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Aetiology Of Diabetes Mellitus

Aetiology And Pathogenesis Of Type 1 Diabetes Mellitus : Oxford Textbook Of Endocrinology And Diabetes

Aetiology And Pathogenesis Of Type 1 Diabetes Mellitus : Oxford Textbook Of Endocrinology And Diabetes

(p. 1712) Aetiology and pathogenesis of type 1 diabetes mellitus (p. 1712) Aetiology and pathogenesis of type 1 diabetes mellitus Oxford Textbook of Endocrinology and Diabetes (2 ed.) As described in Chapter 13.2.3, type 1 diabetes results from the destruction of the glucose-responsive, insulin-secreting cells of the pancreatic islets. Its principal clinical features reflect significant insulin deficiency. In general, the cell damage is immune mediated and other clinical features occur related to other autoimmune processes. Although typically considered to have a short prodrome, in research studies biochemical evidence of impaired glucose metabolism has been detected years before diagnosis, in the form of mild elevation of blood glucose. It is likely that the clinical symptoms only manifest when 90% or more of the cells are lost. The effects of insulin deficiency are enhanced at times of insulin resistance, which explains the apparent link between clinical onset of type 1 diabetes and acute stress, such as an intercurrent infection or other illness, or physiological changes in insulin resistance, such as during puberty. The rate of cell loss is highly variable. It is probable that type 1 diabetes presenting in prepubertal childhood may reflect a more aggressive destructive process, while, at the other extreme, type 1 diabetes may present in adult life with a slow evolution to an absolute need for insulin replacement. The latter is called latent adult onset diabetes (LADA), and confounds the clinical definition of type 1 diabetesoften used in recruiting type 1 patients to trialsof requirement for insulin replacement within a year of diagnosis. The diagnosis of type 1A diabetes, i.e. type 1 diabetes of proven autoimmune pathogenesis, may be made by finding evidence of th Continue reading >>

Types Of Diabetes Mellitus

Types Of Diabetes Mellitus

Diabetes mellitus (or diabetes) is a chronic, lifelong condition that affects your body's ability to use the energy found in food. There are three major types of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes. All types of diabetes mellitus have something in common. Normally, your body breaks down the sugars and carbohydrates you eat into a special sugar called glucose. Glucose fuels the cells in your body. But the cells need insulin, a hormone, in your bloodstream in order to take in the glucose and use it for energy. With diabetes mellitus, either your body doesn't make enough insulin, it can't use the insulin it does produce, or a combination of both. Since the cells can't take in the glucose, it builds up in your blood. High levels of blood glucose can damage the tiny blood vessels in your kidneys, heart, eyes, or nervous system. That's why diabetes -- especially if left untreated -- can eventually cause heart disease, stroke, kidney disease, blindness, and nerve damage to nerves in the feet. Type 1 diabetes is also called insulin-dependent diabetes. It used to be called juvenile-onset diabetes, because it often begins in childhood. Type 1 diabetes is an autoimmune condition. It's caused by the body attacking its own pancreas with antibodies. In people with type 1 diabetes, the damaged pancreas doesn't make insulin. This type of diabetes may be caused by a genetic predisposition. It could also be the result of faulty beta cells in the pancreas that normally produce insulin. A number of medical risks are associated with type 1 diabetes. Many of them stem from damage to the tiny blood vessels in your eyes (called diabetic retinopathy), nerves (diabetic neuropathy), and kidneys (diabetic nephropathy). Even more serious is the increased risk of hea Continue reading >>

