blood glucose serum insulin mmoVL pmol/L 8.0 glucose blood levels 7.5 insulin blood levels 350 1267.0 E starch-rich food (. ::::: : sucrose-rich food(glucose-fructose) 300 6.5 250 1086.0 5.5 200 905.0 150 4.5 100 724.0 3.5 3.0 0 mga7:009:0011:0013:0015:0017001900210023:001:003005:00700 breakfast lunch dinner ased on [Daly 98
Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced. There are three main types of diabetes mellitus Type 1 DM results from the pancreas's failure to produce enough insulin This form was previously referred to as " insulin-dependent diabetes mellitus"(IDDM)or juvenile diabetes Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly. non insulin-dependent diabetes mellitus"(NIDDM)or"adult onset diabetes Gestational diabetes is the third main form and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels
Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.There are three main types of diabetes mellitus: Type 1 DM results from the pancreas's failure to produce enough insulin. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly. "non insulin-dependent diabetes mellitus" (NIDDM) or "adultonset diabetes". Gestational diabetes is the third main form and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels
1型糖尿病 2型糖尿病 C遗传易感性 遗传易感性 环境因素 环境因素 肩启动自身免疫[阝胞严重受损」【原发性β细胞缺陷发生胰岛素抵抗 胰岛素绝对不足 〔胰岛素相对不足、葡萄糖摄取利用↓ 高血糖 1型或2型糖尿病 1型和2型糖尿病的基本病因和基本机制示意图
遗传易感性 环境因素 高血糖 启动自身免疫 细胞严重受损 原发性细胞缺陷 发生胰岛素抵抗 遗传易感性 环境因素 胰岛素绝对不足 胰岛素相对不足、葡萄糖摄取利用↓ 1型糖尿病 2型糖尿病 1型或2型糖尿病 1型和2型糖尿病的基本病因和基本机制示意图
Pathophysiology of Type 1 Diabetes Mellitus Genetic predisposition Environmental factors Autoantigens form on insulin-producing beta cells and circulate in the bloodstream and lymphatics Processing and presentation of autoantigen by antigen presenting cells Activation of T helper 1 lymphocytes Activation of T helper 2 lymphocytes IFN-Y IL-2 IL-4 Activation of macrophages Activation of autoantigen Activation of B lymphocytes to with release of IL-1 and TNF-a specific T cytotoxic(CD8cells produce islet cell autoantibodies and anti GAD65 antibodies Destruction of beta cells with decreased insulin secretion
Pathophysiology of Type 1 Diabetes Mellitus
Pathophysiology of Type 2 Diabetes Mellitus Genetic predisposition Obesity -Diet, inactivity Adipokines, ifree fatty acids inflammatory cytokines ↓ Activity of ghrelin l Beta cell mass and function Insulin resistance ↓ Activity of incretins t Demand for insulin synthesis ↓ Amylin Hypoinsulinemia Hyperinsulinemia t Glucagon- Tissue effects and Tissue effects without hyperglycemia hyperglycemia(insulin (type 2 diabetes resistance without diabetes
Pathophysiology of Type 2 Diabetes Mellitus