what is the pathophysiology of diabetes mellitus?
Diabetes - 4 Answers
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1 :
The following pdf document (1st url) states: "Diabetes is a chronic metabolic disorder in which the body cannot metabolize carbohydrates, fats, and proteins because of a lack of, or ineffective use of, the hormone insulin. Diabetes is classified into three primary types that are different disease entities but share the symptoms and complications of hyperglycemia (high blood glucose). Impaired glucose tolerance, formerly known as "borderline diabetes" is a degree of hyperglycemia that may precede type 2 diabetes." The following websites also offer statements on the pathophysiology of diabetes mellitus. (I'm assuming that you're already aware that there is more than one type of diabetes mellitus.)
2 :
an immune response destroys that insulin producing beta cells of the panceas, completely
3 :
Pathophysiology is the study of the changes seen in normal mechanical, physical, and biochemical functions that are either caused by a disease or the result of an abnormal syndrome. The pathophysiology of a given disease or syndrome describes its causes, symptoms and effects. The pathophysiology of diabetes mellitus is a bit complicated. Diabetes mellitus, most commonly known only as diabetes, is a syndrome of disordered metabolism, usually due to a combination of hereditary and environmental causes, resulting in abnormally high blood sugar levels called hyperglycemia. There are three primary types of diabetes mellitus: Type 1, Type 2, and gestational diabetes. Each is with different behaviors and triggers but all are related and characterized by shared symptoms such as hyperglycemia. Gestational diabetes is one of the three main types. This occurs during pregnancy and usually goes away after the baby is born. Women suffering from gestational diabetes while pregnant have an increased risk of developing Type 2 diabetes later in life. There are also other risks associated with gestational diabetes for both the infant and mother such as unstable blood sugar at birth, obesity later in life and macromasia or the condition known as "fat baby". Type 2 diabetes is the most common form of the disease. In Type 2 diabetes, the pancreas produces insulin but the body cannot react, respond or process it properly. Type 1 diabetes is the last type which results when the pancreas loses its ability to produce insulin. It is considered an autoimmune disorder because the body's own immune system attacks and destroys the cells in the pancreas that produce insulin. Symptoms of diabetes include excess thirst and hunger, frequent urination, fatigue, irritability, and unexplained weight loss. Diabetes can cause serious long term physical effects if not treated properly. Early detection is important. Treatment for diabetes can include changes to diet and lifestyle paired with medications, may it be insulin injections or oral insulin medications, depending on the type diagnosed. Hope this helps.
4 :
Type 1 diabetes requires a specific gene which has been identified. We do not test for this gene as we have absolutely no idea how likely a person is to develop diabetes if they have the gene. In susceptible individuals a common viral infection leads to an auto-immune response which targets the beta (insulin producing) cells of the pancreas. When approximately 95% of these cells have been destroyed glucose elevates, symptoms ensue, and the diagnosis is made. As type 1 diabetics are not able to produce insulin the only treatment is with insulin. Only modern analog insulin is appropriate for usage today. Type 2 diabetes is far more complex. It has a stronger genetic component but no specific genes have been identified. We believe that it is poly-genetic (multiple genes) with incomplete penetrance (these genes may be 'on' or 'off'). This may explain why some family members develop type 2 diabetes and other do not. Most people associate type 2 diabetes with obesity but this is mis-leading. Most type 2 diabetics are over-weight or obese as defined by Body Mass Index but most over-weight and obese individuals do not develop diabetes. By the time of diagnosis approximately 50% of the beta cells of the pancreas have been destroyed and there is an increased rate of beta cell apoptosis (cell death). Thus within 10 years of diagnosis most type 2 diabetics require insulin. There are also pathological changes in the brain which loses its sense of satiety, the stomach which empties too quickly, the small intestine which produces incretin mimetics which are degraded too rapidly, dysfunction of the alpha cells of the pancreas resulting in increased glucagon secretion which causes the liver to release glucose, and insulin sensitivity most especially involving myocytes (muscle cells). There are other physiological flaws as well but this should give you some idea of the complexity. If I may be of further assistance please let me know. I wish you the very best of health and in all things may God bless. JR
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