INTRODUCTION Diabetes mellitus is a group of metabolic disorders which is characterized by hyperglycemia due to insulin deficiency or resistance or both reasons. (1) According to that diabetes mellitus can be divided as type I and type II. This is common and its incidence is rising, 171 million people had diabetes in 2000 it is expected this condition to be doubled in 2030. It is spread in all the countries and therefore has become a major burden upon healthcare facilities. (2) “To manage diabetes, patients must take treatment for diabetes. There are two major treatments. They are diet treatment and tablet treatment. Oral anti diabetes drugs sulphonamide (sulphonylureas) and guanidine derivaties (biguanides) are used by 30% of all diabetes.” (6) Metformin is a biguanide which is an effective oral anti hyperglycemia drug which is widely used to control type II diabetes mellitus and more recently in pregnancy. (7) INSULIN AND GLUCAGON The pancreas, in addition to its digestive process has two important hormones, Insulin and Glucagon which are important for the maintenance of blood glucose level at a narrow range. Not only glucose, but also they are important for protein and lipid metabolism. Glucagon is secreted by the alpha cells of the islet of Langerhans and Insulin is secreted by the beta cells of Langerhans. Both are secreted to portal vein. (8) ACTION OF INSULIN Immediately after a high carbohydrate meal, Insulin secrets rapidly due to glucose absorption into blood. This insulin act on many tissues in body and insulin turn causes rapid uptake, storage and use of glucose almost all issues of the body, but especially by the muscles, adipose tissue and liver. (8) ACTION OF GLUCAGON Glucagon hormone has several functions t... ... middle of paper ... ...not only used with Type II Diabetes, but also with gestational diabetes mellitus. It is an effective and safe treatment for pregnant mothers who have diabetes. It also helps to normalize menstrual cycle and it increases the rate of spontaneous ovulation and may improve hirsutism. (7) (5) (4) CONCLUSION Diabetes mellitus is a syndrome which causes relative or absolute insulin deficiency and characterized by hyperglycemia. The most common type is Type II Diabetes Mellitus. Metformin which is a biguanid group drug is the first line treatment for diabetes mellitus. Hypoglycemia does not usually occur with metformin and other advantages are the lower incidence of weight gain. It is mainly absorbed in intestine inhibits the hepetia gluconeogenesis and increases insulin sensitivity. Metformin is contraindicated in patients with hepatic, renal, heart and respiratory failure.
Scheen AJ. Antidiabetic agents in subjects with mild dysglycaemia: Prevention or early treatment of type 2 diabetes. Diabetes and Metabolism. 2007;33:3-12.
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
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
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.
The pancreas is composed of exocrine and endocrine tissues. The exocrine portion of the pancreas synthesizes and secretes pancreatic juices. The endocrine portion is composed of miniscule islands of cells, called the islets of Langerhans. These islets of Langerhans do not release their secretions into the pancreatic ducts. Instead, they release hormones into the blood stream, and these hormones in turn help control blood glucose levels (Function of the Pancreas). Beta cells of the islets of Langerhans secrete insulin, which
Diabetes is a disease in which a person’s body in unable to make or utilize insulin properly which affects blood sugar levels. Insulin is a hormone that is produced in the pancreas, which helps to regulate glucose (sugar) levels, break down carbohydrates and fats, and is essential to produce the body’s energy. The CDC (2013) offers reliable insight, summarized here, into the different types of diabetes, some causes, and health complications that may arise from the disease.
When the blood glucose is higher than the normal levels, this is known as diabetes disease. The body turns the food we eat into glucose or sugar and use it for energy. The insulin is a hormone created by the pancreas to help the glucose get into the cells. The sugar builds up in the blood because either the body doesn’t make enough insulin or can’t well use its own insulin (CDC, 2015). In the United States diabetes is known as the seventh leading cause of death. There are different types of diabetes. However, there are two main types of diabetes and these are; Diabetes type 1 and Diabetes type 2 (CDC, 2015).
Insulin is released when the β cells of the islets of langerhans in the pancreas detect an increase in blood sugar levels. Insulin’s release is also stimulated by increased levels of amino acids and acetylcholine denoting activation of the parasympathetic nervous system. Both of these things signify digestion, which is usually responsible for increases in blood sugar. In...
Diabetes Milletus is a chronic disease that occurs when the pancreas is no longer producing sufficient hormone called insulin which regulates the body’s blood sugar levels. Insulin is the crucial key for glucose to enter and fuel the cells in the body. Without insulin, all the glucose from the food eaten will simply remain extracellularly thus there is an increase level of glucose found in the blood. Although this disease is manageable and treatable through constant monitoring and proper diet, exercise and medicine treatment plan, health risk is at an all time high due to poor awareness to those undiagnosed with the disease.
The 'Standard' of the 'Standard'. Gestational Diabetes. Retrieved from http://www.babycenter.com/0_gestational-diabetes_2058.bc. Bennett, L.B., Bolem, S., Wilson, L.M., Bass, E.B., Nicholson, W.K. (2009). The 'Standard' of the 'Standard'.
The pancreas has two functions; to make enzymes that help digest fats and proteins and the other, to produce insulin that controls the blood sugar level called glucose. It consists of Islet cells (1 of 3 types), which are endocrine glands. This means the Islet cells secret the insulin directly into the blood stream. The pancreas contains many more of these Islet cells than the body needs to maintain a normal insulin level. Even when half of the pancreas is removed, the blood sugar level can still remain normal. The pancreas is also made up of exocrine glands, which produce enzymes for digestion.
Blood glucose levels are the measurement of glucose in an individual’s blood. This is important because glucose is the body’s main source of fuel and the brains only source of fuel. Without energy from glucose the cells would die. Glucose homeostasis is primarily controlled in the liver, muscle, and fat where it stored as glycogen. The pancreas is also a significant organ that deals with glucose. The pancreas helps regulate blood glucose levels. Alpha-islet and beta-islet pancreatic cells measure blood glucose levels and they also regulate hormone release. Alpha cells produce glucagon and beta cells produce insulin. The body releases insulin in response to elevated blood glucose levels to allow the glucose inside of cells and
Diabetes is one of the common long term conditions in many countries (Singh, 2005; Diabetes UK, 2015) and it requires careful management in other to prevent a severe medical emergencies and dreadful complications in the long run (Smith, 2014). Diabetes is classified in two main categories; Type 1 and Type 2 diabetes. Diabetes mellitus is same as diabetes and it is an abnormal chemical reaction in which carbohydrate, protein and fat metabolism is disturbed due to resistance of insulin (Type 2 diabetes) or the absence of insulin (Type 1 diabetes) (Dunning, 2005; WHO, 2011). Diabetes is as a result of high blood sugar and it usually arises when the pancreas does not produce enough insulin in the body or the body cells do not
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
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.