Ahmed Abd-Almonaem Elrufaie - 202062

Diabetes Mellitus

Type 1 Diabetes

Insulin dependent diabetes that results from autoimmune destruction of the β‐islet
cells.

Pathogenesis

Autoimmune disorder following viral infection in patients with genetic susceptibility

HLA‐DR3 and HLA‐DR4 haplotypes are at greatest risk CD4+ T cells induce
macrophage and CD8 T cells to destroy pancreas ‐ cellular Autoantibodies are against
the glutamic acid decarboxylase (GAD) protein

Type 2 Diabetes

Insulin independent diabetes that results from pancreatic “burn out”

Pathogenesis

Insulin Resistance, decreased ability for tissue to respond to presence of insulin Down
regulation of receptor, dephosphorylation, decreased signals The pancreas must
increase production to meet resistance, Strong link to obesity Beta‐Cell Dysfunction,
Continual production of massive insulin leads to burnout. Pancreas does not produce
insulin in sufficient amounts, despite of hyperglycemia and insulin resistance

↓Insulin production, ↓islet size

Diagnosis

1. Urinary glucose

2. Fasting Blood Glucose - ≥126 mg/ dl pre-diabetes: 100-126 mg/dl

3. Random Blood Glucose - ≥ 200 mg/dl

4. Oral Glucose Tolerance Test - Diagnosis of IGT with 2-hour plasma glucose ≥ 200
mg/dl

5. Capillary Glucose

6. HA1C - ≥ 6.5% is diagnostic for diabetes, should be confirmed with a second

HBA1C