Hyperinsulinemia develops due to an increased tissue demand. As tissue response to insulin is decreased, the beta cells in the pancreas must produce more. Over time the pancreas must produce more and more until the beta cells cannot keep up with tissue demand. Beta cell dysfunction develops and leads to type 2 diabetes. This dysfunction can be due to a relative decrease in mass of beta cells (beta cell death), abnormal secretion in insulin by beta cells, or a combination of the two. Because beta cells are especially sensitive to elevated glucose levels and free fatty acids, beta cells will undergo programmed cell death when confronted with these conditions. Other conditions associated with obesity also contribute to apoptosis of beta cells; …show more content…
Glucagon is a hormone that works to increase blood glucose levels by stimulating the breakdown of glycogen to glucose, and the production of glucose from none carbohydrate pathways. Glucagon is an antagonist to insulin by making more glucose and keeping it available in the blood stream, whereas insulin works to transport glucose from the blood stream into tissue cells. Amylin is another hormone produce by beta cells. It is co-secreted with insulin and works to inhibit glucagon. Typically and dysfunction of insulin production is associated with a dysfunction in amylin production. Incretins are peptides found in the gastrointestinal tract. They are peptide hormones that are released in response to the intake of food. Incretins are responsible for the sensitivity of beta cells to blood glucose levels, and help improve insulin response to meals. These peptides bind to the beta cells and stimulate the production and release of insulin (McCance, 2010). A combination of multiple factors dysfunction is responsible for type 2 diabetes. When treating the disease, the number one priority to control glucose intake and decrease weight of the patient. A reduction in weight will result in a decrease in insulin need. Medications like metformin, pioglitazone, and glimepiride can also help to control blood glucose by working with …show more content…
It works by lowering blood glucose and increasing glucose tolerance. Metformin works in three ways to achieve this. First, it decreases the production of glucose in the liver. Second, metformin reduces the absorption of glucose in the stomach (Burchum, 2015). These to mechanisms decrease the overall availability of glucose in the blood stream. However, metformin also increases sensitivity of receptors to insulin in tissues such as fat and skeletal muscle. This causes an increase of glucose uptake by cells and further decreases serum glucose levels. These mechanisms cause and overall decrease in free glucose circulating in the blood. However, the third mechanism is dependent on the availability of insulin. Without insulin, metformin cannot work to increase cellular uptake of glucose. Metformin does not stimulate the release of insulin from the pancreas, it simply works with it to lower blood glucose. Because of this, there is no danger of hypoglycemia while using metformin alone. Metformin should not be used in patients with impaired kidney function. It is not metabolized, and is excreted by the kidneys completely unaltered. This creates a problem in patients with kidney impairment or failure. The potential for metformin to cause toxicity is present (Burchum,
Type 1 diabetes develops when the beta-cells are killed off by the immune system. This is because an inflammation is caused which the immune system fights off, ultimately destroying all/majority of beta cells. The role of the beta cells is to produce insulin within the pancreas. The beta cells are signalled when to release insulin’s to certain parts of the body. A person with type 1 diabetes is likely to have lost 70-80%1 of their beta-cells mass which is why they must manually inject insulin into themselves to maintain a healthy blood glucose level. When the blood glucose level falls (hypoglycaemia) you begin to lose energy.
This is monitored by the cells within the Islets of Langerhans, which is located in the control (the pancreas). After skipping a meal or tough physical exercise blood glucose concentration decreases. Alpha cells in the islets detect this drop and are stimulated to secrete glucagon. Glucagon is a polypeptide hormone which influences an increase in blood glucose concentration. Glucagon travels through the bloodstream until it reaches glucagon receptors which are predominantly found in the liver, as well as, the kidneys. Glucagon stimulates the breakdown of stored glycogen to be released into the bloodstream as glucose. It also stimulates the conversion of amino acids into glucose and the breakdown of fat into fatty acids. These effectors cause an increase in blood glucose levels back towards the normal. This increase in blood glucose concentration is detected by the alpha cells which then stop the secretion of
According to Lewis and associates, DM is a chronic disease that affects multiple body systems. For the purpose of this paper, only DM type 2 will be discussed based on the assumption that a majority of patients aged 60 years or older have this type. The primary defects of this disease consist of insulin resistance, decreased insulin production, inappropriate glucose production by the liver, and alterations in production of adipokines. Insulin resistance is the result of defects in the body’s insulin receptors. This finding predates all cases of DM type 2 and the development of impaired glucose tolerance. In insulin resistance, beta cells in the pancreas are stimulated to increase insulin production to compensate for the lack of response by the insulin receptors. Gradually, the beta cells begin to fail to secrete enough insulin to meet the body’s demands resulting in hyperglycemia. As a result of increased glucose in the liver, the liver begins to malfunction and release glucose at inappropriate times, thereby worsening hyperglycemia. Adding to the problem, glucose and fat metabolism is altered in adipose tissue, which is generally abundant in those with DM type 2. (Lewis et al., 2011)
