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Diabetes 1 Effects on Glucose Metabolism

The American Association of Diabetes estimated in 2007 the number of diagnosed children and adult diabetics at 23.6 million in the U.S. alone. With approximately 1.6 million new cases being diagnosed in people aged 20 years and older each year, diabetes is fast reaching epidemic levels. Type 1 (insulin-dependent) diabetes accounts for about 5 to 15 percent of all diabetes cases.

  1. Definition

    • Often called "diabetes mellitus" (DM), diabetes is a chronic disease that affects multiple body systems, with potentially life-threatening consequences. It is essentially a disorder of protein, fat and carbohydrate metabolism, resulting from lacking, insufficient or ineffective insulin.

    Features

    • While type 1 diabetes usually occurs in people aged 30 or younger, it can be diagnosed in adults who are in their late 30s or early 40s. The key feature of type 1 diabetes is that most of the insulin-producing cells (beta cells) of the pancreas are progressively destroyed. As a result, type 1 diabetics produce little or no insulin.

    Causes

    • Type 1 diabetes is an autoimmune disorder associated with a combination of environmental and genetic factors. In autoimmune diseases, the body's immune system, which normally defends against foreign infectious agents, attacks and destroys its own cells.

    Role of Insulin

    • The beta (insulin-producing) cells of the pancreas are the most important glucose-sensing cells of the body. Rising blood glucose normally stimulates insulin production by the pancreas. Insulin is important for glucose metabolism because it enables the body's cells to take it up, so they can make energy.

    Normal Metabolic Effects

    • After a carbohydrate-rich meal, blood glucose levels rise. As a result, insulin causes the liver to slow its production and release of glucose. Insulin also causes the liver and muscles to remove excess glucose from the blood and convert it into its storage form, glycogen.

      In other tissues, such as muscle and adipose (fat) tissue, insulin also increases the number of glucose transporters in the cell surfaces, after a meal. This allows cells to take up excess blood glucose. Thus, blood glucose levels are kept in check. If the amount of glucose in the cells exceeds energy needs, it is stored.

    Metabolic Effects on Other Tissues

    • Type 1 diabetes mainly impairs glucose metabolism because of insulin deficiency, and a relative excess of glucagon. Glucagon is a hormone that has effects opposite to insulin, as it causes glucose-producing organs to release glucose in the blood. As a result, one of the key effects of type 1 diabetes is high blood glucose (hyperglycemia), which must be remediated by insulin injections and careful dietary regimens. It's important to note that persistently high blood glucose levels can lead to grave consequences, particularly for the eyes, heart, nerves, kidneys, gums and teeth.

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