Patient has Diabetes Mellitus Type 2 due to his unhealthy lifestyle as evidenced by
obesity. Your body either produces insufficient insulin or uses it poorly if you have
type 2 diabetes. Then, not enough glucose enters your cells and too much remains in
your blood. Insulin resistance occurs in muscle, fat, and liver cells, which prevents
the cells from absorbing enough sugar. The amount of insulin produced by the
pancreas is insufficient to maintain blood sugar levels within a safe range.(Mayo
Clinic, 2023) If your blood is high in sugar, it might become thick and sticky and flow
slowly through your body. According to Anton Paar (2024), blood viscosity is a
measurement of how thick and sticky an individual's blood is. It is a direct measure
of how well blood flows through blood arteries. Deep vein thrombosis (DVT) often
arises from vein damage, triggering the coagulation cascade. Venous stasis
facilitates platelet aggregation at the injury site, forming an initial clot composed of
platelets and fibrin. This thrombus grows as more platelets and fibrin become
trapped within the fibrin meshwork. Thus, triggered the patient’s history of Deep
Vein Thrombosis, which then led to the client’s chief complaints of Left Leg Popliteal
Pain and Left Lower Extremity Progressive Edema. Subsequently, patient was
diagnosed with Left Leg Deep Vein Thrombosis.
According to Cleveland Clinic (2022), the endothelium is a significant organ that
helps maintain your blood flowing freely throughout your body. It is made up of
over a trillion endothelial cells, which secrete chemicals that help blood flow.
Immediately after endothelial cell injury, endothelial cells and platelets are activated
promoting the expression of cell adhesion molecules. This vascular response
promotes leukocyte rolling and tethering onto the endothelium that initiates an
inflammatory event which can lead to thrombosis. (American Heart Association,
2020) When the endothelium is damaged, the subendothelial collagen becomes
exposed. Thus leading to coagulation cascade as the platelets will become activated
and then bind to subendothelial collagen exposed upon endothelium injury.
(Pubmed, 2021) As stated by Britannica (2024), when a blood vessel is damaged,
the clotting enzyme thrombin converts fibrinogen, a soluble protein in blood
plasma, into fibrin, a tough protein that forms long fibrous chains often called as
fibrin mesh. The fibrin strands radiate from the platelets and form a net or mesh
that traps more platelets and blood cells, thus forming a blood clot. (Streiff, 2024)
These blood clots will then enlarge and would interfere with the blood flow as it
would serve as an obstruction in the blood vessels. As mentioned by The Health
University of Utah (2024), if the blood clot does not properly break down and
continues to obstruct the blood flow, it will then lead to Deep Vein Thrombosis.
References:
https://www.kansashealthsystem.com/-
/media/Files/PDF/Cray/Hyperglycemia.pdf
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-
causes/syc-
20351193#:~:text=Type%202%20diabetes%20is%20mainly,levels%20within%20
a%20healthy%20range.
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-
causes/syc-
20351193#:~:text=Type%202%20diabetes%20is%20mainly,levels%20within%20
a%20healthy%20range.
https://my.clevelandclinic.org/health/body/23471-endothelium
!!https://www.ahajournals.org/doi/pdf/10.1161/ATVBAHA.108.162289#:~:text=I
mmediately%20after%20endothelial%20cell%20injury,which%20can%20lead%2
0to%20thrombosis. (2008-2020)
!!https://pubmed.ncbi.nlm.nih.gov/21193111/#:~:text=Platelets%20play%20a%2
0central%20role,and%20glycoprotein%20(GP)%20VI. (2011-2021)
https://www.britannica.com/science/fibrin
https://www.msdmanuals.com/home/blood-disorders/blood-clotting-
process/how-blood-clots
?!https://healthcare.utah.edu/thrombosis/dvt#:~:text=What%20Is%20Deep%20V
ein%20Thrombosis,pelvis%2C%20groin%2C%20or%20arm. (N.D. – 2024)
