Diabetes in pregnancy
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
Diabetes mellitus is a heterogeneous group of disorders all characterized by hyperglycemia. Type 2 diabetes, as described above, is commonly related to obesity and appears to be inherited in a polygenic manner. There are a number of less common forms of type 2 diabetes, formerly called “MODY” (maturity onset of diabetes in youth), which are inherited as single gene defects in an autosomal dominant manner (3). It is not yet clear whether insulin resistance alone is sufficient to cause type 2 diabetes or whether there must also be an element of relative insulinopenia. Type 1 diabetes, on the other hand, is an autoimmune disorder in which the immune system is directed against the islet cells in the pancreas. There is clearly a genetic predisposition toward such pancreatic destruction, as evidenced by the preponderance of specific HLA antigens in individuals with type 1 diabetes. However, the genetic predisposition is not sufficient to bring about the disease, as evidenced by the less than 50% concordance of identical twins for this disorder (3).
Diagnosis and Screening of Diabetes Mellitus in the Elderly
Medha N. Munshi, Lewis A. Lipsitz in Geriatric Diabetes, 2007
Type 1 diabetes is essentially the result of β-cell destruction, which usually leads to absolute insulin deficiency. The rate of β-cell destruction is variable. Traditionally this form of immune-mediated diabetes was thought to occur during childhood and adolescence, however it can occur at any age; rarely even in the eighth and ninth decade of life (16). Patients with type 1 diabetes ultimately become insulinopenic requiring insulin therapy for survival. The presentation of type 1 diabetes is usually acute or sub-acute with classic symptoms of polyuria, polydipsia, polyphagia, loss of weight, recurrent infections, or fatigue. Type 1 diabetes in older adults tends to present in a more sub-acute or chronic manner mimicking type 2 diabetes with fewer symptoms to none at all. This particular form of diabetes is often referred to as latent autoimmune diabetes of the adult (LADA).
Diabetes
Hugh McGavock, Dennis Johnston in Treating Common Diseases, 2017
The main treatment of type 1 diabetes is the replacement of insulin, supplemented by a balanced, calorie-controlled diet and regular, rhythmic exercise (walking, jogging, cycling, swimming or aerobics, depending on individual ability and preference). Figure 6.1 shows the pattern of normal insulin secretion over 24 hours. Note the rapid onset of high concentrations of insulin within minutes of starting each meal, and the return to baseline concentrations within 3 hours, coinciding with the digestion and absorption of food and the consequent rise in blood glucose, amino acids and fats. Note also that there is a minimum ‘background’ basal secretion of insulin between meals and at night. In type 1 diabetes, insulin secretion is zero, or close to zero. Modern treatment aims to replicate this normality, in so far as that is possible.
Transplantation of rat pancreatic islets vitrified-warmed on the nylon mesh device and the silk fibroin sponge disc
Published in Islets, 2020
Kenyu Nakayama-Iwatsuki, Takahiro Yamanaka, Jun Negishi, Junki Teshima, Yasushi Tamada, Masumi Hirabayashi, Shinichi Hochi
Type I diabetes mellitus (T1D) is a consequence of the destruction of insulin-producing pancreatic β-cells due to an autoimmune disorder, which leads to chronic hyperglycemia, affecting the functionality of various organs. The transplantation of pancreatic islets has been considered useful for the clinical treatment of T1D since the Edmonton protocol for islet transplantation made the long-term insulin independence of T1D patients possible using a glucocorticoid-free immunosuppressive regimen.1 However, multiple transplantation treatments are required by most patients to achieve insulin independence. As the islet number required for a transplantation treatment exceeds the total number of islets isolated from a single donor, the severe shortage of islet donors is a significant limitation of the global dissemination of islet transplantation.2 Furthermore, damages of the islet and extracellular matrix due to enzymatic digestion during the islet isolation process3 as well as an instant blood-mediated inflammatory reaction4 lead to the loss of transplanted islets, causing an increase in the islet number required for successful transplantation.
Effect of resveratrol treatment on graft revascularization after islet transplantation in streptozotocin-induced diabetic mice
Published in Islets, 2018
Eun-Mi Lee, Inwon Park, Ye-Jee Lee, Young-Hye You, Ji-Won Kim, Myung-Jun Kim, Yu-Bae Ahn, Pilhan Kim, Seung-Hyun Ko
Type 1 diabetes is a progressive autoimmune disease characterized by immune-mediated destruction of insulin-producing β–cells within pancreatic islets. Patients should be treated with multiple exogenous insulin injections daily throughout their lifetime. Therefore, ITx is considered an attractive therapy to cure type 1 diabetes. For this reason, the ITx technique has progressed rapidly over of the last 40 years, and applied to highly selected patients with type 1 diabetes.5,28 However, several obstacles, such as donor availability or selection, engraftment, islet damage during procurement process, and side effects of immunosuppression must be overcome.29,30 Enormous acute stress and injury to islets during this process could be derived from hypoxia, inflammatory cytokines, or oxidative stress.15,28 Therefore, a highly pure, viable, and sufficient number of isolated islets with successful revascularization of transplanted islets are critical elements.
Use of genetically modified lactic acid bacteria and bifidobacteria as live delivery vectors for human and animal health
Published in Gut Microbes, 2022
Romina Levit, Naima G. Cortes-Perez, Alejandra de Moreno de Leblanc, Jade Loiseau, Anne Aucouturier, Philippe Langella, Jean Guy LeBlanc, Luis G. Bermúdez-Humarán
Type 1 diabetes is a chronic autoimmune disease characterized by a destruction of the insulin-producing β cells of the pancreas due to attack by autoreactive T cells resulting in hyperglycemia. L. lactis has been studied as a vehicle for oral vaccines in the treatment of different autoimmune diseases. Oral immunization with a GM strain of L. lactis expressing the heat shock protein 65 and tandemly repeated IA2P2 (HSP65-6IA2P2) in mice was studied. It was observed that the GM strain was capable of efficiently delivering the antigen at the mucosal level, inducing immunotolerance and preventing the appearance of type 1 diabetes in animals.143 A genetically modified L. lactis strain was also used as a strategy to administer proinsulin and IL-10 combined with low dose of anti-CD3 (aCD3) and it was observed a restoration of β-cell tolerance and glucose homeostasis in diabetic mice.144 In addition, a GM strain of L. lactis expressing IL-4 and IL-10 was able to protect against type 1 diabetes in mice by preventing hyperglycemia and reducing pancreatic cell destruction.145
Related Knowledge Centers
- Blurred Vision
- Glucose
- Hyperglycemia
- Polyphagia
- Immune System
- Autoimmune Disease
- Polydipsia
- Polyuria
- Insulin
- Blood Sugar Level