NCBI Bookshelf. Dean L, McEntyre J.
The Genetic Landscape of Diabetes [Internet]. When the amount of glucose in the blood increases, e. Insulin stimulates muscle and fat cells to remove glucose from the blood and stimulates the liver to metabolize glucose, causing the blood sugar level to decrease to normal levels.
In people with diabetes, blood sugar levels remain high. This may be because insulin is not being produced at all, is not made at sufficient levels, or is not as effective as it should be.
Gestational diabetes is a form of diabetes that occurs in pregnancy, and other forms of diabetes are very rare and are caused by a single gene mutation. For many years, scientists have been searching for clues in our genetic makeup that may explain why some people are more likely to get diabetes than others are. Diabetes is classified by underlying cause.
Table 1 compares the presentation phenotype of type 1 and type 2 diabetes. Type 2 diabetes commonly occurs in adults who are obese. There are many underlying factors that contribute to the high blood glucose levels in these individuals. An important factor is the body's resistance to insulin in the body, essentially ignoring its insulin secretions. A second factor is the falling production of insulin by the beta cells of the pancreas.
Therefore, an individual with type 2 diabetes may have a combination of deficient secretion and deficient action of insulin. In contrast to type 2, type 1 diabetes most commonly occurs in children and is a result of the body's immune system attacking and destroying the beta cells. The trigger for this autoimmune attack is not clear, but the result is the end of insulin production. Physicians have observed the effects of diabetes for thousands of years.
For much of this time, little was known about this fatal disease that caused wasting away of the body, extreme thirst, and frequent urination. It wasn't until that the first patient was successfully treated with insulin. One of the effects of diabetes is the presence of glucose in the urine glucosuria.
Ancient Hindu writings, many thousands of years old, document how black ants and flies were attracted to the urine of diabetics. The Indian physician Sushruta in B.
Up until the mids, the treatments offered for diabetes varied tremendously. The most successful treatments were starvation diets in which calorie intake was severely restricted. Naturally, this was intolerable for the patient and at best extended life expectancy for a few years.
A breakthrough in the puzzle of diabetes came in German physicians Joseph von Mering and Oskar Minkowski surgically removed the pancreas from dogs. The dogs immediately developed diabetes. Now that a link was established between the pancreas gland and diabetes, research focused on isolating the pancreatic extract that could treat diabetes. When Dr. Frederick Banting took up the challenge of isolating a pancreatic extract, he was met with much skepticism.
Many great physiologists had tried and failed to isolate an internal secretion from the pancreas.
Charles Best, a medical student at the time, worked as his assistant. To concentrate what we now know as insulin, Banting tied the pancreatic ducts of dogs. The pancreatic cells that released digestive enzymes and could also destroy insulin degenerated, but the cells that secreted insulin were spared.
Over several weeks the pancreas degenerated into a residue from which insulin could be extracted. In July , a dog that had had its pancreas surgically removed was injected with an extract collected from a duct-tied dog. In the two hours that followed the injection, the blood sugar level of the dog fell, and its condition improved.
Another de-pancreatized diabetic-like dog was kept alive for eight days by regular injections until supplies of the extract, at that time called "isletin", were exhausted. Further experiments on dogs showed that extracts from the pancreas caused a drop in blood sugar, caused glucose in the urine to disappear, and produced a marked improvement in clinical condition.
So long as the extract was being given, the dogs were kept alive. The supply of the extract was improved: the pancreas of different animals were used until that of the cow was settled upon.
This extract kept a de-pancreatized dog alive for 70 days.
The Genetic Landscape of Diabetes [Internet].
Collip, a biochemist, was drafted to continue improving the purity of the pancreas extract, and later, Best carried on this work. A young boy, Leonard Thompson, was the first patient to receive insulin treatment. On January 11, , aged 14 and weighing only 64 pounds, he was extremely ill. The first injections of insulin only produced a slight lowering of blood sugar level. The extract still was not pure enough, and abscesses developed at the injection site.
DBP Header Menu
Collip continued to refine the extract. Several weeks later, Leonard was treated again and showed a remarkable recovery. His blood sugar levels fell, he gained weight and lived for another 13 years. He died from pneumonia at the age of During the spring of , Best increased the production of insulin to enable the treatment of diabetic patients coming to the Toronto clinic. Over the next 60 years, insulin was further refined and purified, and long-acting and intermediate types were developed to provide more flexibility.
A revolution came with the production of recombinant human DNA insulin in Instead of collecting insulin from animals, new human insulin could be synthesized.
In , Banting and Macloed were awarded the Nobel Prize for the discovery of insulin. Banting split his prize with Best, and Macloed split his prize with Collip.
In his Nobel Lecture, Banting concluded the following about their discovery:. It enables the diabetic to burn sufficient carbohydrates, so that proteins and fats may be added to the diet in sufficient quantities to provide energy for the economic burdens of life. To view this, you will need to have Flash installed on your computer. Over 18 million Americans have diabetes; of these, about 5 million do not know they have the disease 1.
This form of diabetes can go undiagnosed for many years, but the number of cases that are being diagnosed is rising rapidly, leading to reports of a diabetes epidemic. However, the prevalence of type 2 diabetes is now at epidemic proportions. In the United States, diabetes accounts for over billion dollars of health care costs and is the fifth leading cause of death 2. The number of new cases being diagnosed continues to rise.
It has been estimated that of the children born in the year , 1 of 3 will suffer from diabetes at some point in their lifetime 3. Diabetes is predicted to become one of the most common diseases in the world within a couple of decades, affecting at least half a billion people 4. Estimate your risk of developing Type 2 Diabetes.
But now type 2 diabetes is increasingly being diagnosed in young adults and even in children. This young generation of diabetics will have many decades in which to develop the complications of diabetes.
In , 4. This increased to 7. The driving force behind the high prevalence of diabetes is the rise of obesity in the population. In today's society, it can be difficult to maintain a healthy weight.
ADA Standards, Statements, and Reports
We have the combination of ample food and a sedentary lifestyle. This is in stark contrast to only a couple of hundred years ago, when people were more active and food supplies were not as abundant. As a result, many of us are heavier than we should be. Calculate your ideal weight. It is a calculation that takes your height and weight into consideration and gives you a score.
A score of 18— If you are overweight, your score lies within the range to 25— Calculate your BMI. By the year , this had increased to an estimated Obesity is a major problem for the United states. Every year, an estimated , US adults die of causes related to obesity 7.
What is Diabetes Mellitus? (Symptoms, Causes, Treatment, Prevention)
Epidemics of infectious diseases increase when there is increased spread of the infectious agent and decrease when the number of victims who are susceptible falls they either become immune or they die. An epidemic of a genetic disease such as type 2 diabetes is similar.
Introduction about diabetes mellitus pdf american
The number of cases rises when there is a rise in environmental risk abundant food supplies, lack of activity and decreases when the number of susceptible individuals falls by deaths from the complications of diabetes. The classic example of an epidemic of diabetes is found on an remote island in the Pacific Ocean, the island of Nauru. Before the turn of the 20th century, the lifestyle of Nauruans was harsh.
The soil was poor, agriculture was difficult, and frequent episodes of starvation were common. In , it was discovered that Nauru contained phosphate rock, which was then mined for use in fertilizer, and for which the islanders received royalties.
Diabetes: An Introduction
Over several decades, the Nauruans became extremely wealthy, and with their new-found riches came major lifestyle changes. Food was now abundant and could be bought from stores. Instead of fishing and farming, Nauruans now led sedentary lives.