Diabetes Mellitus and Insulin

Diabetes Mellitus and Insulin

We can break down food into many different
types of nutrients. One of the most important nutrients our body
needs is a sugar called glucose, which is the fuel that powers the cells of our body. Glucose is transported throughout the body
by blood and requires careful regulation, since too much glucose in the blood can lead
to disastrous consequences, such as diabetes mellitus. Watch this episode of Medicurio to learn more
about the symptoms, cause, and treatment of
this disease. Let’s talk about blood glucose regulation
first. The body has many ways to increase or decrease
the amount of glucose in the blood. Some ways to increase blood glucose include eating
a meal, synthesizing glucose from scratch, or releasing glucose from storage, while some
ways to decrease blood glucose are to transport glucose into cells, which either use up glucose
for energy or store it. Throughout the day, the body is constantly
making slight adjustments to keep blood glucose levels at an optimal range. These slight adjustments are controlled by
the hormones insulin and glucagon, but in this video, we’ll focus on insulin. Insulin is released into the bloodstream when
blood glucose is high, such as after a meal. It signals to cells to take in glucose for
energy or storage. It also prevents more glucose from being synthesized
or released from storage. Therefore, the overall effect of insulin is
to decrease blood glucose levels. Diabetes mellitus, or simply diabetes, occurs
when this insulin signalling pathway is broken. Without proper functioning of insulin, blood
glucose levels skyrocket. Despite glucose being a very important source
of fuel for the body, too much of it in the blood is extremely damaging. In the short term, high blood glucose leads
to the hallmark symptom of diabetes: glucosuria, or glucose in the urine. In fact, the term “mellitus” means “honey”
in Latin to reflect this symptom of sweet-tasting urine. How does this occur? At the kidneys, glucose is filtered out of
the blood and into the urine, but is later transported back into the blood since the
body does not want to lose this valuable source of fuel. This reabsorption uses proteins which have
a maximum rate of transport. When there is too much glucose in the blood,
more of it is filtered into the urine. Even at their maximum transport rate, the
proteins cannot transport all of the glucose out of the urine, leading to glucosuria. This causes excess urination, since the presence
of glucose in the urine draws in more water by osmosis. Excess thirst and dehydration are a consequence of this
since more water is lost through urine. In addition, since cells cannot take up glucose
for energy without insulin, the body perceives itself to be “starving”, leading to both
increased appetite and fatigue. In the long term, high blood glucose damages
blood vessels in the eyes and kidneys, which is why diabetes is the leading cause of adult
blindness and kidney failure. High blood glucose also damages nerves, leading
to loss of sensation in the feet and hands. When those areas get injured, such as from
cuts or from blood vessel damage, the person does not notice the injury, leading to infections
and necrosis that eventually require amputation. Most importantly, the damage to blood vessels
in the heart and brain can lead to high blood pressure, stroke, and heart attacks, which account for most of the deaths in diabetic patients. Most diabetes cases can be divided into two
types based on how the insulin signalling pathway is malfunctioning. Type 1 diabetes accounts for around 10% of diabetes cases, while Type 2 makes up most of the remainder. The last few percentage points are attributed
to rarer forms of diabetes that you can check out in the video description. Type 1 diabetes is caused by a lack of insulin
production. In the pancreas, there are special clusters
of endocrine cells called the islets of Langerhans. One type of endocrine cell in these islets
is the beta cell, which produce and release insulin. In Type 1 diabetes, the beta cells are destroyed
by the immune system. Therefore, the body can no longer produce
insulin and blood glucose levels rise uncontrollably, leading to the symptoms mentioned earlier. Scientists believe both genetic mutations
and environmental factors, such as infections, may play a role in triggering this autoimmune
attack. An additional symptom of Type 1 diabetes is
rapid weight loss, as fat cells, or adipocytes, begin to break down fats into another type
of energy molecule known as ketone bodies. Large amounts of these ketone bodies are released
into the blood, which can be taken up by other cells as an alternative source of fuel. However, ketone bodies are slightly acidic
molecules, so excessive amounts of these molecules can acidify the blood. This is known as diabetic ketoacidosis, which
is a life-threatening condition if untreated. However, when most people think of “diabetes”,
they are probably imagining the more common Type 2 diabetes associated with obesity, a
high sugar and fat diet, and a lack of exercise. These three lifestyle factors, as well as
genetic factors, dramatically increase the risk of developing Type 2 diabetes. Unlike Type 1 diabetics, Type 2 diabetics
continue to produce insulin. However, their cells have become resistant
to insulin, meaning that more insulin is required to achieve the same effect of lowering blood
glucose. To compensate for insulin’s ineffectiveness,
beta cells will produce even more insulin. However, when insulin resistance becomes so
severe that the insulin required by the body exceeds the maximum amount of insulin produced
by beta cells, symptoms of high blood glucose begin to appear. Weight loss and diabetic ketoacidosis from
fat breakdown also occur in some cases of Type 2 diabetes. Furthermore, in some cases the continued overproduction
takes a toll on the beta cells, which eventually die and causes a lack of insulin production,
further worsening the problem. The cause of insulin resistance is still not
well understood; however, factors such as high insulin levels from excessive sugar consumption
and fat around the liver and pancreas are being investigated as possible causes of insulin
resistance. It is important to note that it is very difficult
to “cure” diabetes as of now. Doctors are only able to make living with
diabetes tolerable, as long as medications are taken and lifestyle changes occur. Current treatment depends on the type of diabetes. Since the high blood glucose of Type 1 diabetes
is caused by a lack of insulin, simply administer insulin during periods of high blood glucose,
such as after a meal. However, this is easier said than done. Insulin is a protein and will get degraded
in the stomach if taken orally. Therefore, Type 1 diabetics must inject insulin
directly into the bloodstream, usually just under the skin of their abdomen. The dose is also extremely important – too
little and blood glucose levels remain high, but too much insulin will cause blood glucose
levels to plummet, leading to coma or even death. On the other hand, decreasing high blood glucose in Type 2 diabetes is much more complicated. Insulin is only effective in around 30% of
patients as cells are already insulin resistant, so other methods of decreasing blood glucose
are required. Many diabetic drugs have been developed which
target the mechanisms of blood glucose regulation mentioned in the beginning of this video. These drugs can decrease glucose absorption
in the intestines after a meal, decrease synthesis of new glucose, or increase insulin sensitivity
which leads to more glucose uptake by cells. For example, the drug metformin is the first
line treatment to Type 2 diabetes because it can activate certain metabolic pathways
to both decrease glucose synthesis and increase glucose uptake by cells by increasing insulin
sensitivity. However, despite our best efforts, diabetes
is the 6th leading cause of death worldwide, with 3 people dying from diabetes complications
every minute. Therefore, the best treatment of diabetes is to prevent diabetes from occurring in the first place. Though no prevention method is known for Type
1 diabetes, frequent exercise and a healthy diet drastically reduces the risk of the much
more common Type 2 diabetes. Currently, it is estimated that 400 million
adults, which is around 10% of the worldwide adult population, is living with diabetes,
although this number is expected to increase in the future. If more people become aware of and avoid the
lifestyle choices associated with diabetes, we can slow down or even reverse this trend. Furthermore, Type 2 diabetes in particular develops slowly and silently over time, leading scientists to suspect that almost half of the worldwide
diabetic population is undiagnosed, which is why it is so important to educate the public
about the causes and symptoms of this disease. It is also important to note that diabetes
is an extremely complex and not fully understood disease that scientists are still finding
new information about everyday. So if you want to learn more about diabetes,
like new treatments and research, check out the links in the description below. Thanks for watching, and see you next time
on Medicurio.

