Pathophysiology of Cerebrovascular Accident (CVA) due to Diabetes Mellitus Type 2

Predisposing Factors:

Precipitating Factors:

Diabetes
Genetics
Ethnicity
Gender (Male)

Smoking
Lifestyle
BMI = 29.36

Increased fat and calories in diet

Increase in storage of adipose tissue

Increase circulating fatty acids interfere with insulin signaling

Insulin resistance

Glucose collect in the ECF

-cells produce more insulin to compensate

Stimulates hepatic gluconeogenesis

resulting to overproduction of glucose
Hyperglycemia

Death of -cells in pancreas

Glucotoxicity

Continuous increase of blood glucose

levels
Increase blood viscosity

Disruption of blood flow to the brain

O2 and glucose supply to the brain

Activation of genes
that prompt

Ischemic cascade

O2 extraction by the
brain

Neurons unable to maintain aerobic respiration;

switch to anaerobic respiration
Headache

Build-up of lactic acid

Change of blood pH

Influx of intracellular calcium and

glutamate

Cell membrane destruction

Cell injury and death

Breakdown of cell membrane and proteins
form free radicals
Neurological dysfunction

Hemiplegia, trouble speaking and

understanding, trouble seeing in one or
both eyes, headache, trouble walking,
dizziness, loss of balance and
coordination

If treated:
Prompt management of
ischemic stroke can have a
good prognosis.
Treatment:

Medications
Physical Therapy

If not treated:

Increased ICP
Fever (infection)
Emboli
Seizure
Another stroke
Coma
Death