Diabetes is a chronic (lifelong) disease marked by high
levels of sugar in the blood.
The defect in this condition is that either the pancreas
does not produce enough insulin or it produces
sufficient insulin, but the cells of the body are unable
to use the insulin properly.
Beta Cells: secrete
Autoimmunity occurs in islet of Langerhans
against the beta cells...
-Peptide Hormone, regulates blood sugar.
-Causes body cells to take up glucose from the blood.
-Insulin receptors found on:
Without insulin, too much glucose stays in your blood.
Over time, high blood glucose can lead to serious
problems with your heart, eyes, kidneys, nerves, and
gums and teeth.
4 major types:
1) Type 1 Diabetes
2) Type 2 Diabetes
3) Gestational Diabetes
Diabetes is becoming a world pandemic.
Incidence prevalence are increasing dramatically,
with an estimated
171 million diabetics in 2000
and a projected increase to 366 million by 2030
Type 1 diabetes causes an estimated 5–10% of all
Also called ―Insulin
dependent diabetes‖ or
Autoimmune destruction of
insulin-producing (beta cells)
of the pancreas
Results in total insulin
Age of onset: usually
childhood, young adulthood
Age below 30 years
polyuria -Excessive urination
polydipsia- Excessive thirst
EATS A LOT BUT DOES
Bed wetting in children
-Poorly understood, plenty of theories.
-Injury to islets…
-Random failure of tolerance…
Cell mediated response:
-Type 1 diabetes is caused by a T cell–mediated
autoimmune destruction of the pancreatic beta
Molecular mimicry: similar epitopes between
pathogen and host.
Coxsackie & hCMV:
Viruses can produce proteins similar
to those of the host.
Immune cells present viral protein
homologous to self protein.
tolerance and autoimmunity
The exact cause of type 1 diabetes is unknown.
In most people with type 1 diabetes, the body's own
immune system — which normally fights harmful
bacteria and viruses — mistakenly destroys the insulinproducing (islet) cells in the pancreas.
Several alleles of HLA-DQB1 are associated
with an increased risk of developing type 1
The locus also has the genetic name IDDM1
as it is the highest genetic risk for type 1
The strongest gene, IDDM1, is located in
the HLA Class II region on chromosome
6, at staining region 6p21.
Certain variants of this gene increase the risk
for decreased histocompatibility
characteristic of type 1.
Such variants include DRB1 0401, DRB1
Race. White people
have a greater risk for
developing type 1
diabetes than black,
Asian, or Hispanic
For identical twins, when one twin had type 1
diabetes, the other twin only had it 30%–50% of the
Despite having exactly the same genome, one twin had
the disease, where the other did not; this suggests
environmental factors, in addition to genetic factors, can
influence disease prevalence.
mumps virus or cytomegalovirus may trigger the
autoimmune destruction of the islet cells, or the virus
may directly infect the islet cells.
Research suggests that vitamin D may be protective
against type 1 diabetes.
However, early drinking of cow's milk — a common
source of vitamin D — may increase infants' risk of the
Complications in Type 1 Diabetes
A condition arising due to low blood glucose.
It can be caused by eating less than usual, more
exercise than normal or too much insulin administered.
Sometimes referred to as an ―insulin reaction‖
Must be treated before immediately before symptoms
Pale skin color
Sudden moodiness or behavior
changes, such as crying for no
Clumsy or jerky movements
Difficulty paying attention or
Tingling sensations around the
If you pass out from hypoglycemia, people should:
◦ NOT inject insulin
◦ Inject glucagon
◦ Call for emergency help
A technical term for high blood glucose.
It can be caused by a clog in insulin pump
tubing, missing an insulin dose, eating more than
usual, stress or less exercise than normal.
Can be a serious problem if you don’t treat it
Ketones are acids that build up in the blood.
They appear in the urine when the body doesn’t have
They can poison the body.
They are also an indicator that your diabetes is getting out
of control or that you are getting sick.
They are present in high amounts in a condition known as:
Results from a failure to treat hyperglycemia
Mostly occur in individuals with type 1
It is a serious condition that can lead to
diabetic coma or even death.
Treatment for this condition usually takes
place in the hospital.
You can prevent this by learning the warning
signs and by checking blood and urine
Increase with duration of diabetes
50% retinopathy in 20 years of Type 1
Retinal changes related to diabetes
◦ Hemorrhage, swelling, decreased vision
Leading cause of blindness
kidneys of diabetics leading
to impaired renal function
In type 1 diabetics, 10 – 15
Increased risk for Type 1 and 2
Development of arterial occlusion
and thrombosis resulting in
Increased susceptibility to infection
Normal inflammatory response is
Slower than normal healing.
Foot ulcers and infections
Latent Autoimmune Diabetes in
It is a form of (type 1 diabetes)
which is diagnosed in individuals
who are older than the usual age
of onset of type 1 diabetes.
― Late-onset Autoimmune
Diabetes of Adulthood, "Slow
Onset Type 1" diabetes, and
sometimes also "Type 1.5
◦ Patient is symptomatic plus
Casual plasma glucose (non-fasting) is 200 mg/dl
Fasting plasma glucose of 126 mg/dl or higher
Two hour plasma glucose level of 200 mg/dl or
greater during an oral glucose tolerance test
Key Pieces Of Diabetes Self-Management
Eating too much sugar causes
Diabetes is a nuisance, but
You can catch diabetes from
Herbs and natural
supplements can help prevent
or treat diabetes
Diabetes can be kept under check by proper
care and treatment
Once diabetes is established it cannot be
cured, so stop running after magical cures!!.
Take insulin through daily shots or an insulin pump.
Eat a healthy diet that spreads carbohydrate throughout the day.
Check blood sugar levels several times a day.
Get regular exercise.
When a small child has diabetes, the parents have the responsibility for
blood sugar control.
Treatment may change based on the results of daily home blood sugar
tests and other tests or exams.
Insulin cannot be taken in pill form.
If it were to be consumed orally, it would break down during
digestion just like normal proteins in your food.
Insulin must be injected into the fat under your skin in order
for it to get into your bloodstream.
Type 1 diabetes is fatal if not
treated with external insulin.
-fast acting and slow acting
During this procedure, islets (clusters of cells from the pancreas that
help make insulin) are taken from the pancreas of a deceased organ
donor. Then, the islets are purified, processed, and transferred to
someone else. These then begin to make and release insulin
individually. This could possibly be the biggest step in helping
patients with type 1 diabetes live without insulin injections.
Prevention all starts with a better lifestyle
taking medicine as directed
taking care of your body
check feet to make sure there is no nerve damage or interruption of blood flow
take care of teeth
control blood pressure and high
check in with your doctor at least once a month
have your blood sugar checked along with weight, blood pressure, and feelings
Check blood sugar levels daily by using home monitoring device