Diabetes mellitus: Pathology review
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Diabetes mellitus: Pathology review
Pathology
Adrenal gland disorders
Congenital adrenal hyperplasia
Primary adrenal insufficiency
Waterhouse-Friderichsen syndrome
Hyperaldosteronism
Adrenal cortical carcinoma
Cushing syndrome
Conn syndrome
Thyroid gland disorders
Thyroglossal duct cyst
Hyperthyroidism
Graves disease
Thyroid eye disease (NORD)
Toxic multinodular goiter
Thyroid storm
Hypothyroidism
Euthyroid sick syndrome
Hashimoto thyroiditis
Subacute granulomatous thyroiditis
Riedel thyroiditis
Postpartum thyroiditis
Thyroid cancer
Parathyroid gland disorders
Hyperparathyroidism
Hypoparathyroidism
Hypercalcemia
Hypocalcemia
Pancreatic disorders
Diabetes mellitus
Diabetic retinopathy
Diabetic nephropathy
Pituitary gland disorders
Hyperpituitarism
Pituitary adenoma
Hyperprolactinemia
Prolactinoma
Gigantism
Acromegaly
Hypopituitarism
Growth hormone deficiency
Pituitary apoplexy
Sheehan syndrome
Hypoprolactinemia
Constitutional growth delay
Diabetes insipidus
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Gonadal dysfunction
Precocious puberty
Delayed puberty
Premature ovarian failure
Polycystic ovary syndrome
Androgen insensitivity syndrome
Kallmann syndrome
5-alpha-reductase deficiency
Polyglandular syndromes
Autoimmune polyglandular syndrome type 1 (NORD)
Endocrine tumors
Multiple endocrine neoplasia
Pancreatic neuroendocrine neoplasms
Zollinger-Ellison syndrome
Carcinoid syndrome
Pheochromocytoma
Neuroblastoma
Opsoclonus myoclonus syndrome (NORD)
Endocrine system pathology review
Adrenal insufficiency: Pathology review
Adrenal masses: Pathology review
Hyperthyroidism: Pathology review
Hypothyroidism: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Diabetes mellitus: Pathology review
Cushing syndrome and Cushing disease: Pathology review
Pituitary tumors: Pathology review
Hypopituitarism: Pathology review
Diabetes insipidus and SIADH: Pathology review
Multiple endocrine neoplasia: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Assessments
Diabetes mellitus: Pathology review
USMLE® Step 1 questions
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Questions
USMLE® Step 1 style questions USMLE
of complete
| Laboratory value | Result |
| Sodium | 132 mEq/L |
| Potassium | 4.2 mEq/L |
| Bicarbonate | 16 mEq/L |
| Glucose | 532 mg/dL |
Memory Anchors and Partner Content
Transcript
Content Reviewers
Elizabeth Nixon-Shapiro, MSMI, CMI
Marisa Pedron
Contributors
Anca-Elena Stefan, MD
Sam Gillespie, BSc
Elizabeth Nixon-Shapiro, MSMI, CMI
In the Emergency Department, two individuals came in. One of them is 12 years old Timmy, who is severely dehydrated, presents with rapid and deep breaths, abdominal pain, nausea and vomiting. On the clinical examination, his breath actually smells fruity and sweet. Timmy’s parents said that he had been eating a lot lately, but he actually lost weight. Also, they said that Timmy is also drinking water all the time and going to the bathroom a lot. The other person is 55 year old Oliver, who also came in with severe dehydration, lethargy and his family said he had a seizure about 2 hours ago, and in the past month, he had lost some weight, although he had been eating. Both individuals underwent several investigations, including glucose levels, ketone bodies BMP and an ABG.
Okay, based on both individuals’ symptoms, we can assume that both suffer from diabetes mellitus. Diabetes mellitus is a condition where glucose can’t be properly moved from the blood into the cells. This leads to high levels of glucose in the blood and not enough of it inside cells. Since cells need glucose as a source of energy, not letting glucose enter means that the cells starve for energy despite having glucose right on their doorstep.
In general, the body controls how much glucose is in the blood with two hormones: insulin and glucagon. Both of these hormones are produced in the islets of Langerhans of the pancreas. Insulin is secreted by the beta cells, while glucagon is secreted by the alpha cells. Insulin reduces blood glucose levels. It does that by binding to insulin receptors embedded in the cell membrane of insulin-responsive tissues, like muscle cells and adipose tissue. When activated, the insulin receptors cause vesicles containing glucose transporter that are inside the cell to fuse with the cell membrane, allowing glucose to be transported into the cell.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Type 1 Diabetes Mellitus in Pediatrics" Pediatrics in Review (2008)
- "Hyperglycemic Crises in Adult Patients With Diabetes" Diabetes Care (2009)
- "Diabetes mellitus: definition, classification and diagnosis" Wien Klin Wochenschr (2016)
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