27 Replies to “Diabetes Mellitus and Insulin”

  1. It's worth mentioning that ketones are perfectly safe while you have a functioning pancreas!

    Great video. I did not know that some / most? T2 medicine is reducing the amount of glucose in the body when you could just reduce the consumption of carbohydrates.. But I guess that wouldn't earn the companies that produce those drugs any money…

  2. I'm a type 1 diabetic. If anyone has any questions regarding lifestyle changes as a type 1 I"m willing to answer them.

  3. Educating me while in High School would have been very helpful for me to understand what Type 2 diabetes is hand how to avoid it in later life.  Too late now.

  4. I thoroughly enjoyed your explanation, liked and subbed (and rung the little bell). However, If I can offer some critique of a disproportionately minuscule thing for how long this response is… In the last 20 seconds of your demonstration you suggest that diabetes is part of societal agency factors. Diet and exercise. Specifically, individuals that need to be held accountable for their own 'healthy lifestyle' (which is a paradox- worthy of self-investigation). Inadvertently, you make no mention of the structural factors of society that are intertwined with the epidemiology. For example. Not mentioning that there is also a free-market over-saturation of sugar and fat consumables available to people that makes these products cheaper in comparison to healthier alternatives; which affects individuals in lower socioeconomic positions more than others. Which exponentially worsens their situation.

    Companies that produce products and Governments that protect the companies, that essentially poison one tenth of the population should be held more accountable than the individual. Now to clarify what I mean by "Companies… Governments…should be held more accountable…" is that our collective focus can not solely rest on the individual, as the structural parameters that perpetuate poor health exists and we should challenge the status quo. Tobacco smoking, which is a similar product still exist under similar yet heavily reduced circumstances. Rates of smoking are decreasing in places around the world, and it is through education of the agency and the structural factors that this is possible.

    Also if you made it this far congratulations. But to squash any sugar lobbyist lurking about with the argument of "they chose to consume our products" I would say – You have knowingly profited off the ill health and suffering of may individuals and you have come to the rescue of your own disintegrating moral complex and capital self-interests, Bravo.

  5. A subcutaneous injection is not directly into the blood. It is injected into adipose, fat, tissue.

  6. Explicit explaination. I have some doubts regarding weight gain in type 2 diabetes. I know that obesity(mainly abdominal) induce insulin resistance because they release adipokines .My question is why there's no significant muscle wasting and weight loss in these patients as they also aren't able to use glucose as primary fuel and would eventually end up using stored fat and proteins, so they should become lean. I appreciate if you can clear my doubt.

  7. I'm on the Autism Spectrum can you do a vid on the way the brain is affected please I hate having to explain this near constantly I'm no good with simple explanations you are please do this

  8. Question: I could be getting a Pancreas transplant in the near future. The doctors say this will essentially cure my type 1 diabetes. If type one is caused by my immune system attacking my beta cells, wouldn't my immune system just do it all over again?

  9. I got taught about diabetes so many times both in school and high school that I think I could rehearse this video from memory lol

  10. The cure for type 2 diabetes is simple: stop eating so many carbs. You're body will heal itself and go away. Unfortunately, no one apparently can see this simple pathological solution and implement it. Carbohydrate over-consumption leads to diabetes in 99% of the cases. Just. Stop. Eating. Unnecessary. CARBS. That's all.

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