Diabetes Mellitus is a metabolic disease characterized by long-term hyperglycemia (increased blood glucose concentration). A metabolic disorder is a group of biochemical and physiological abnormalities linked with various other risk factors like cardio vascular diseases, abdominal obesity, high blood sugar level, hyperlipidemia, and many more.
Out of diagnosed cases of diabetes, 5.8% suffer from type 1 and 90-95% suffer from type 2 diabetes globally. Further, it is predicted that by 2030 the worldwide prevalence of diabetes among adults will increase to 7.7%, and expect 552 million people will have the disease. Glucose is the main source of getting energy for the human body that provides energy production cycles for the cells and muscles. It’s the main source of fuel for the brain cells.
A number of hormones affect the amount of blood sugar. The major blood glucose-regulating hormone is insulin. Beta cells of the pancreas produce insulin with a major role in glucose entry into cells other than the brain and red blood cells. Insulin is a tiny protein with a human weight of 5,808 molecules. It comprises two α and β polypeptide chains, which have been connected to S-S bridges, with 21 and 30 amino acid residues, respectively. In the beta cells of the Golgi appliance, proinsulin, a long chain protein molecule, is generated. Packaged in granules, it is transformed by four amino acids into insulin and C peptide chain.
Insulin and connecting peptides are released in equal quantities in response to all insulin secretagogues: a less concentration or partially hydrolyzed pro-insulin is released as well. Granules in β cells consist of insulin in crystals form which is composed of two zinc atoms and six insulin molecules. Zn consists of three insulin regulators that are connected in three symmetrical patterns. The human pancreas contains almost 8 mg of insulin representing up to 200 biological units. The biological unit was characterized on the basis of the hypoglycemic activity of insulin in rabbits. But the unit is characterized by advanced purification techniques based on weight.
The current insulin standards used for testing contain 28 units per milligram. The potassium channels are gated by ATP molecules. The level of potassium is diffused down at the resting state of the cell. The level of ATP is low at this stage. The intracellular potential is maintained as fully polarized. At this, the release of insulin is lowest. If the concentration of glucose rises, then it increases ATP production and closes potassium channels. This results in depolarization of the cell. During muscle and nerve activities the calcium channels which are gated by voltage opens a result of depolarization. This allows more calcium to enter the cell. As the intracellular calcium increases cause an increase in insulin secretions. High insulin levels consequently close the ATP dependent potassium channels proceeded by depolarization of the membrane.
Insulin is removed from the circulatory system with help of two very important organs such as the liver and kidneys. The liver filters about 60% of blood carrying insulin through the pancreas. This occurs with the help of the portal vein present at the terminal site. The rest of the insulin is removed with the help of the kidneys. The kidney filters almost 35-40% of this hormone. The diabetic patients receiving insulin treatment are given subcutaneous insulin injections. In such patients, the ratio of organ filtration by liver and kidney is reversed. The shelf life of circulatory insulin is only 3-5 minutes.
The major symptoms[i] of type 2 diabetes are
- polyuria,
- polydipsia,
- polyphagia
The insulin receptor is a tyrosine kinase comprised of two subunits α (extracellular) and β(cytosolic). Insulin binds toα subunit induces a conformational change that is transduced to β subunits. Auto-phosphorylation initiates a cascade of cell signaling responses includes phosphorylation and insulin action is terminated by the dephosphorylating reaction.
Diabetes DM are many kinds of diabetes, including type1, type 2, and pregnancy. In Type I, pancreatic cells (β cells) cannot generate insulin that leads to high blood glucose levels that lead to absolute insulin shortage. Type I is also known as insulin-driven diabetes. It has also been dubbed insulin-dependent diabetes over recent years since patients with type 1 can no longer generate insulin, which means that glucose remains in the bloodstream and does not enter cells producing high levels of blood glucose. Autoimmune processes are used to kill beta cells in type 1. Diagnosed at any age this condition can be recognized.
Type II diabetes is the most frequent kind (non-insulin-dependent diabetes). It occurs when the body acquires insulin resistance, various variables such as obesity, etc. are involved. Beta pancreatic cells generate insulin but not enough to operate such that insulin shortage prevails this illness is caused by several variables that are predisposing, such as obesity, family history of diabetes, excessive triglycerides. Autoantibodies include type 1 diabetes as opposed to type 2 diabetes. The extrinsic triggers and genetic risk factors for type 1 diabetes development are diets or any infectious agent. There are about 18 genomic areas associated with the development of type 1 diabetes. The most researched form of insulin-dependent diabetes type1 involves genes that encode immune-response proteins called HLA. Two genes are also present except this HLA gene. First, T1DM is an insulin gene, and second, CTLA4 controls immune responses (Wolf et al., 2004). The cell surface of molecules contains small amino acids in form of chains that are analyzed by the immune cells. They start attacking when immune cells find an appropriate chain. Without the presence of HLA genes chains of viruses, bacteria, and tumor cells cannot be found. Some HLA genes forms elevate the risk of healthy cell destruction by immune cells in the body.
The treatment [ii]of Diabetes type 2 includes medical and non-medical interpretations. On-medical interventions are as follows,
- Diet
- Healthy eating
- Exercise
- Lifestyle changes
- Regular monitoring of Blood sugar level
- Weight loss leading to lesser insulin resistance
- Low carbs and high protein diet
The medical interventions for the treatment of type 2 diabetes include following classes of medicines
- Metformin
- Sulfonylureas
- Glibenclamide
- Glipizide
- Glinides
- Thiazolidinedione’s
- Insulin therapy
[i] https://www.webmd.com/diabetes/type-2-diabetes
[ii] https://www.webmd.com/diabetes/type-2-diabetes