Diabetes: Mechanism, Pathophysiology And Management-a Review

Diabetes: Mechanism, Pathophysiology And Management-a Review

Anees A Siddiqui1*, Shadab A Siddiqui2, Suhail Ahmad, Seemi Siddiqui3, Iftikhar Ahsan1, Kapendra Sahu1 Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jamia Hamdard (Hamdard University), Hamdard Nagar, New Delhi (INDIA)-110062. School of Pharmacy, KIET, Ghaziabad U.P. SGC college of Pharmacy, Baghpat(UP) Corresponding Author:Anees A Siddiqui E-mail: [email protected] Received: 20 February 2011 Accepted: 02 May 2011 Citation: Anees A Siddiqui, Shadab A Siddiqui, Suhail Ahmad, Seemi Siddiqui, Iftikhar Ahsan, Kapendra Sahu “Diabetes: Mechanism, Pathophysiology and Management-A Review” Int. J. Drug Dev. & Res., April-June 2013, 5(2): 1-23. Copyright: © 2013 IJDDR, Anees A Siddiqui et al. This is an open access paper distributed under the copyright agreement with Serials Publication, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Related article at Pubmed, Scholar Google Visit for more related articles at International Journal of Drug Development and Research The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. Over the last three decades, the status of diabetes has been changed, earlier it was considered as a mild disorder of the elderly people. Now it becomes a major cause of morbidity and mortality affecting the youth and middle aged people. According to the Diabetes Atlas 2006 published by the International Diabetes Federation, the number of people with diabetes in India currently around 40.9 million is expected to rise to 69.9 million by 2025 unless urgent preventive steps are taken. The main force of the epidemic of diabetes is the rapid epidemiological transition associated with changes in dietary patterns and decreased physical activity a Continue reading >>

Global Aetiology And Epidemiology Of Type 2 Diabetes Mellitus And Its Complications

Global Aetiology And Epidemiology Of Type 2 Diabetes Mellitus And Its Complications

Globally, the number of people with diabetes mellitus has quadrupled in the past three decades, and diabetes mellitus is the ninth major cause of death. About 1 in 11 adults worldwide now have diabetes mellitus, 90% of whom have type 2 diabetes mellitus (T2DM). Asia is a major area of the rapidly emerging T2DM global epidemic, with China and India the top two epicentres. Although genetic predisposition partly determines individual susceptibility to T2DM, an unhealthy diet and a sedentary lifestyle are important drivers of the current global epidemic; early developmental factors (such as intrauterine exposures) also have a role in susceptibility to T2DM later in life. Many cases of T2DM could be prevented with lifestyle changes, including maintaining a healthy body weight, consuming a healthy diet, staying physically active, not smoking and drinking alcohol in moderation. Most patients with T2DM have at least one complication, and cardiovascular complications are the leading cause of morbidity and mortality in these patients. This Review provides an updated view of the global epidemiology of T2DM, as well as dietary, lifestyle and other risk factors for T2DM and its complications. Continue reading >>

Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus

Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus

University of Gondar, Ethopia *Corresponding Author: Habtamu Wondifraw Baynes Lecturer Clinical Chemistry University of Gondar, Gondar Amhara 196, Ethiopia Tel: +251910818289 E-mail: [email protected] Citation: Baynes HW (2015) Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus. J Diabetes Metab 6:541. doi:10.4172/2155-6156.1000541 Copyright: © 2015 Baynes HW. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Diabetes Mellitus (DM) is a metabolic disorder characterized by the presence of chronic hyperglycemia either immune-mediated (Type 1 diabetes), insulin resistance (Type 2), gestational or others (environment, genetic defects, infections, and certain drugs). According to International Diabetes Federation Report of 2011 an estimated 366 million people had DM, by 2030 this number is estimated to almost around 552 million. There are different approaches to diagnose diabetes among individuals, The 1997 ADA recommendations for diagnosis of DM focus on fasting Plasma Glucose (FPG), while WHO focuses on Oral Glucose Tolerance Test (OGTT). This is importance for regular follow-up of diabetic patients with the health care provider is of great significance in averting any long term complications. Keywords Diabetes mellitus; Epidemiology; Diagnosis; Glycemic management Abbreviations DM: Diabetes Mellitus; FPG: Fasting Plasma Glucose; GAD: Glutamic Acid Decarboxylase; GDM: Gestational Diabetes Mellitus; HDL-cholesterol: High Density Lipoprotein cholesterol; HLA: Human Leucoid Antigen; IDD Continue reading >>

Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus

Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD more... Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. See the image below. Simplified scheme for the pathophysiology of type 2 diabetes mellitus. See Clinical Findings in Diabetes Mellitus , a Critical Images slideshow, to help identify various cutaneous, ophthalmologic, vascular, and neurologic manifestations of DM. Many patients with type 2 diabetes are asymptomatic. Clinical manifestations include the following: Classic symptoms: Polyuria, polydipsia, polyphagia, and weight loss Diagnostic criteria by the American Diabetes Association (ADA) include the following [ 1 ] : A fasting plasma glucose (FPG) level of 126 mg/dL (7.0 mmol/L) or higher, or A 2-hour plasma glucose level of 200 mg/dL (11.1 mmol/L) or higher during a 75-g oral glucose tolerance test (OGTT), or A random plasma glucose of 200 mg/dL (11.1 mmol/L) or higher in a patient with classic symptoms of hyperglycemia or hyperglycemic crisis Whether a hemoglobin A1c (HbA1c) level of 6.5% or higher should be a primary diagnostic criterion or an optional criterion remains a point of controversy. Indications for diabetes screening in asymptomatic adults includes the following [ 2 , 3 ] : Overweight and 1 or more other risk factors for diabetes (eg, first-degree relative with diabetes, BP >140/90 mm Hg, and HDL < 35 mg/dL and/or triglyceride level >250 mg/dL) ADA recommends screening at age 45 years in the absence of the above criteria Microvascular (ie, eye and kidney disease) risk reduction through control of glycemia and blood pressure Macrovas Continue reading >>

Causes Of Diabetes

Causes Of Diabetes

Tweet Diabetes causes vary depending on your genetic makeup, family history, ethnicity, health and environmental factors. There is no common diabetes cause that fits every type of diabetes. The reason there is no defined diabetes cause is because the causes of diabetes vary depending on the individual and the type. For instance; the causes of type 1 diabetes vary considerably from the causes of gestational diabetes. Similarly, the causes of type 2 diabetes are distinct from the causes of type 1 diabetes. Type 1 diabetes causes Type 1 diabetes is caused by the immune system destroying the cells in the pancreas that make insulin. This causes diabetes by leaving the body without enough insulin to function normally. This is called an autoimmune reaction, or autoimmune cause, because the body is attacking itself. There is no specific diabetes causes, but the following triggers may be involved: Viral or bacterial infection Chemical toxins within food Unidentified component causing autoimmune reaction Underlying genetic disposition may also be a type 1 diabetes cause. Type 2 diabetes causes Type 2 diabetes causes are usually multifactorial - more than one diabetes cause is involved. Often, the most overwhelming factor is a family history of type 2 diabetes. This is the most likely type 2 diabetes cause. There are a variety of risk factors for type 2 diabetes, any or all of which increase the chances of developing the condition. These include: Living a sedentary lifestyle Increasing age Bad diet Other type 2 diabetes causes such as pregnancy or illness can be type 2 diabetes risk factors. Gestational diabetes causes The causes of diabetes in pregnancy also known as gestational diabetes remain unknown. However, there are a number of risk factors that increase the chances of deve Continue reading >>

Etiology And Pathogenesis Of Diabetes Mellitus In Children

Etiology And Pathogenesis Of Diabetes Mellitus In Children

Etiology and Pathogenesis of Diabetes Mellitus IN Children Berrin Ergun-Longmire, M.D. and Noel Keith Maclaren, M.D. Chief, Pediatric Endocrinology, The Herman and Walter Samuelson Childrens Hospital at Sinai, Baltimore, MD 21215 Director, BioSeek Endocrine Clinic, 200 W 57th St, Suite 605, New York, New York, 10019, and College of Medicine of Cornell University, New York The term diabetes mellitus describes a group of disorders of abnormal carbohydrate metabolism that result in hyperglycemia. Individual metabolic lesions in diabetic patients lead to their underlying relative or absolute impairment in insulin secretion and/or varying degrees of peripheral resistance to the actions of insulin. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus revised the diagnostic criteria, using data from three cross-sectional epidemiologic studies that have defined cut-off levels of glycemia that are eventually associated with increased micro-vascular disease, such as retinopathy. Two replicate fasting levels that exceed 126 mg/dl (>7 mmol/L) are diagnostic of diabetes in the absence of symptoms. Definition of the cut-point for normal fasting blood glucose levels was dropped from 110 mg/dl to 100 mg/dl, meaning that a value of 100 mg/dl or above would lead to a diagnosis of impaired fasting glucose (IFG). Persons with IFG levels (FPG= 100-125 mg/dl (5.66.9 mmol/l) and/or with impaired glucose tolerance test (IGT) (2 hour post-load glucose 140-199 mg/dl (78.8 mmol/L-11.1 mmol/L) are at risk of diabetes and should be observed periodically to detect hyperglycemic progression. Replicate, two-hour glycemic responses >200 mg/dl (>11.1 mmol/L) after a standard oral glucose tolerance test also indicates diabetes. However, this stage is often reached before the fas Continue reading >>

