Juvenile-onset diabetes

There are multiple causes of diabetes. Whereas the molecular bases of some forms of diabetes are well understood, in many cases etiologies are unknown. It is customary to divide diabetes into two main forms insulin-dependent diabetes mellitus (IDDM), also referred to as Type I or juvenile-onset diabetes, and noninsulin-dependent diabetes mellitus (NIDDM), also called Type II or maturity-onset diabetes (3). 

Human insulin Two peptide chains A, 21 amino acids long, and B, 30 amino acids long . coli Juvenile onset diabetes Approved for sale A and B chains made separately as fusion proteins and joined in vitro Compared with animal Insulins some undesirable side-effects have been noted... 

HF Heart failure JODM juvenile-onset diabetes mellitus... 

Failure of the body to synthesize sufficient insulin results in the development of insulin-dependent diabetes mellitus (IDDM). This is also known as type-1 diabetes or juvenile-onset diabetes. 

In both types of diabetes, however, this normal process malfunctions. A gland called the pancreas, found just behind the stomach, makes insulin. In people with insulin-dependent diabetes, the pancreas does not produce insulin at all. This condition usually begins in childhood and is known as Type I (formerly called juvenile-onset) diabetes. These patients must have daily insulin injections to survive. People with non-insulin-dependent diabetes usually produce some insulin in their pancreas, but their bodies tissues do not respond well to the insulin signal and, therefore, do not metabolize the glucose properly, a condition known as insulin resistance. 

Type 1 Autoimmune disease resulting in an absolute deficiency of insulin. Formerly referred to as juvenile onset diabetes, type I DM or insulin dependent diabetes mellitus (IDDM). Ketosis is common in poorly controlled subjects. 

Diabetes mellitus has been traditionally classified into insulin-dependent diabetes mellitus (IDDM), also known as type I (formerly called juvenile-onset diabetes mellitus), and non-insulin-dependent diabetes mellitus (NIDDM), also known as type II (formerly referred to as adult-onset diabetes mellitus). There are clearly varying degrees of overlap, and though it is often important to know whether a particular individual possesses relative insulin deficiency or relative insulin resistance or both, some of the more salient differences between IDDM and NIDDM are summarized in Table 67.1. 

In type I (juvenile onset) diabetes mellitus, the inability to release insulin (and thus to mobilize glucose... 

Finally, membrane proteins are also increasingly glycosylated in diabetes (65). Reid, et al. (68) recently identified an anti-M alloagglutinin in juvenile-onset diabetes that would agglutinate M-positive cells that had been pre-incubated in glucose. This suggests that Amadori products could act as haptens and elicit an immune reaction towards glycosylated tissues. 

Figure 4. TOP The amount of keto amine-linked glycosylation of insoluble collagen plotted as a function of subject s age. BOTTOM The amount of insoluble collagen plotted as a function of subject s age. Key O. normal +, juvenile-onset diabetic and , maturity-onset diabetic.

Insulin is the only currently effective treatment for the millions of diabetics who suffer from Type I diabetes (also known as insulin-dependent and juvenile onset diabetes). There are also a significant number of people with Type II diabetes (also known as maturity-onset diabetes) who need insulin. Insulin is a peptide, and if given orally it is broken down by enzymes in the gut (see Section 1.6.1). Thus it has always... 

Pathogenesis and complications (A). Type I diabetes mellitus typically manifests in childhood or adolescence (juvenile onset diabetes mellitus) it is caused by the destruction of insulin-producing B cells in the pancreas. A genetic predisposition together with a precipitating factor (viral infection) could start an autoimmune reaction against B-cells. Replacement of insulin (daily dose-40U, equivalent to -1.6 mg) becomes necessary. 

Diabetes mellitus (DM) is an increasingly common disease of sugar metabolism. Juvenile-onset diabetes, also known as Type I or insulin-dependent diabetes (IDDM), is an autoimmune disease that results in decreased release of insulin by the pancreas. Late-onset diabetes, also known as Type II or non-insulin-dependent diabetes (NIDDM), results from reduced sensitivity of cells to the insulin signal. A convenient animal model for studying diabetes and testing alternative therapies is the streptozotocin-freated diabetic rat. Streptozotocin (STZ) attacks the pancreas and decreases insulin production and release, thus, mimicking many aspects of the human disease. Since insulin is not orally absorbed, the oral administration of vanadium compounds that are insuhn-mimetic or insulin-enhancing would be a very attractive therapy ... 

Type 1 Diabetes Mellitus (Formerly Insulin-Dependent Diabetes Mellitus IIDDM], Type I, or Juvenile-Onset Diabetes)... 

The foregoing section indicates some reasons why peptide-based drugs are needed. If a peptide hormone is not produced in sufficient quantities or is defective in structure, then a replacement is required. Peptides, especially very small molecules, have a very short half life in the body. The reason for this is the ubiquitous occurrence of proteolytic enzymes that effect hydrolysis of peptides to the constituent amino acids. Although longer peptides, especially those with structural features such as disulphide bonds, survive longer in vivo, they are more likely to stimulate the body s immune system to produce antibodies and effect removal of the peptides. This is particularly likely to occur with molecules that differ structurally from the naturally occurring hormones. Thus, treatment of juvenile-onset diabetes mellitus with insulins from animal sources can occasionally stimulate the patient s immune system... 

Diabetes mellitus is a group of devastating metabolic dis-eases caused by insufficient insulin synthesis, increased insulin destruction, or ineffective insulin action. All of its metabolic effects result when the body s cells fail to acquire glucose from the blood. The metabolic imbalances that occur have serious, if not life-threatening, consequences (Figure 16A). In insulin-dependent diabetes mellitus (IDDM), also called type I diabetes, inadequate amounts of insulin are secreted because the (3-cells of the pancreas have been destroyed. Because IDDM usually occurs before the age of 20, it has (until recently) been referred to as juvenile-onset diabetes. Noninsulin-dependent diabetes mellitus (NIDDM), also called type II or adult-onset diabetes, is... 

Krupin T, Waltman SR. Fluorophotometry in juvenile onset diabetes long term followup. Jpn J Ophthalmol 1985 29 139-145. 

Krupin T, Waltman SR, Oestrich C, et al. Vitreous fluorophotometry in juvenile-onset diabetes mellitus. Arch Ophthalmol 1978 96 812-814. 

Insulin, a pancreatic hormone, is used in diabetic ketoacidosis and ketosis-prone and juvenile-onset diabetes melli-tus, and in diabetes inadequately controlled by diet and oral hypoglycemics (see Table 19 and Figure 54). 

Type 1 diabetes mellitus is referred to as insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes because Type 1 diabetes mellitus usually begins in childhood or adolescence. In T) e 1 diabetes mellitus, the pancreas produces little or no insulin. 

Diabetes mellitus, a chronic metabolic disease cause by insulin deficiency. This disease results from either insuSident insulin secretion or decreased sensitivity of the insulin receptor in the target cells. Two types of diabetes mellitus are known, insulin-dependent (type I) diabetes mellitus (IDDM), also termed juvenile-onset diabetes mellitus, caused by a deficiency of pancreatic fi cells and often strikes suddenly in childhood, and non-insulin-dependent (type II) diabetes mellitus (NIDDM), that may be associated with loss of fuUy active insulin receptors on normally insulin-responsive cells and is strongly cor-rdated with obesity. Although more than 80 years have passed since the discovery of insulin, the molecular actions of insulin have only begun to be investigated... 

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