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Pathophysiology of Diabetes
Pathophysiology of Diabetes
Pathophysiology of Diabetes
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Introduction
Diabetes Mellitus is a disease of the endocrine system primarily differentiated between type 1 and type 2. Type 1 diabetes occurs when the pancreas is unable to produce insulin and was previously seen in the younger generation which is no longer the case.1 Type 2 diabetes is the more prevalent of the two types and involves elevated blood sugar levels due to the insufficient production of insulin. Risk factors that make an individual higher risk for type 2 diabetes include increasing age, obesity, family history, a sedentary lifestyle.1,2 Innovative drug therapies for type 2 diabetes remain important for the treatment and reduction of the disease.
The prevalence of diabetes according to the CDC is 26 million Americans currently diagnosed with diabetes, 79 million with pre-diabetes, and 7 million unaware they have diabetes.1 Diabetes is currently more prevalent in the western countries due to physical inactivity and obesity, but as more Eastern countries develop the western lifestyle it becomes an increasing worldwide epidemic.1 The risk for developing type 2 diabetes increases with age (especially after age 40), but is increasing most rapidly in the adolescent and young generation.1 It is therefore critical that education as well as drug therapies are implemented to decrease the rising prevalence of this illness.
The pathophysiology of type 2 diabetes is characterized by both insulin resistance and insulin secretion. Peripheral insulin resistance and inadequate insulin secretion by the pancreas due is due to beta cell dysfunction. The resistance results in elevated free fatty acids and inflammation which leads to an overall decreased amount of glucose taken up into the muscle, increased glucose production, and incr...
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...6 and Sitagliptin at week 52 (p <0.001). Canagliflozin 100 mg and 300 mg reduced body weight vs placebo (week 26: –3.7%, –4.2%, –1.2%, respectively; p <0.001) and sitagliptin (week 52: –3.8%, –4.2%, –1.3%, respectively; p <0.001). Both canagliflozin doses reduced FPG and systolic BP vs placebo (week 26) and sitagliptin (week 52) (p <0.001).5
Overall adverse effects (AE) and AE-related discontinuation rates were generally similar across groups, but higher with canagliflozin100 mg (5.2%). Genital mycotic infection and osmotic diuresis-related AE rates were higher with canagliflozin vs sitagliptin and sitagliptin/placebo. Hypoglycemia incidence was higher with canagliflozin over the 52 weeks (6.8%) clinical study. Urinary tract infections (UTIs) were similar across groups over 52 weeks. One death was reported in all treatment arms except for canagliflozin 100mg.5
(15)Patel M, Mahaffey K, Garg J, Pan G, Singer D, Hacke W, Breithardt G, Halperin J, Hankey G, Piccini J, Becker R, Nessel C, Paolini J, Berkowitz S, Fox K.. (2011). Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.. New England Journal Of Medicine. 365 (10), 883-91.
Lipid altering drugs include several classes of medications each of which have their own mechanism of action. Statins inhibit HMG CoA reductase (hydroxymethylglutaryl CoA reductase), which is the rate-limiting enzyme for the production of cholesterol in the liver. Statins competitively inhibit this enzyme and induce an increased expression of LDL receptors in the liver. Which in turn increases the uptake catabolism of serum LDL into the liver resulting in decreased serum cholesterol level. This reduction in serum LDL and cholesterol levels has resulted in reduction of 10-year CHD and stroke risk. Pitavastatin was approved in Japan since 2003 and was granted FDA approval in 2009 and is marketed under the name of Livalo. Several phase III and IV trials have shown that Pitavastatin is both safe and efficacious in lowering both serum LDL and Triglycerides (TG) by 29.1% and 22.7% respectively from baseline levels which was significant. These studies showed that only 10% of Pitavastatin treated patients had adverse events (AE) in which 84% of these events were mild and about 1% were serious adverse events (SAE)6, 12, 14, 16-26, 28-31. Atorvastatin is the most commonly used statin in clinical practice; the F...
