DIABETES MELLITUS

Type I and Type II

Group IV
10.24.23
CLINICAL CHEMISTRY
AMBA, INCISO, CRUZ,ZEVACH,PODIOTAN,QUIJANO,REBUSIT
INTRODUCTION

DIABETES MELLITUS

A group of metabolic diseases characterized by hyperglycemia resulting from defects in

insulin secretion, insulin action, or both.

Hyperglycemia- is an increase in plasma glucose levels.

- During this state, insulin is secreted by beta-cells of the pancreatic islets of

Langerhans.
- Caused by imbalance of hormones.

In 1987, National Diabetes Data Group

- Developed a classification and diagnosis scheme for diabetes mellitus.

- The scheme has two broad categories.
a. Type I Diabetes(IDDM)
● Is characterized by inappropriate hyperglycemia primarily a result
of pancreatic islet B-cell destruction and a tendency to ketoacidosis.
- Ketoacidosis : is a serious complication of diabetes that can
be life-threatening. DKA is most common among people with
type 1 diabetes.
- : develops when your body does not have enough insulin to
allow blood sugar into your cells for use as an energy.
● It is a result of cellular-mediated autoimmune destruction of the
B-cells of the pancreas, causing an absolute deficiency of insulin
secretion.

- Might be caused by Virus, Autoimmunity, or any other factors that might destroy the
beta cells of the islets of Langerhans.

- These are also the reason why there is a continued elevation of blood glucose level
while the insulin level remains low.
- This is also the reason why a patient needs to inject insulin because again, the
pancreas cannot make its own insulin.

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 ➢ OTHER NAMES: Juvenile onset Diabetes , Insulin Dependent DM
➢ FREQUENCY: 10-15%
➢ AGE OF ONSET: <20 years old (Childhood)
➢ INSULIN INJECTION: Yes
➢ GENETIC BASIS: Possibly
➢ TREATMENT:
■ Sugar controlled healthy diet
■ Exercise; daily insulin injection
■ Regular testing of blood sugar level urine ketone test (if blood sugar
level is too high)
b. Type II Diabetes (NIDDM)
● In contrast, includes hyperglycemia cases that result from insulin
resistance with an insulin secretory defect.
- Type 2 Diabetes Mellitus constitutes the majority of
diabetes cases.
- Has rare ketoacidosis.
- Insulin resistance in this peripheral tissue or cell is
frequently associated with aging, family history, or
obesity(failure to exercise)

- As the blood glucose continues to rise, the insulin will be produced from the pancreas as
a response to increased blood glucose levels which is why both are increased.

➢ OTHER NAMES: Adult-onset Diabetes, Non-insulin Dependent DM

➢ FREQUENCY: 85-95%
➢ AGE OF ONSET: Adulthood
➢ INSULIN INJECTION: Not in the beginning, however, as the disease progresses,
insulin is frequently needed to control blood glucose levels.
➢ GENETIC BASIS: Definitely
➢ TREATMENT:
■ Sugar controlled healthy diet
■ Exercise
■ Keep in normal weight range
■ Diabetic pills or insulin shots (some cases)
■ Regular testing of blood sugar levels

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SIGNS AND SYMPTOMS

a. INCREASE URINATION (Polyuria) : Happens because as the glucose in the blood

increases, the body tries to compensate for it and decrease its level by the kidney.
b. EXCESSIVE THIRST (Polydipsia) : As the kidney tries to filter glucose in the
blood, the water goes along with it losing then, a significant amount of water
which is why thirst is felt most of the time, if the patient has diabetes.
c. TIREDNESS AND EXCESSIVE HUNGER (Polydipsia) : In diabetes, the blood
glucose cannot be used up by the cells of the body which is why the patient might
feel tired, lethargic, or unable to do daily routines due to lack of energy.
d. THRUSH OR GENITAL ITCHING : Since urine contains a lot of glucose, this now
creates a lot of bacteria to thrive in the genital region producing a kind of
infection.
e. SLOW HEALING OF WOUNDS : When we have a lot of glucose in the blood, the
viscosity of the blood increases which also affects the flow of the oxygen all
throughout the body.
f. BLURRED VISION : Glucose not only accumulates in our blood but also in the lens
of our eyes. This may cause the liquid of our eyes to become cloudy resulting in
blurred vision or worse, blindness.
g. WEIGHT LOSS: Very particular in Type 1 DM, if we have diabetes mellitus, the
glucose cannot be utilized by the body will use our fats producing then
ketoacidosis (Type 1 DM).

CHRONIC COMPLICATIONS OF DM

BLINDNESS
KIDNEY DISEASE
NERVE DAMAGE
CARDIOVASCULAR DISEASES
STROKE
HEART ATTACK
LOSS OF CIRCULATION in arms and legs that could lead to amputation.

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 Classification of Diabetes Pathogenesis

TYPE I ● Beta-cell destruction

● Absolute insulin
deficiency(body failure to
produce insulin)
● Requires insulin injection
● Autoantibodies:
➔ Islet cell
autoantibodies
➔ Insulin
autoantibodies
➔ Glutamic acid
decarboxylase
autoantibodies
➔ Tyrosine phosphatase
IA-2 and IA2B
autobodies.

Type II ● Insulin resistance with an

insulin secretory defect
(cells fail to use insulin
properly)
● Most common form
● Relative insulin deficiency
➔ Aging
➔ Family history
➔ Obesity
➔ Failure to exercise
➔ Manifest symptoms
hyperglycemia and
hyperinsulinemia
➔ Onset usually during
adulthood

ENDOCRINE ROLE OF THE PANCREAS (HORMONES)

● Insulin
● Glucagon

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 ● Somatostatin
● Pancreatic Polypeptide
● Other Hyperglycemic hormones
1. Epinephrine
2. Growth Hormone
3. Adrenocorticotropic Hormone (ACTH)
4. Thyroxine

CONCLUSION

Millions of individuals around the world suffer from the deadly medical illness known as
diabetes. It can lead to a number of health issues, so it needs to be addressed right away
to avoid long-term harm to the body. An individual can take action to properly manage
their diabetes and enjoy a healthy life by becoming aware of the many types, causes,
symptoms, and available treatments for the disease. It's critical to get medical help right
away if you have any diabetes symptoms.

REFERENCES