Facts On Diabetes
Diabetes mellitus: The facts about diabetes
Diabetes mellitus is a syndrome of chronic hyperglycaemia due to relative insulin deficiency, resistance, or both. It affects more than 120 million people world-wide, and it is estimated that it will affect 370 million by the year 2030. Diabetes is usually irreversible and, although patients can have a reasonably normal lifestyle, its late complications result in reduced life expectancy and major health costs. The facts about diabetes include macrovascular disease, leading to an increased prevalence of coronary artery disease, prepheral vascular disease and stroke, and microvascular damage causing diabetic retinopathy and nephropathy. Neuropathy is another major complication.
Insulin is the key hormone involved in the storage and controlled release within the body of the chemical energy available from food. It is coded for on chromosome 11 and synthesized in the beta-cells of the pancreatic islets. The synthesis, intracellular processing and secretion of insulin by the beta-cell is typical of the way that the body produces and manipulates many peptide hormones. About 50% of secreted insulin is extracted and degraded in the liver; the residue is broken down by the kidneys. C-peptide is only partially extracted by the liver (and hence provdes a usefull index of the rate of insulin secretion), but is mainly degraded by the kidneys.
Blood glucose levels are closely regulated in health and rarely stray outside the range of 3.5-8.0 mmol/L (63-144mg/dL), despite the varying demands of food, fasting and exercise. The principal organ of glucose homeostasis is the liver, which absorbs and stores glucose (as glycogen) in the postabsorptive state and releases it into the circulation between meals to match the rate of glucose utilizatiby perpheral tissues. The liver also combines 3-carbon molecules derived from breakdown of fat (glycerol), muscle glycogen (lactate) and protein (e.g. alanine) into the 6-carbon glucose molecule by the process of gluconeogenesis.
About 200g of glucose is produced and utilized each day. More than 90% is derived from liver glycogen and hepatic gluconeogenesis, and the remainder from renal gluconeogenesis.
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