Diabetes mellitus
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Diabetes mellitus. Control of blood glucose levels. What you do this lesson. Copy all notes that appear in blue or green Red / White notes are for information and similar notes will be found in your monograph Read up on all diabetes information in your monograph for the next lesson.

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Diabetes mellitus

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Diabetes mellitus

Diabetes mellitus

Control of blood glucose levels


What you do this lesson

What you do this lesson

  • Copy all notes that appear in blue or green

  • Red / White notes are for information and similar notes will be found in your monograph

  • Read up on all diabetes information in your monograph for the next lesson


Diabetes mellitus

What is Diabetes mellitus?Afailure to control blood glucose levels and an impaired ability to store glucose in the form of liver and muscle glycogen


Symptoms of diabetes mellitus

Symptoms of diabetes mellitus

Classic symptoms of diabetes are –

  • Frequent urination, with large volumes of urine (especially at night)

  • Excessive thirst

  • Hunger

  • Weight loss

    Other symptoms –

  • Fatigue

  • Blurry vision

  • Gum and urinary tract infections

  • Slow healing of skin

  • Genital itching in women


Diabetes mellitus

CONTROL OF BLOOD SUGAR LEVELS

  • After a meal excess glucose is stored as glycogen in the liver and

  • skeletal muscles)

  • As glucose levels fall, the liver releases glucose into the blood

  • stream to prevent hypoglycaemia.


Diabetes mellitus

Two hormones control this process -

Insulin and Glucagon

Both are secreted in the pancreas by the Islets of Langerhans

Beta (β) cells produce insulin

Alpha (a) cells produce glucagon


Control of blood glucose levels by insulin and glucagon

Control of blood glucose levels by insulin and glucagon


Diabetes mellitus

Insulin and its effects

Insulin is a protein hormone which binds to specific receptors on the cell membrane of target cells and initiates the following

  • Insulin binds to receptor

  • Activated insulin receptor promotes movement of glucose transporter molecules from intracellular pool to the cell membrane

  • Glucose transporters allow glucose to enter the cell

  • When insulin levels decrease glucose transporters move from cell membrane to intra-cellular storage pool, where they can be recycled


Diabetes mellitus

Insulin

  • Affects skeletal muscle , liver and fat cells and stimulates the uptake of glucose by these cells

  • Insulin increases the permeability of muscles to glucose as normally they are not very permeable

  • Liver cells are very permeable but become more so in the presence of insulin and they are also stimulated to increase glycogen formation

In obese individuals the number of insulin receptors decreases and therefore glucose uptake is decreased.

This reduction in receptors leads to insulin resistance


Glucagon

Glucagon

Low blood glucose

Alpha cells of pancreas release glucagon

Liver breaks down glycogen

Glucose released into blood


Diabetes mellitus

Complications associated with diabetes –

  • Hypertension

  • Stroke

  • Kidney disease

  • Nerve damage

  • Increased risk of atherosclerosis

  • Impaired vision due to cataracts or damaged retinas.


Diabetes mellitus

Diabetic ulceration


Diabetes mellitus

Diabetes not controlled

properly may lead to loss of sight through degeneration of retina.


Forms of diabetes mellitus

Forms of diabetes mellitus

  • Type 1 (early onset, insulin dependent diabetes mellitus IDDM)

  • Type 2 (late onset, non-insulin dependent diabetes mellitus NIDDM)


Type 1 iddm

Failure of the pancreas to produce adequate amounts of insulin as a result of an autoimmune response

Accounts for 5-10% of cases

The sympton weight loss is caused by body breaking down fat to supply energy as cells cannot utilise glucose

Treatment = regular insulin injections subcutaneously

Type 1 (IDDM)


Type 2 niddm

Type 2 (NIDDM)

  • Accounts for 95% of cases

  • Associated with obesity

  • Plasma insulin levels normal but cells are less sensitive to insulin (insulin resistance)

  • Reduced uptake of insulin into skeletal muscle and fat cells

  • Possibly due to a reduced number of insulin receptors on the cell membrane


Diabetes mellitus

In summary

  • insulin is produced but not used efficiently by the cells

  • pancreas compensates by producing more insulin

  • B cells become “worn out” and insulin production decreases

  • Blood glucose increases and diabetes develops


Diabetes mellitus

For interactive game on diabetes see ‘My Diabetic Dog’

At the Nobel Prize medical website

Click here


Treatment for niddm

Diet

Weight control

Adequate exercise

Begin an insulin increasing agent

Lower blood pressure

Treatment for NIDDM


Diabetes mellitus

Comparison of type 1 and type 2

type 1type 2

Ageunder 20over 40

% of diabeticsless than 10%over 90%

appearance of symptomsrapidslow

obesity at onsetuncommoncommon

β cell no.decreasedvariable

Condition of Cells of Isletsinflamednormal

Family historyuncommoncommon


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