Symptoms & Causes Of Diabetes

Symptoms & Causes Of Diabetes

What are the symptoms of diabetes? Symptoms of diabetes include increased thirst and urination increased hunger fatigue blurred vision numbness or tingling in the feet or hands sores that do not heal unexplained weight loss Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble. What causes type 1 diabetes? Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease. What causes type 2 diabetes? Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes. Overweight, obesity, and physical inactivity You are more likely to develop type 2 diabetes if you are not physically active and are overweight or obese. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Insulin resistance Type 2 diabetes usually begins with insulin resista Continue reading >>

Type 2 Diabetes Causes

Type 2 Diabetes Causes

Type 2 diabetes has several causes: genetics and lifestyle are the most important ones. A combination of these factors can cause insulin resistance, when your body doesn’t use insulin as well as it should. Insulin resistance is the most common cause of type 2 diabetes. Genetics Play a Role in Type 2 Diabetes Type 2 diabetes can be hereditary. That doesn’t mean that if your mother or father has (or had) type 2 diabetes, you’re guaranteed to develop it; instead, it means that you have a greater chance of developing type 2. Researchers know that you can inherit a risk for type 2 diabetes, but it’s difficult to pinpoint which genes carry the risk. The medical community is hard at work trying to figure out the certain genetic mutations that lead to a risk of type 2. Lifestyle Is Very Important, Too Genes do play a role in type 2 diabetes, but lifestyle choices are also important. You can, for example, have a genetic mutation that may make you susceptible to type 2, but if you take good care of your body, you may not develop diabetes. Say that two people have the same genetic mutation. One of them eats well, watches their cholesterol, and stays physically fit, and the other is overweight (BMI greater than 25) and inactive. The person who is overweight and inactive is much more likely to develop type 2 diabetes because certain lifestyle choices greatly influence how well your body uses insulin. Lack of exercise: Physical activity has many benefits—one of them being that it can help you avoid type 2 diabetes, if you’re susceptible. Unhealthy meal planning choices: A meal plan filled with high-fat foods and lacking in fiber (which you can get from grains, vegetables, and fruits) increases the likelihood of type 2. Overweight/Obesity: Lack of exercise and unhealthy me Continue reading >>

Diabetes Mellitus Type 2 Pathophysiology

Diabetes Mellitus Type 2 Pathophysiology

Type 2 diabetes is caused by either inadequate production of the hormone insulin or a lack of response to insulin by various cells of the body. Normal regulation of blood sugar Glucose is an important source of energy in the body. It is mainly obtained from carbohydrates in the diet which are broken down into glucose for the various cells of the body to utilize. The liver is also able to manufacture glucose from its glycogen stores. In a healthy person, a rise in blood sugar after a meal triggers the pancreatic beta cells to release the hormone insulin. Insulin, in turn, stimulates cells to take up the glucose from the blood. When blood glucose levels fall, during exercise for example, insulin levels also decline. As well as insulin stimulating the uptake of glucose from the blood by body cells, it also induces the: Stimulates the conversion of glucose to pyruvate (glycolysis) to release free energy Conversion of excess glucose to glycogen for storage in the liver (glycogenesis) Uptake and synthesis of amino acids, proteins, and fat Pathology of type 2 diabetes In type 2 diabetes, the body either produces inadequate amounts of insulin to meet the demands of the body or insulin resistance has developed. Insulin resistance refers to when cells of the body such as the muscle, liver and fat cells fail to respond to insulin, even when levels are high. In fat cells, triglycerides are instead broken down to produce free fatty acids for energy; muscle cells are deprived of an energy source and liver cells fail to build up glycogen stores. This also leads to an overall rise in the level of glucose in the blood. Glycogen stores become markedly reduced and there is less glucose available for release when it may be needed. Obesity and lack of physical activity are thought to be maj Continue reading >>

