Insulin & Glucagon are synthesized in pancreatic islet cells

Pancreas

Small IntestinePancreatic Duct

Acini Cells Islet Cells

Alpha Cells: secrete GLUCAGON

Beta Cells: secrete INSULIN

Muscle Cells uptake glucose from blood

Insulin Resistance: Decreased Uptake

Insulin Deficiency: Decreased Insulin Production

Diabetes: chronically high plasma glucose levels

Insulin secreted; excess glucose stored in muscle or fat

Insulin not secreted or not effectiveExcess glucose remains in bloodCan only be eliminated via kidney (VERY SLOW)

1) Excess glucose in renal filtrate (glucosuria)

2) Glucose in filtrate draws water away from renal ISF….huge increase in urine volume

3) Decreased blood volume & pressure

4) Circulatory system fails to compensate over time…anaerobic metabolism from dying tissues

5) Metabolic acidosis shuts down CNS

6) DEATH!

Diabetes: Multisystem Pathophysiology

Amputation in DiabetesHypovolemia = Root Cause

Reduced Blood Flow Impared Healing

Low Flow, High Tissue Glucose/Low O2

Rapid, Aggressive Infection

Amputation to containinfection