Testing and treatment of diabetes

Fasting Plasma Glucose Test

(FPG) -  (cheap, fast)

                *fasting B.G.L. 100-125 mg/dl  signals pre-diabetes

                *>126 mg/dl signals diabetes

Oral Glucose Tolerance Test

(OGTT)

                *tested for 2 hrs after glucose-

                rich drink

                *140-199 mg/dl signals pre-

                diabetes

                *>200 mg/dl signals diabetes 

¨       80 to 90 mg per 100 ml, is the normal fasting blood glucose concentration in humans and most mammals  which is associated with very low levels of insulin secretion.

Diabetes – Insulin

(synthesis, storage, secretion)

Produced within the pancreas by β cells à islets of Langerhans

insulin mRNA is translated as a single chain precursor called preproinsulin

removal of signal peptide during insertion into the endoplasmic reticulum generates proinsulin

Within the endoplasmic reticulum, proinsulin is exposed to several specific endopeptidases which excise the C peptide, thereby generating the mature form of insulin

Stored as β granules 

This light micrograph of a section of the human pancreas shows one of the islets of Langerhans, center, a group of modified glandular cells. These cells secrete insulin, a hormone that helps the body metabolize sugars, fats, and starches. The blue and white lines in the islets of Langerhans are blood vessels that carry the insulin to the rest of the body. 

The bulk of the pancreas is an exocrine gland secreting pancreatic fluid into the duodenum after a meal. Inside the pancreas are millions of clusters of cells called islets of Langerhans. The islets are endocrine tissue containing four types of cells. In order of abundance, they are:

beta cells, which secrete insulin and amylin;

alpha cells, which secrete glucagon;

delta cells, which secrete somatostatin

gamma cells, which secrete a polypeptide.

Pancreatic Hormones

Insulin

Amylin

Glucagon

Somatostatin

Pancreatic Polypeptide

Complications

Heart disease and stroke

High blood pressure

Eye problems

Nerve damage

Infections

Gum disease

Problems in pregnancy

Treatments for Type II Diabetes

Treatments take into consideration:

Age

Sex

Weight

Occupation

Most Effective Treatments

Diet

Exercise

Oral hypoglycemic agents

Insulin treatments