Intro :p

Everything hurts, what do I do?

Q.4: Does the Patient Have Type 1

or Type 2 Diabetes ?
What are the pathological differences?
Presentations by Cherry Zhen, 2256144
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WebMD Baidu Tongji Expedia

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 Home Recent Tabs Homeostasis

Is homeostasis a real word?

Blood-Glucose Homeostasis Homeostasis is a term to describe the

self-regulating process in an organisms to
maintain internal stability in ever changing
external factors.

Blood glucose homeostasis utilises two

hormones which work in tandem to the
maintain the blood glucose levels in a suitable
range: 70-100 mg/dL

Insulin: Rise in blood glucose → Beta cells

release Insulin → Promotes uptake of glucose
in the Liver → Glucose to Glycogen

Glucagon: Drop in blood glucose → Alpha

cells release Glucagon → Promotes
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breakdown of glycogen → Glucose released

into blood stream.
 Home Recent Tabs PANCREAS!

What is a pancreas?

The pancreas is the home to around 1 million

Islets of Langerhans, irregularly shaped
patches of endocrine tissue.
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Cells within the Islets produce hormones

Insulin & Glucagon
 Home Recent Tabs Diabetes Mellitus

Diabetes Mellitus
Diabetes Mellitus (DM) is a metabolic disease
which involves elevated blood glucose levels over a
long period, impairing the body's ability to
self-regulate the glucose levels to keep
homeostasis.

Although there are several types of Diabetes

Mellitus recognised, the most common types being
Diabetes Type 1 and 2. Both types share mutual
symptoms, although their pathology completely
differs.

Uncontrolled diabetes can lead to a spectrum of

health complications.
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- Cardiovascular/Kidney Disease
- Vision impairment
- Nerve Damage
 Home Recent Tabs Type 1

You can type something here…

Type 1
Type 1 diabetes, or
insulin-dependent diabetes, is an
autoimmune condition where the
body's immune system attacks and
destroys the insulin-producing beta
cells in the pancreas.

Thus, this condition involves Genetic predisposition plays a

insufficient insulin production in the big part in the risk factor of Type
body. Type 1 commonly develops in 1 DM. Known influences of risk
childhood or adolescence, requiring being:
lifelong insulin replacement therapy
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to survive. - Major Histocompatibility

Complex (MHC)
- Human Leukocyte Antigen
(HLA)
 Home Recent Tabs Type 1; Pathology

You can type something here…

T1DM Pathology
3 stages of T1D development:
Stage 1:

● Asymptomatic
● normal fasting glucose + Glucose
tolerance
● ≥2 pancreatic autoantibodies.

Stage 2:

● Presence of pancreatic autoantibodies

● Dysglycemia
● Impaired glucose tolerance
● Still asymptomatic

Stage 3:

● Clinical Symptoms
● High fasting glucose
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● ≥126 mg/dL
● glucose ≥200 mg/dL two hours
after ingesting
 Home Recent Tabs Type 1; Pathology

You can type something here…

T1DM Pathology 1) T lymphocytes, specifically CD8+ cytotoxic T cells and

CD4+ helper T cells, play a central role in the immune
response by recognizing antigens on the surface of
beta cells and marking them for destruction.

2) The immune cells release pro-inflammatory signaling

molecules called cytokines; such as interleukin-1
(IL-1), interleukin-2 (IL-2), and interferon-gamma (IFN-
γ), contribute to inflammation in the pancreatic islets
and promote the destruction of beta cells.

3) The cytokines, in addition to other immune cell

activities, lead to inflammation. This inflammation
disrupts the normal functioning of beta cells and
ultimately causes their destruction.

Beta cell destruction:

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- Direct cytotoxic effects

- Indirectly through the activation of other
immune cells.
 Home Recent Tabs Type 2

T2DM

Type 2 Risk Factors:

Type 2 diabetes mellitus (T2DM) is a

chronic metabolic disorder due to
elevated blood sugar levels resulting
from a combination of insulin
resistance and inadequate insulin
production.

Body cells become resistant to the

effects of insulin, which facilitates the
uptake of glucose from the
bloodstream into cells.

With insulin resistance, the cells do not

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respond effectively to insulin, and this

results in higher blood sugar levels.
 Home Recent Tabs Type 2; Pathology

T2DM Pathology To compensate for insulin resistance, the

pancreas initially produces more insulin. This
compensatory hyperinsulinemia helps in moving
glucose into the cells. Over time, the pancreas
ability to produce adequate insulin reduces.

In individuals with Type 2 diabetes, the liver may

produce excess glucose, even when blood sugar
levels are already high. Excessive
Gluconeogenesis

- Adipose tissue can play a role in insulin

resistance, releasing a substance called
adipokines
- Chronic low-level inflammation is observed
in people with Type 2 diabetes.
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Inflammatory cytokines, such as

interleukin-6 (IL-6), can disrupt insulin
signaling.
 Home Recent Tabs Pathological Differences

Pathological Differences
Type 2:
Type 1:

- Insulin resistance
- Autoimmune disease
- Prolonged excessive
- Type 1 diabetes often has a
uptake of glucose in the
sudden and rapid onset,
body
- Typically in youth
- Damaged Insulin
- Require lifelong insulin
receptors
replacement therapy
- Genetic predisposition
- Beta cell destruction
- Typically occurs in adulthood
- Complete absence of
- Produces insulin but not
Insulin
enough
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 Home Recent Tabs Case Study: Lisa

Case Study: Lisa

Symptoms:

- Frequent Urination Lisa has multiple symptoms which is

- Increased Thirst typically more commonly seen in type 2
- Fatigue diabetic patients.
- Acetone Breath
- Acanthosis Nigricans Blood tests of Serum antibodies to islet
- More typically found in IR cells: Negative
individuals
- Overweight: 100Kg Blood tests of Serum antibodies to
- Low HDL: 25 glutamic acid decarboxylase: Negative
- High Triglyceride: 1500
*Lisa has type 2 diabetes.*
Inherited susceptibility:
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- Twin sister has diabetes

- Both grandmothers have type 2
diabetes
 Home Recent Tabs Referencing :)

References:
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892884/#:~:text=Through%20its%20various%20hormones%
2C%20particularly,referred%20to%20as%20glucose%20homeostasis.
2. https://www.britannica.com/science/islets-of-Langerhans
3. https://www.who.int/data/gho/indicator-metadata-registry/imr-details/2380#:~:text=Rationale%3A,and%20m
onitoring%20glycemia%20are%20recommended.
4. https://www.ncbi.nlm.nih.gov/books/NBK551501/#:~:text=Diabetes%20mellitus%20(DM)%20is%20a%20meta
bolic%20disease%2C%20involving%20inappropriately,endocrinopathies%2C%20steroid%20use%2C%20etc.
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321245/#:~:text=Human%20type%201%20diabetes%20is,cl
inically%20symptomatic%20(stage%203).
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 Home Recent Tabs The End

Finally!

Thank you for listening!

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