Diabetes mellitus type mechanisms

Type 2 Diabetes Mellitus This is the most prevalent form of diabetes and is characterized by both an insulin secretion defect and insulin resistance. Maturity-onset diabetes of the young (MODY), attributable to mutations of the glucose kinase gene (discussed earlier), may also be classified as type 2 diabetes mellitus. Obesity is a contributory factor and may predispose to insulin resistance with eventual development of type 2 diabetes mellitus. The precise mechanism by which obesity leads to insulin resistance in the target tissues is not understood. However, in several animal models (e.g., ob/ob mouse, db/db mouse) mutations have been identified that cause both obesity and diabetes mellitus. Unlike type 1 diabetes mellitus, type 2 is not an autoimmune disease. Studies with monozygotic twins have revealed a 90% concordance rate for type 2 diabetes mellitus, suggesting the involvement of genetic factors in the development of the disease. 

However, the increasing incidence over time of Thl-related disorders (diabetes mellitus type 1, Crohn disease, multiple sclerosis) has also been suggested to be more likely to be due to an alternative possible mechanism — reduced immune suppression and effect on regulatory T cells (Tedeschi Airaghi, 2001). 

Guertzentein (1999) To check the benefits of passion fruit peel to reduce blood glucose. The yellow passion fruit was efficient in the treatment of diabetes mellitus type 11, and the probable mechanism of this action was the high content of pectin, which helps to decrease the level of glucose and cholesterol in the blood. 

To gain further insight into the mechanisms involved in defective insulin-stimulated glucose uptake in skeletal muscle of insulin-resistant subjects, the possible role of IMCL in the pathogenesis of skeletal muscle insulin resistance and type 2 diabetes mellitus was explored by comparing insulin sensitivity (GIR) and IMCL content of insulin-resistant and insulin-sensitive offsprings of patients with type 2 diabetes. Twenty-six healthy subjects were included in the first study, 13 of them classified as insulin-sensitive and further 13 as insulin-resistant. Metabolic and anthropometric data are given in Table 4. 

Treating Diabetes Mellitus. There are two main types of diabetes. Type I diabetes (previously called insulin-dependent diabetes mellitus, IDDM) is a severe form which occurs most commonly in juveniles and young adults and which results from an absolute insulin deficiency arising from pancreatic B cell destruction, presumably via an immune-mediated mechanism. Type II diabetes (previously called non-insulin-dependent diabetes mellitus, NIDDM) is a milder, heterogeneous form of diabetes which occurs more... 

Diabetes was also more common in 63 patients taking clozapine than in 67 receiving typical depot neuroleptic drugs (299). The percentages of type 2 diabetes mellitus were 12% and 6% respectively. Nevertheless, the mechanism is not known. In six patients with schizophrenia, clozapine increased mean concentrations of blood glucose, insulin, and C peptide (300). The authors concluded that the glucose intolerance was due to increased insulin resistance. 

More direct interference with glucose metabolism cannot be excluded. Interferon alfa can reduce the sensitivity of peripheral tissues or liver to insulin and accelerate the destruction of stimulated pancreatic beta-cells (540,541) this could be a possible mechanism in patients not exhibiting islet cell antibodies. This is also in keeping with rare instances of induction or exacerbation of type II noninsulin dependent diabetes mellitus (SEDA-19, 335). 

Autoimmune diseases have been reported to be more frequent in human subjects treated with several recombinant cytokines [38], For instance, increased titers or the new occurrence of autoantibodies have been observed in hepatitis C patients treated with the recombinant interferons-alpha (IFNa). Quite a few clinical case reports describe the development of organ-specific as well as systemic autoimmune diseases including systemic lupus erythematosus, insulin-dependent type I diabetes mellitus, autoimmune thrombocytopenia, autoimmune hemolytic anemia, myasthenia gravis, and autoimmune thyroiditis in patients under IFNa therapy. Although the mechanism involved is not fully elucidated, the available data support the pathogenic potential of IFNa in autoimmunity [31]. In contrast, autoimmune effects associated with IFNp therapy are thought to be of lesser concern based on the current clinical evidence [38], Thyroid autoimmunity in contrast to other autoimmune diseases is frequent in patients treated with recombinant interleukin-2 (rIL-2). Thus, among 281 previously euthyroid cancer patients treated with rIL-2, up to 41%... 

Belury, M. A. 2003. Conjugated linoleic acid in type 2 diabetes mellitus implications and potential mechanisms. In Sebedio, J., Christie, W. W., and Adolf, R. (Eds.), Advances in Conjugated Linoleic Acid Research (2, pp. 305-315). Champaign, IL AOCS Press. 

The exact mechanisms of tacrolimus-induced diabetes are unknown. In one renal transplant patient with genetic susceptibility, tacrolimus was associated with insulin-dependent diabetes mellitus and the simultaneous occurrence of anti-glutamic acid decarboxylase antibody (54). Within 2 months after conversion from tacrolimus to ciclosporin, the antibody was no longer detected and the patient s insulin requirements fell dramatically. Tacrolimus-induced direct beta cell toxicity, with subsequent development of beta cell autoimmunity, was therefore suggested as a possible mechanism in patients with genetic susceptibility for type I diabetes. 

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