This document provides an overview of diabetes mellitus (DM), including its types, signs and symptoms, and pathophysiology. DM is a metabolic disorder characterized by high blood sugar levels over a prolonged period. There are two main types of DM: type 1 DM results from the body's inability to produce insulin due to the destruction of pancreatic beta cells, while type 2 DM involves insulin resistance where cells do not properly respond to insulin. The pathophysiology section explains insulin's role in metabolic processes and the effects of insulin deficiency or resistance. Pharmacological management of DM is also briefly mentioned.

1. DIABETES MELLITUS
Mr. Anirban Ghosh
Masters in Pharmacology

2. Contents
• Introduction
• Types, Sign and symptoms
• Pathophysiology
• Pharmacology

3. Introduction
• Diabetes mellitus (DM) is a metabolic disorder in which high blood sugar levels
over prolonged period of time. It is characterized by hyperglycaemia, glycosuria,
hyperlipidemia etc..
• Diabetes is due to either the pancreas is not processing enough insulin or the cells
of the body stop responding properly to the insulin production.

4. Types, Sign and symptoms

5. Insulin receptor and its cellular actions

6. Type 1 DM/ IDDM/ Juvenile diabetes
• The type 1 diabetes is characterized by
destruction of the pancreatic beta cells.
This condition is caused due to
combined genetic, immunological and
viral factors contribute to cell
destruction.
• This is abnormal response of the body
in which the antibodies are direct
against the normal tissues as if they
were foreign and eventually can
damage Islet of Langerhans, specific
area of the pancreas that produce
insulin, reducing the production of
insulin or totally no production of
insulin

7. Type 2 DM/ NIDDM/ Adult onset diabetes
• Insulin resistance begins this condition,
in which cells fail to respond to insulin
properly.
• The primary cause is excessive body
weight and not enough exercise.
• There are 2 main problems related to
insulin in type 2 diabetes:
i. Insulin resistance: insulin do not
bind with the special receptor on
cell surface.
ii. Impaired insulin secretion: insulin
secreting glands release irregular
amount of insulin.

8. Diabetic ketoacidosis due to insulin lack

9. Glucose
transporter
Calcium
channels
Glucose
Glucose
Metabolism
ATP
Closes
Potassium
channel
Insulin
Insulin
granules
Ca+
Pancreatic hormones mechanism of release
Leads to
depolarizationDecreases
potassium
conductance
R

10. R
Glycogen
synthetase
Glycogen
Gluconeogenesis
Glucose
Protein
Amino
Acids
Glucagon
Urea
excretion
Lipase Free
Fatty
Acids
Ketone
Bodies
Liver
Lipid
Energy
utilization
Gluco-1-
phosphatase
Role in metabolic processes: Review

11. Insulin
R
Decreases
Increases
Glycogen
synthetase
Protein
Amino
Acids
Glucose
Gluconeogenesis
Urea
excretion
Lipase Free
Fatty
Acids
Ketone
Bodies
Liver
Glycogen
Lipid
Energy
utilization
Gluco-1-
phosphatase
Role in metabolic processes: insulin effect

12. Hyperglycemia
Glycogen
synthetase
Glycogen
Gluco-1-
phosphatase
Energy
utilization
Gluconeogenesis
Protein
Amino
Acids
Insulin
R
Decreases
Increases
Urea
excretion
(Azoturia)
Lipase Free
Fatty
Acids
(Ketonemia
and Acidosis)
Liver
Lipid
Hyperlipemia
Ketone
Bodies
Insulin deficiency condition

13. Pharmacology

14. Pharmacology

15. Management

16. Thank you