Diabetes, Diabetes mellitus and complication

Diabetes

Diabetes develops when your body can’t make or properly use a natural hormone.  This hormone, called mellitus is made in your pancreas. It helps your body’s cells take in sugar from your bloodstream.

Diabetes Mellitus :

A group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.

20.8 million in US ( 7% of population) under the diabetes problem.

Consists of 3 types:

                1) Type 1 diabetes

                2) Type 2 diabetes

                3) Gestational diabetes

Complications :

Stroke

Heart attack

Kidney disease

Eye Disease

Nerve Damage

Diabetes Mellitus Details and Three Types of Diabetes

Type 1 Diabetes

                - cells that produce insulin are destroyed

                - results in insulin dependence

                - commonly detected before 30

Type 2 Diabetes

                - blood glucose levels rise due to

                                1) Lack of insulin               production

                                2) Insufficient insulin      action (resistant cells)

                - commonly detected after 40

                - effects > 90%

                - eventually leads to β-cell failure

(resulting in insulin dependence)

Gestational Diabetes

3-5% of pregnant women in the US develop gestational diabetes

Type 1 diabetes: insulin levels are grossly deficient.  Thus type 1 diabetes is invariably treated with insulin and known as IDDM( Insulin dependent daibetes melitus)

Type 2 diabetes: frequently associated with obesity.  Serum insulin levels are normal or elevated, so this is a disease of insulin resistance.  A number of treatment options may be employed. Also known as NIDDM( Non-Insulin dependent daibetes melitus) 

Three Types of Diabetes

Type I Diabetes

–        Body’s immune system attacks cells that make insulin.

–        Cells die causing high sugar levels in blood.

–        Lack of insulin coupled with high blood sugar may cause acid build up in the blood.

Type II Diabetes

Your body probably still makes insulin, but your body’s cells can’t use it well.

Life with Type II Diabetes

Who gets it?

–        Anyone can develop Type II Diabetes

Risk Factors You Can Control

–        Your Food habit

–        Smoking

–        Lack of physical activity

–        High blood pressure/high cholesterol

Risk Factors You Can’t Control

–        Family History

–        Gestational Diabetes

–        Age

–        Ethnic Group

Symptoms of Type II Diabetes

Increased urination

Increased appetite

Fatigue

Blurred vision

Frequent or slow-healing infections (including internal wounds, skin lesions etc.)

Erectile dysfunction in men

Gestational Diabetes

Occurs in some old women

About 4% world wide

It can cause problems during pregnancy, labor, and delivery.

This type of diabetes is diagnosed in the last months of pregnancy.

Women who get gestational diabetes are more likely to develop Type II Diabetes.

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