Diabetes mellitus type 2 is an endocrine disorder that causes impaired use of carbohydrates while enhancing the use of proteins and lipids. This is called insulin resistance, in which the pancreas cannot make enough insulin to keep blood glucose levels normal, or the body is unable to use what is produced. The impairment causes blood glucose level to rise higher than normal. There is no cure for type 2 diabetes mellitus and it is life threatening when left untreated. Signs and symptoms of this disorder include vision changes, increased thirst, increased hunger, increased frequency of urination, stomach pain, nausea and vomiting, erectile dysfunction, and absences of mentruation. These can occur abruptly, or over a long period of time. Long-term complications from diabetes include kidney damage, eye damage, and blindness. The risk factors for developing diabetes mellitus include genetics, sedentary lifestyle, high blood pressure, history of diabetes during pregnancy, poor diet, obesity, high cholesterol, and abdominal obesity. Diabetes mellitus can be managed through the use of medication, or by reducing risk factors, such as avoiding obesity, inactivity, and poor nutrition.
As of the year 2011, 28.8 million people living in the United States were suffering from diabetes. This accounts for 8.3% of the US population (CDC, 2011). While this number may seem small, diabetes is a rapidly growing disease that needs a solution given that it is the seventh leading cause of death. According to the American Diabetes Association, (A.D.A.), diabetes is a condition in which the pancreas is unable to produce the amount of insulin needed to convert food, sugars, and starches to energy for the body. Therefore, the blood sugar levels rise, also known as hyperglycemia. There are two types of diabetes: Type 1 and Type 2. Type 1 diabetes is commonly found in children or young adults and only makes up 5% of diabetes cases. A person with Type 1 diabetes does not produce insulin at all. Type 2 diabetes is the more common form of the disease. People who struggle...
Diabetes Mellitus, Type 2 is a metabolic disorder that is related to increased glucose levels in the blood, which is known as hyperglycemia. Insulin under typical function aids in carrying glucose from the body’s bloodstream into cells. However, in DM II, insulin production is hindered, insulin receptors are more resistant, and/or there is an inappropriate secretion of glucagon. This causes glucose to increase in the blood since there are not enough functioning insulin receptors to help transfer glucose to cells. Chronic elevated glucose levels damage small blood vessel resulting in peripheral neuropathy, retinopathy, and acceleration of atherosclerosis. The elevated levels also impair immune function and wound healing ability (Lippincott Williams & Wilkins, 2011).
Long range BMI target/goal is less than 25. If lifestyle changes are not enough, than drugs that help lower cholesterol levels, high blood pressure and blood sugar can be used such as statins, fibrates or nicotinic acid. 4Other things that can be done include trying to fight the insulin resistance by starting thiazolidinedione. Also, treating the different risk factors like elevated blood pressure, prothrombotic and proinflammatory state independently. Our patient has 4 of the 5 risk factors: low HDL, high triglycerides, high fasting blood glucose, and central obesity.
Diabetes Mellitus is a chronic medical condition that affects millions of people. This chronic condition is associated with high levels of glucose in the blood. As a newly diagnosed patient it is crucial to be aware how our bodies react to food consumption in regards to how insulin is produced to fully understand the concept of insulin production by the pancreas.
Diabetes Mellitus is a chronic condition which afflicts millions of people around the world. It is related to the insulin hormone, which is secreted by cells in the pancreas, regulates the level of glucose in the bloodstream and supports the body with breaking down the glucose to be used as energy. In someone who has diabetes, the body doesn’t produce enough insulin or cells don’t respond to the insulin that is produced. There are three main types of diabetes, type 1, type 2, and gestational. I will be discussing type 1 and type 2.
