Prince Carl P.

Magluyan BSN – 2G

Precipitating factors:
 Previous GDM
PATHOPHYSIOLOGY
 Pre-gestational DM
Predisposing factors:  Lack of physical activity
 Family history  Previous delivery of baby
 Obesity weighing more than 9pounds
 Hypertension  Polycystic ovarian syndrome
 Ethnicity

Stimulates diabetes

Insufficient insulin production Insulin rejection/resistance by the cells and tissues

IF TREATED:
Metformin Synthesizing drug
Increase blood glucose level

Reduces demand on
Liver and pancreas compensate
beta cells for insulin
secretion
Insulin production and usage remains insufficient

Reduced tissue uptake of glucose

Protects beta cells reserve Intracellular Extracellular

Euglycemia maintained Hypoglycemia Hyperglycemia

Overcomes insulin resistance

Glucogenesis and Methylglyoxal Hypertrophy +
Gluconeogenesis disarray of myofibrils

Endothelial dysfunction
Breakdown of fats Fibrosis
Decreased protein
synthesis
Cachexia
Atherosclerosis
High level of Ketones Lethargy Stiffness of the heart
Polyphagia
z
Decreased gamma Coronary Heart Disease
Diabetic ketoacidosis globulins Dysfunction of calcium
Susceptibility to transporting protein
infections
Impaired wound Arrhythmias Heart Failure
healing
Delayed contraction
Myocardial infarction and relaxation

Sudden Cardiac Death Diabetic hypertrophy and

reduced cardiac output

Arrhythmias Heart Failure

Myocardial infarction and

sudden cardiac death