Once this therapy is unsuccessful, medications are added, changed, or increased.

factors that put one at a higher risk for type ll DM include being overweight, high-fat content in the trunk, inactivity, family history, ethnicity/race, age, prediabetic, gestational diabetes, and polycystic ovarian syndrome.

Correct Answer:

Correct 

There are very complex interactions that result in the development of Type II diabetes. The pathophysiology of type 2 diabetes mellitus is characterized by peripheral insulin resistance, impaired regulation of hepatic glucose production, and declining β-cell function, eventually leading toβ -cell failure. Type 2 diabetes mellitus consists of a constellation of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. It is often associated with obesity.

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