Physiology 3120 Lecture Notes - Insulin Resistance, Polyphagia, Angiopathy

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Diabetes mellitus: diabetes greek (large volume of urine); mellitus latin (a sweet taste) In severe cases, get ketosis (build-up of ketones in bloodstream), acidosis, coma and death: long-term complications: retinopathy (damage to retina or lens; get expansion and contraction); nephropathy; angiopathy. Insulin-dependent; failure to secrete sufficient insulin to regulate glucose utilization. Autoimmune destruction of pancreatic b-islet cells; b-islet cells produces proteins after an insult that promote immune reaction; the cascade is fairly rapid once it"s initiated. Increased glucose filtration = water excretion = dehydration: glucose converted to sorbitol (via the polyol pathway ) which damages the lens, nerves, and capillaries. Increased glycosylation of proteins (via the glyoxal pathway ; especially haemoglobin); end-products are diagnostic (levels of glycosylated haemoglobin resides in serum for a long time) and damaging. Insulin resistant/impaired insulin secretion; overall, a decreased cellular response to insulin. Onset in mid-life (now seeing more and more cases in juveniles)

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