Our body obtains the energy by digesting the carbohydrates into glucose. Volumes of glucose are required by the body to create ATP. ATP is short for 'Adenosine Triphosphate ' and is an energy carrier. When we consume too many carbohydrates our body produces a lot of glucose and as a result blood glucose levels rise and sometimes they may rise over the normal range of blood glucose concentration. To bring it back within the healthy range, the homeostatic system of blood glucose regulation is used. The blood flows through the pancreas where the beta cells, receptors, detect the high blood glucose level. To counteract this stimuli beta cells alert the control centre, which are also the beta cells located in the islets of Langerhans in the pancreas. The secretion of insulin has to be done quickly but can only be carried out when insulin gene is switched on. Turning on the insulin gene switch can take 30 minutes to an hour therefore, the production of insulin by beta cells are done in advance and are packaged in vesicles right until blood glucose rises. Glucose comes into the beta cell to trigger the vesicle that contains the insulin to move towards the plasma membrane and fuse. This releases the insulin into the bloodstream where they are distributed throughout the body and only affect specific target cells. The receptor, a protein, on the target cell’s plasma membrane recognises and connects
The pathophysiology of diabetes mellitus in is related to the insulin hormone. Insulin is secreted by cells in the pancreas and is responsible for regulating the level of glucose in the bloodstream. It also aids the body in breaking down the glucose to be used as energy. When someone suffers from diabetes, however, the body does not break down the glucose in the blood as a result of abnormal insulin metabolism. When there are elevated levels of glucose in the blood, it is known as hyperglycemia. If the levels continue to remain high over an extended period of time, damage can be done to the kidneys, cardiovascular systems; you can get eye disorders, or even cause nerve damage. When the glucose levels are low in one’s body, it is called hypoglycemia. A person begins to feel very jittery, and possibly dizzy. If that occurs over a period of time, the person can possibly faint. Diabetes mellitus occurs in three different forms - type 1, type 2, and gestational.
Metformin is prescribed for long-term treatment of Type II Diabetes Mellitus. It can be used alone or in combination with other drugs for diabetes management as part of a health plan that includes proper diet and exercise. Metformin, which has a low affinity for plasma protein binding, limits glucose production in the hepatic system, lowers absorption of glucose in the intestines and improves insulin sensitivity by enhancing uptake and utilization of glucose (FDA, 2008). This drug does not cause an increase in insulin, making it less likely to cause a patient to become hypoglycemic compared with other common antihyperglycemic medications.
Other hormones (glucagons, epinephrine, growth hormone, and cortisol) work to oppose the effects of insulin and are often referred to as counterregulatory hormones. These hormones work to increase blood glucose levels by stimulating glucose production and output by the liver and by decreasing the movement of glucose into the cells. Insulin and the these counterregulatory hormones provide a sustained but regulated release of glucose for energy during food intake and periods of fasting and usually maintain blood glucose levels within the normal range. An abnormal production of any or all of these hormones may be present in diabetes.
The thyroid is one of the most essential glands in the body. It is located in the endocrine system, and sits right in the neck just above where the collar bones meet. The thyroid gland functions to produce hormones that control how every cell in the body utilizes energy, also known as a process called metabolism. When a person's thyroid abnormally produces an excessive amount of thyroid hormones, this is a condition referred to as hyperthyroidism. The causes of hyperthyroidism are known to include: eating too much food with iodine, graves disease, inflammation due to viral infections, tumors of the testes and ovaries, taking a large amount of thyroid hormone, receiving medical imaging tests consisting of contrast dye iodine, and growth of thyroid or pituitary gland (Board "Hyperthyroidism"). With an overactive thyroid, the body tends to speed up its functions. Symptoms vary from, fast heartbeats, rapid weight loss, abnormal sweating, nervousness, and mood changes. Hyperthyroidism is normally diagnosed through a series of lab tests. If not properly taken care of, condition may worsen leading to bone and heart problems in the long run. As far as treatment is concerned, options may vary from person to person depending on age and the level of activity of the thyroid. Treatments include antithyroid medicines, radioactive iodine ablation, and the last resort, surgery. Though all treatment plans work, radioactive iodine ablation is a permanent and more reliable remedy for an overactive thyroid. Radioactive iodine ablation is in fact the most commonly used cure for people with hyperthyroidism problems in the US today. “The treatment has been around since 1942 and has been extensively used since the 1950's” ("Radioactive Iodine Treatment o...
Diabetes refers to a set of several different diseases. It is a serious health problem throughout the world and fourth leading cause of death by disease in the country. All types of diabetes result in too much sugar, or glucos in the blood. To understand why this happens it would helpful if we understand how the body usually works. When we eat, our body breaks down the food into simpler forms such as glucose. The glucose goes into the bloodstream, where it then travels to all the cells in your body. The cells use the glucose for energy. Insulin, a hormone made by the pancreas, helps move the glucose from bloodstream to the cells. The pathophysiology of diabetes mellitus further explains the concept on how this disease works. Pancreas plays an important role of the metabolism of glucose by means of secreting the hormones insulin and glucagon. These hormones where then secreted by Islets of Langerhans directly to the blood. Inadequate secretion of insulin results on impaired metabolism of glucose, carbohydrates, proteins and fats which then result to hyperglycemia and glycosuria. Hyperglycemia is the most frequently observed sign of diabetes and is considered the etiologic source of diabetic complications both in the body and in the eye. On the other hand, glucagon is the hormone that opposes the act of insulin. It is secreted when blood glucose levels fall.
