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Diabetes Mellitus Overview and Treatments


Estimated lifetime risk of developing diabetes for individuals born in the ... In the case of type 1 diabetes, insulin levels are grossly deficient. ... – PowerPoint PPT presentation

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Title: Diabetes Mellitus Overview and Treatments

Diabetes Mellitus Overview and Treatments
Estimated lifetime risk of developing diabetes
for individuals born in the United States in 2000
Narayan et al, JAMA, 2003
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)
  • estimated 14.6 million diagnosed (only 2/3)
  • 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
  • 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
  • - commonly detected after 40
  • - effects gt 90
  • - eventually leads to ß-cell failure
  • (resulting in insulin dependence)

Gestational Diabetes 3-5 of pregnant women in
the US develop gestational diabetes
Fasting Plasma Glucose Test (FPG) - (cheap,
fast) fasting B.G.L. 100-125 mg/dl signals
pre-diabetes gt126 mg/dl signals diabetes
Oral Glucose Tolerance Test (OGTT) tested for
2 hrs after glucose- rich drink 140-199 mg/dl
signals pre- diabetes gt200 mg/dl signals
A.K.A. Glycated Hemoglobin tests
  • 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.

In the case of type 1 diabetes, insulin levels
are grossly deficient. Thus type 1 diabetes is
invariably treated with insulin
  • Type 2 diabetes is 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

  • Animation showing overview of diabetes
  • http//www.healthscout.com/animation/1/34/main.htm

  • Pancreatic Hormones
  • Insulin
  • Amylin
  • Glucagon
  • Somatostatin
  • Pancreatic Polypeptide

Who need insulin medicine
  • Type I (insulin dependent) diabetes patients
    whose body produces no insulin.
  • Type 2 diabetes patients that do not always
    produce enough insulin.

  • subcutaneous injection

Insulin drug evolution
Stage 1 Insulin was extracted from the glands
of cows and pigs. (1920s) Stage 2
Convert pig insulin into human insulin by
removing the one amino acid that distinguishes
them and replacing it with the human version.
  • Stage 3 Insert the human insulin gene into E.
    coli and culture the recombinant E.coli to
    produce insulin (trade name Humulin). Yeast is
    also used to produce insulin (trade name
  • Novolin) (1987).

Recombinant DNA technology has also made it
possible to manufacture slightly-modified forms
of human insulin that work faster (Humalog and
NovoLog) or slower (Lantus) than regular human
In Conclusion
  • 2 major types of diabetes
  • (3 with Gestational)
  • Type 1 gt insulin dependant (5-10)
  • Type 2 gt insulin resistance disease often
    succumbs to insulin dependence (gt90)
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