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Diabetes mellitus

Diabetes mellitus. Type 1, IDDM, juvenile DM. 2 types. 1. Insulin dependent (autoimmune mediated) 2. Non- Insulin dependent (non-autoimmune mediated). Endocrine Pancreas. Produce and secretes: 1. Insulin 2. Glucagon Important in glucose homeostasis.

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Diabetes mellitus

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  1. Diabetes mellitus Type 1, IDDM, juvenile DM

  2. 2 types • 1. Insulin dependent (autoimmune mediated) • 2. Non- Insulin dependent (non-autoimmune mediated)

  3. Endocrine Pancreas • Produce and secretes: • 1. Insulin • 2. Glucagon • Important in glucose homeostasis

  4. Insulin dependent (autoimmune mediated) • Results from autoimmune destruction of insulin-producing beta cells of the pancreas The subsequent lack of insulin leads to increased blood and urine glucose. • Eventually, type 1 diabetes is fatal unless treated with insulin.

  5. Cause • Diabetes type I is induced by a combination of genetic susceptibility, a diabetogenic trigger and exposure to a driving antigen. • MHC : DRB1 0401, DRB1 0402, DRB1 0405, DQA 0301, DQB1 0302 and DQB1 0201

  6. Process of Immune destruction

  7. Environmental 2. Viruses: (Coxsackie virus & Rubella virus) 3. Diet: (through influencing gut flora, intestinal permeability, and immune function in the gut) 4. Chemicals and drugs:(Pyrinuron, a rodenticide streptozotocin, an antibiotic and antineoplastic agent used in chemotherapy for pancreatic cancer)

  8. Diagnosis • 1. Clinical • 2. Biochemical (high blood sugar, H 1 C) • 3. Auto-Abs against pancreatic islet

  9. Treatment -Replacement with insulin. -Islet graft ?

  10. Adrenal glands Suprarenal Glands

  11. Adrenal glands

  12. The cortices produce: • Cortisol • Aldosterone. Addison’s disease occurs when adrenal glands do not produce enough Cortisol and sometimes Aldosterone. Production of Cortisol is regulated by the pituitary gland's secretion of ACTH

  13. Autoimmune Addison’s disease • It is an autoimmune inflammation of adrenal glands, resulting in their gradual destruction and inability to make sufficient amounts of adrenal hormones.

  14. Addison’s disease occurs when more then 90% of adrenal gland tissue is destroyed.

  15. Presence of Addison’s disease or other autoimmune diseases in families. • Commonly associated with polyglandular syndromes • Presence of autoantibodies

  16. Clinicals • Manifested as: • Hypotension • Fatigue • Poor appetites, • Nausea • Dizziness • Weight loss

  17. Diagnosis • Clinical • Cortisol levels in blood. • ACTH Stimulation Test • Insulin-Induced Hypoglycemia Test • CT scan of abdomen • NMRI (nuclear magnetic resonance imaging)

  18. Treatment • Hormonal replacement

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