Due to the inability to produce Insulin from the Pancreatic Beta cells located in the Islet of Langerhans. This occurs because the Body’s Immune system identifies the Beta cells as “foreign” material. B lymphocytes synthesise antibodies specific to the Beta cell and these cause more B and T lymphocytes to travel to the Islets. T cells are also involved and secrete chemical messengers called cytokines which allow communication between the immune cells to co-ordinate the attack. Cytokines advocate the necrosis of Beta cells and, and this leads to a larger production of Immunoglobins targeting specifically the Insulin within them. This causes the Beta cells to swell up also known as “Insulitis”, and is the early stages of Diabetes. Most people don’t realise they are developing diabetes because symptoms apparent for several years, and by this time over 90% of their Beta cells are destroyed and are unable to be restored. This is referred to as “Insulin Dependent Diabetes” and occurs in the early stages of life usually between the ages of 5 and 20...
Type 1 diabetes has a genetic onset that often occurs in adolescence (Porth, 2005). It is an autoimmune disease in which the insulin-producing beta cells within the liver are destroyed (Dorman, 1993). This causes a deficiency in insulin secretion, which ultimately leads to high blood glucose levels, also referred to as hyperglycemia (Guthrie & Guthrie, 2004). The mechanism for insulin deficiency leading to hyperglycemia is described in more detail in the following section and in Figure 1.
Diabetes type 1 occur when the immune system destroys the beta cells, they are responsible to create insulin and are located
Diabetes is a chronic disorder of metabolism characterized by a partial or complete deficiency of the hormone insulin. With this, there are metabolic adjustments that occur everywhere in the body. Specific to this child is Type One Diabetes. This is characterized by demolition of the pancreatic beta cells, which produce insulin. Because of this, it leads to complete insulin deficiency. Within Type One diabetes, there are two different forms. First there is immune-mediated deficiency, which typically results from an autoimmune destruction of the beta cells. The second type is called idiopathic type one, in which the cause is unknown. (Wong, Hockenberry, Wilson, 2015)
Diabetes Mellitus is a chronic health condition in which the level of glucose in the blood is higher than usual. Type 1 diabetes occurs when the pancreas does not create enough insulin and type 2 diabetes occurs when insulin is produced, but is not adequate in lowering blood glucose levels or there is resistance to the insulin (Edwards, 2007, p. 9). Diabetes mellitus is the leading cause of end-stage kidney disease, foot and leg amputations, and new cases of blindness in the United States (Ignatavicius & Workman, 2010, p. 1465-66). People with type 1 diabetes are required to take insulin to manage their glucose levels. People with type 2 diabetes are usually prescribed oral medications such as sulfonylurea agents, meglitinide analogues, or biguanides to help control their glucose levels. Twenty to 30% of people with type 2 diabetes require insulin therapy as well (Ignatavicius & Workman, 2010, p. 1471). In addition to medication therapy, diet and weight control can help manage both type 1 and type 2 diabetes. Because diabetes mellitus can cause such severe complications, it is important that people with diabetes understand the importance of certain health and lifestyle choices, such as their diet and weight to manage their disease. Patients with diabetes mellitus should pay special attention to the amount of carbohydrates, protein, fat, and minerals that are included in their diet. Monitoring these components of their diet, along with weight management, can help control their diabetes mellitus.
The pancreas uses these two hormones in order to monitor blood glucose levels. After a meal, blood glucose usually rises. This is when insulin secretion will start (Nussey S, Whitehead S. “Endocrinology: An Integrated Approach”). Consequently, blood glucose decrease to the normal range. This is how insulin maintains blood levels when is high. However, when blood level falls below normal range, glucagon comes into play. Low blood glucose occurs usually when hungry and during exercise. This will then triggers glucagon secretion. When blood level falls, the body goes into imbalance. Hence is why in order to maintain homeostasis glucagon is crucial. The body will tell the pancreas to increase more glucose and the pancreas will secrete glucagon by taking glycogen from the liver to produce glucose. The glucose will produce energy and will make blood glucose concentration increase (Homeostasis of Insulin and Glucose, Abpischools.org). When the pancreas cannot maintain homeostasis, many problems will arise in the body. When the pancreas fails to produce insulin, type 1 and 2 diabetes can occur. For those with type 1 diabetes, insulin injections will be needed in order to regulate blood glucose level, otherwise, glucose levels will be out of control. For type 2 diabetes, they are not insulin dependent like type 1, however, the body does not create enough in the body. When blood glucose