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Diabetes Mellitus Overview and Treatments

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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


1
Diabetes Mellitus Overview and Treatments
2
Estimated lifetime risk of developing diabetes
for individuals born in the United States in 2000
Narayan et al, JAMA, 2003
3
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

4
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
    cells)
  • - 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
5
Testing
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
diabetes
A.K.A. Glycated Hemoglobin tests
A1C
  • 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.

6
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
    employed.

7
  • Animation showing overview of diabetes
  • http//www.healthscout.com/animation/1/34/main.htm
    l

8
  • Pancreatic Hormones
  • Insulin
  • Amylin
  • Glucagon
  • Somatostatin
  • Pancreatic Polypeptide

9
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.

Treatment
  • subcutaneous injection

10
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.
11
  • 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
insulin.
12
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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