PHS 1200 Lecture Notes - Lecture 3: Insulin Receptor, Diabetic Ketoacidosis, Diabetes Mellitus Type 1

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In the 20th century, banting, best, collip, macleod extracted and purified insulin from pancreas, first treated in 1921. Patients need insulin replacement to live (no c peptide) Type i diabetes has an acute presentation: Indicdence in canada= 20/100,000/year and is increasing by 3-4%/year: hyperglycemia, tiredness, wightloss, polyuria, thirst, polydipsia, nausea and cimiting signal impending ketoacidosis. Honeymoon period= temporary remission in some after administration of insulin, however this is short lived as beta cells contunie to deteriorate. Complications over time (mortality increased 4-7x: mucrovascular: nephropathy, neuropathy, retinopathy, microvascular: coronary heart disease, kidney, nerve and eye problems; major risk of blindness. Patients survive without therapeutic insulin, although this may improve control (c=peptide present) Represents as least 90% of diabetic population. Patients mostly older and obesesymptoms: tiredness, thirst, polyuria, nocturia. Characterized by high fasting glucose; glucose intolerance. Cause: impaired insulin secretion and tissue insensitivity to insulin; strong genetic predisposition.

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