Type 2 Diabetes Mellitus: Update On Diagnosis, Pathophysiology, And Treatment

Type 2 Diabetes Mellitus: Update On Diagnosis, Pathophysiology, And Treatment

Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment Division of Diabetes, Endocrinology, and Metabolism, Cornell University Medical College, New York, New York 10021 Search for other works by this author on: Division of Diabetes, Endocrinology, and Metabolism, Cornell University Medical College, New York, New York 10021 Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 84, Issue 4, 1 April 1999, Pages 11651171, Richard J. Mahler, Michael L. Adler; Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment, The Journal of Clinical Endocrinology & Metabolism, Volume 84, Issue 4, 1 April 1999, Pages 11651171, SIXTEEN million individuals in the United States with type 2 diabetes mellitus and an additional 3040 million with impaired glucose tolerance result in health care costs exceeding 100 billion dollars annually ( 1 ). Treatment is predominantly directed at microvascular and macrovascular complications ( 2 ). In type 1 diabetes mellitus the relationship between glycemic control and microvascular complications has been well established ( 3 ). The relationship between tight glycemic control and microvascular disease in type 2 diabetes mellitus appears to be established in the recently completed United Kingdom prospective diabetes study ( 4 , 5 ). Despite the morbidity and mortality associated with retinopathy, nephropathy, and neuropathy, cardiovascular disease remains the leading cause of death in type 2 diabetes mellitus ( 6 , 7 ). Consequently, the treatment of confounding risk factors of obesity, hypertension, and hyperlipidemia assumes major importance and must be coordinated with good glycemic control for reduction in total mortality in type 2 diabetes mellitus ( 6 11 ). Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Print Overview Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel. With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level. More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy. Symptoms Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for: Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual. Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger. Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses alternative fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine. Fatigue. If your cells are deprived of sugar, you may become tired and irritable. Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus. Slow-healing sores o Continue reading >>

Aetiology Of Diabetes Mellitus And Its Complications.

Aetiology Of Diabetes Mellitus And Its Complications.

Aetiology of Diabetes Mellitus and Its Complications. This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. The 15th Ciba Foundation Colloquium on Endocrinology, held in England in October 1963, was organized to review information pertaining to the pathogenesis of diabetes mellitus and its complications, particularly with respect to human rather than experimental disease. The small but distinguished list of guests, naturally somewhat weighted with representatives from Great Britain, includes many of the best-known names in the field. The volume opens with chapters on the epidemiology of diabetes by Walker and the genetic aspects of diabetes in the Chinese hamster by Yerganian. Ogilvie and Lacy contribute descriptions of the morphology of the diabetic pancreas and its beta cells. A section on the biosynthesis and secretion of insulin includes chapters by Taylor, Renold, Fajans, and Randle. Renold and Hales write on plasma insulin, and various types of insulin antagonism are discussed by Kipnis, Randle, Vallance-Owen, Bornstein, and Butterfield. Chapters on the biochemistry of blood vessels by Muir and Continue reading >>

Pathophysiology Of Type 2 Dm

Pathophysiology Of Type 2 Dm

Type 2 diabetes is a heterogeneous condition resulting from a combination of reduced insulin secretion and increased requirement for insulin: the relative contribution of each varies from one individual to another. Insulin secretion tends to decline with increasing age, and this may reflect the role of diabetes-associated genes, most of which influence beta cell function rather than tissue sensitivity to insulin. Possible added factors include a reduced incretin effect and deposition of IAPP (islet-associated amyloid peptide) in and around the islets. Diabetes does not develop in individuals with healthy insulin secretory capacity. Insulin resistance - an increased threshold for response to insulin in cells and tissues - is mainly located within skeletal muscle, liver, and fat. The proximate cause of hyperglycaemia is overproduction of glucose by the liver and reduced glucose uptake in peripheral tissues due to insulin resistance. Insulin secretion is increased in the earlier stages of diabetes, but declines with increasing duration as a consequence of progressive beta cell failure. Other potentially important mechanisms associated with type 2 diabetes and insulin resistance include an increase in circulating glucagon, abnormalities of lipid metabolism including increased deposition within cells, and effects mediated by the central nervous system. Insulin secretion The beta cell is derived from neural crest tissue and resembles a neuron in may respects including, for example, release of stored granules in response to depolarization of the membrane. The capacity for beta cell regeneration is reduced or lost in adults, and a decline in beta cell mass is seen with increasing age in parallel with the increasing risk of diabetes. This decline might be influenced by diabetes- Continue reading >>

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