Diabetes

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Intro

Diabetes is a disease in which the body does not produce or can't properly use insulin. Insulin is a hormone needed to convert sugar, starches and other food into energy. Diabetes is diagnosed on the basis of too- high levels of glucose in the blood. If you have diabetes, your blood glucose levels rise because of the food you eat. Food has little effect on blood glucose in people without diabetes.

The glucose tolerance test GTT is helpful in identifying diabetes and other diseases of the liver and disorders of carbohydrate metabolism.

The level of glucose in the blood is very important as it is utilised by all tissues, especially the brain, which at a resting state uses approximately 65% of all available glucose. In normal individuals blood glucose levels are usually found inside a range of .5-5.5mmol/L.

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Glucose concentrations are tightly controlled by various mechanisms; depending on whether the body is fasting or is in the immediate post-absorptive state. In the immediate post-absorptive state, most of the glucose is supplied by glycogenolysis, and as fasting progresses, gluconeogenesis becomes increasingly important. When the body is in a fasting state, the rate of appearance and disappearance of glucose in the blood is approximately .5-.0mg/kg/min; a rate at which all glucose would disappear from the blood within 100 minutes, were it not continuously replaced. (B.Tuch et.al 000)

The biochemical hallmark of diabetes mellitis is chronic hyperglycaemia which results from an absolute or relative deficiency of insulin. (A.J Krentz 000)

There are two main types of diabetes. Type 1 diabetics make little or no insulin, they are said to be inulin deficient, and Type diabetics make normal or even elevated amounts of insulin but their bodies don't respond to the insulin properly, they are said to be insulin resistant. Instead of going into their cells to be used as energy, the unused glucose builds up in their blood and passes through the kidneys and gets excreted in the urine if the glucose level becomes too high.

Normally, insulin, which is synthesised and excreted by ß-cells of the pancreatic inslets in response to glucose and other secretagogues such as amio acids, allows glucose to enter the cells via specific glucose transporters and be used as fuel. Insulin is the principal anabolic hormone of the body exerting many actions on intermediary metabolism, ion transport and gene expression. (B Tuch, et.al 000)

The major action of insulin is to stimulate translocation of facilitative glucose transporters to the cell membrane. So far six different glucose transporters have been identified. They all share sequence homology, suggesting a common ancestral gene. Each has a specific tissue distribution, and there are thought to be 1 transmembrane domains that form a pore through which glucose is transported. (P.J.Watkins et.al 16)

References

Diabetes research, a guide for postgraduates

B.Tuch, M. Dunlop and J. Proietto

Hardwood academic puplishers, Australia 000

Churchill's pocketbook of Diabetes

A.J.Krentz

Harcourt Publishers Ltd, London 000

Diabetes and its management, fifth ed

P.J.Watkins, P.L.Drury and S.L.Howell

Blackwell science Ltd, London 16

Chap 17, 5, Human anatomy and Physiology

5th edition

Elaine.N.Marieb

Benjamin and cummings 1

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