The metabolism of carfilzomib consists of two pathways peptidase cleavage and epoxide hydrolysis, that were found in peptide pieces with the diol metabolite in carfilzomib. The drug has a half-life of less than one hour and is excreted by biliary and renal excretion, less than one percent of the drug remains complete [7]. All drugs eventually have severe side effects depending on the type of drug used. This drug, carfilzomib has mostly common side effects such as a cough, diarrhea, hypertension, thrombocytopenia, muscle spasms, upper respiratory tract infection, and hypokalemia, these side effects are not life-threatening, but during clinical trials a 3.8% of the patients were reported with cardiac failure [7]. In further studies, researchers were able to understand that the higher the drug dose caused severe side effects, patients experience cardiovascular adverse events (CVAE) mainly heart failure, heart attacks, and arrhythmia [4]. This side effects can be taken into account that they may depend on the age and obesity of the
Throughout the whole of the United Kingdom, between 2 and 3 of every 100 people have a known form of diabetes (DTC, 2004). What is diabetes? Explained simply, it is a disease in which the body does not produce or properly use insulin. In the normal state of glucose function, there is a stable release and uptake of glucose, regulated by two hormones produced in the pancreas, glucagon and insulin. There are two distinct mechanisms which give rise to the abnormal blood glucose levels seen in patients with type I and type II diabetes. In type I diabetes, a deficiency in insulin production at the pancreas results in elevated blood glucose levels due to the lack of hormonal regulation. In type II diabetes, although the pancreas produces regular levels of insulin, the body resists the effect of insulin, inhibiting the ability of insulin to break down glucose in the blood. Because of the inherent differences in the biochemical mechanisms of these two diseases, the characteristics associated with type I and type II diabetes are very different. The typical onset of type I diabetes is usually ...
Diabetes mellitus is a group of metabolic disorders characterized by inadequate insulin secretion by the pancreas or cellular destruction leading to an insulin deficiency. Depending on the cause of the insulin shortage, diabetes can be subcategorized into type I and type II. Type I diabetes (T1DM) is usually mediated by the destruction of b-cells in the pancreas resulting in decreased insulin production and secretion. Type II diabetes (T2DM) is the failure of these b-cells to secrete adequate amounts of insulin to compensate for insulin resistance and increased gluconeogenesis combined with an overall resistance to the insulin action (8., 1997). T2DM accounts for 90 to 95 percent of all diabetes cases.
Mellitus Diabetes Type 2 aka Type 2 diabetes is a chronic disease, which there is a high level of sugar. So a person’s body that causes blood glucose (sugar) levels to rise higher than normal. A long-term metabolic disorder characterized by insulin resistance and relative lack of insulin as well. Type 2 diabetes known for noninsulin dependent diabetes mellitus (NIDDM) meaning drugs stimulate endogenous insulin secretion and promoting glucose utilization are required. This condition occurs in the middle age, such as 45-64 years old. 1.7 million New total diabetes cases in the year of 2012. More than 100 million people worldwide has type 2 diabetes. Men’s are at a higher risk than women’s are. Because of men that are most susceptible.
Turner, B. J., Newschaffer, C. J., Zhang, D., Fanning, T., & Hauck, W. W. (1999). Translating clinical trial results into practice. Annals of Internal Medicine, 130(12), 979-986.
The pathophysiology of diabetes type 2 (T2DM) is the development of impaired insulin secretion and insulin resistance. Impaired insulin secretion is the reduction in glucose responsiveness which can occur pre-onset. Impaired glucose tolerance is both activated by a decrease in glucose responsiveness and a decrease in insulin secretion after meals. This in turn can lead to postprandial hyperglycemia. Impaired insulin secretion is often
Those affected by Type I diabetes have a complete lack of insulin due to the lack of functioning beta cells. And thus, daily injections of insulin are needed. Type II Diabetes occurs when insulin is still being produced and pancreatic beta cells still present, however, it is the tissues responsible for the absorption of insulin that fail to respond efficiently or effectively to normal insulin levels. An occurrence commonly known as insulin resistance. Also common in Type I Diabetes, is the fact it presents itself as the individual matures into adulthood, leading to the pancreatic decrease in the levels of insulin being secreted. Type II diabetes is becoming more common due to increasing obesity and failure to exercise, both of which contribute to insulin