diabetes

• what is diabetes mellitus?


  It is a condition in which the body is no longer able to produce sufficient insulin to control its blood glucose concentration.
• What is the outcome of having diabetes mellitus (DM) ?


  DM can lead to prolonged very high or low concentrations of glucose.
• type one diabetes is also known as insulin dependent diabetes, or juvenile onset diabetes as it usually starts in childhood.
• Type one diabetes is thought to be as a result of an autoimmune response in which the body's immune system attacks and destroys beta cells. It can also result from a viral attack
• In a healthy person, glucose is absorbed into the blood and any excess is converted to glycogen in the liver and msucles. This glycogen can then be used to released glucose when needed.
• A person with type one diabetes is no longer able to synthesize sufficient insulin and cant store excess glucose as glycogen. Excess glucose in the blood is not removed quickly, this leaves a prolonged period of high concentration. However, when the blood glucose galls, there is no glycogen store to be used to release glucose. Thus, blood glucose concentration falls too low.
• type 2 diabetes is also known as non insulin dependent diabetes. Someone with type 2 can produce insulin, however, it isnt enough. Also as people age, their responsiveness to insulin declines- this is probably due to the specific receptors on the surface of the liver and muscle cells becoming less responsive and the cells lose their ability to respond to the insulin in the blood.
• In type 2 diabetes, the blood glucose concentration is almost permanently raised- damaging the major organs and circulation.
• What are the factors that can bring an earlier onset of type 2 diabetes?


  Obesity

  lack of regular excercise

  a diet high in sugar, refined sugars specifically

  being asian or afro - caribbean in origin

  family history
• what are the methods of treating type 1 diabetes?


  Insulin injections

  insulin pump therapy

  islet cell transplantation

  complete pancreas transplants
• how does insulin pump therapy work?


  A small device constantly pumps insulin at a controlled rate into the blood stream via a needle which is permanently inserted under the skin
• How does an islet cell transplantation work?


  Healthy beta cells from the pancreas of a deceased donor are implanted into the pancreas of someone with type 1 diabetes
• Research has shown that typr 1 diabetes can be treated with stem cells, these are grown into new islets of langerhans in the pancreas. Stemcells arent yet differentiated and as such can be induced to develop into a vast variety of cell types.
• The most common sources of stem cells are bone marrow and placentas. However, scientists have found precursor cells in the pancreas of adult mice. These cells are capable of developing into a variety of cell types and may be true stem cells. If similar cells can be found in the human pancreas, they can be used to produce new beta cells for patients with type 1 diabetes- allowing them to live without needing to inject insulin constantly.
• type 2 diabetes is usually treated via changes in lifestyle. A type 2 diabetic will be advised to lose weight, exercise regularly, and carefully monitor their diet- this would mean taking care to match carbohydrate intake and use. This may be supplemented by medication that reduces the amount of glucose in the liver released into the bloodstream or that boosts the amount of insulin released from the pancreas. In severe cases, insulin injections or the use of other drugs to slow the absorption of glucose from the digestive system can be used.
• insulin used to be extracted from the pancreas of animals, typically from pigs as their insulin matched human insulin most closely. But, insulin has been produced by the Escherichia coli bacteria which have been genetically modified to manufacture human insulin.
• What are the pros of genetically modified bacteria insulin?


  It is an exact copy of human insulin, so its faster acting and more effective

  there is less chance of developing tolerance to the insulin

  there is less chance of rejection due to an autoimmune response

  there is a lower risk of infection

  it is cheaper to manufacture than to extract from animals

  the manufacturing process is more adaptable to demand

  Some people are less likely to have moral objections to using animal produced insulin than insulin produced by bacteria.