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Diabetes mellitus
Definition
Diabetes is a metabolic disorder resulting in abnormally
high blood sugar levels (hyperglycemia)
Blood sugar is normally
controlled by a hormone called
insulin that is secreted by the
pancreas
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History of Diabetes
First known reference comes from an
Egyptian papyrus dating back to 1550 BC
Diabetes was named by the Greek
physician Aretaeus between 30 and
90 AD
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History of the Disease
Avicenna, a famous Arab physician, described
the complications of the disease and how it
progressed
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French physician Bouchardat recognized
the importance of calorie intake in the
1870s
History of the Disease
Paul Langerhans identified the importance of the pancreas
in the early 19th century and discovered the islets of
Langerhans, a group of cells that would later be known to
produce insulin
History of the Disease
Frederick Banting discovered the hormone insulin and won
the Nobel Prize for his efforts in the 1920s
Mental Break 1
• Who is this?
Mental Break 1
• How about this?
Mental Break 1
• And finally, who is
this?
Statistics
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8% of the population has some form of diabetes
The number of cases increased by 13.5% between
2005 and 2007
Total economic cost of diabetes in the United States
in 2007 was estimated at $174 billion
Healthy Metabolism
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Diabetic Metabolism
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How might this cause problems?
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How it causes problems
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Too much glucose inhibits the
reabsorption of water by the kidney
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Causes excessive thirst and urination
It gets absorbed by parts of the body in
which excess glucose is not tolerated
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Eyes, kidneys, nerves, heart
Can you guess what kind of
major complications excess
glucose in these organs would
cause?
Why diabetes is bad
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If left uncontrolled, diabetes can lead to:
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Heart attack/Stroke – the risk of each is 2 to 4
times higher in people with diabetes
High Blood Pressure – 73% of diabetics have
high blood pressure
Blindness – diabetes is the leading cause of
blindness in adults 20-74 years of age
Why diabetes is bad
Why diabetes is bad
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Kidney failure – diabetes is also the leading
cause of kidney failure
Ketoacidosis - diabetic comas due to
biochemical imbalances that can even lead to
death
Diabetes can also lead to nervous system
disease, gum disease, and pregnancy
complications
Why diabetes is bad
Signs and Symptoms
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Excessive urine production
 Results in increased thirst and fluid intake
Blurred vision
Weight loss (Type 1)
Lethargy
Changes in metabolism
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Diagnosis
Doctors use either a Fasting Plasma Glucose Test
(FPG) or an Oral Glucose Tolerance Test (OGTT) to
confirm that a patient has diabetes
The FPG is recommended because it is easier, faster,
and less expensive to perform
Mental Break 2
• A Public Service Announcement from Michael
Phelps…
• Breakfast: Three fried-egg sandwiches loaded with
cheese, lettuce, tomatoes, fried onions and mayonnaise.
Two cups of coffee. One five-egg omelet. One bowl of
grits. Three slices of French toast topped with powdered
sugar. Three chocolate-chip pancakes.
• Lunch: One pound of enriched pasta. Two large ham
and cheese sandwiches with mayo on white bread.
Energy drinks packing 1,000 calories.
• Dinner: One pound of pasta. An entire pizza. More
energy drinks.
Mental Break 2
• So, eating 12,000
calories a day is ok if
you are Michael
Phelps
Types
Type
1
Type 2
Gestational
Risk factors and treatment for diabetes differ slightly
between the types
However, genetics impact both type 1 and type 2:
having relatives with diabetes increases ones chances
of getting the disease.
Type 1
5-10% of diagnosed diabetes cases in humans
Immune system destroys beta cells in the pancreas,
the only cells in the body capable of making insulin.
Previously known as juvenile diabetes because it most
often diagnosed in children and young adults
Unlike Type 2, diet and exercise cannot prevent the
disease.
Treatment of Type 1
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Insulin replacement therapy – insulin is
supplemented to the body either by injection or an
insulin pump
Strict dietary management is required carbohydrate tracking and monitoring glucose levels
Both of these have to be kept up for the life of the
patient
Treatment of Type 1
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Type 2
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90-95% of diagnosed diabetes cases in humans
Pancreas produces insulin, but the body’s response
to insulin is diminished
Unlike type 1, it is usually a late-onset disease,
meaning that it develops later in life
Type 2
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Prevalence is rapidly increasing and it is also being
found more often in younger people
Both of these observations are being linked to the
obesity epidemic that has taken over the globe.
Obesity has been found to cause increased insulin
resistance which can result in diabetes
Type 2
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Over 85% of diabetics have a Body Mass Index of
over 25, which is classified as overweight
Over 55% have a BMI of over 30, which is obese
Treatment and Prevention of
Type 2
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A proper diet and good exercise habits can support
weight loss and effectively limit the effects of the
disease.
Management of glucose levels
is still required and often
insulin replacement therapy
is also needed.
Gestational
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Characterized by high glucose levels in pregnant
women who never showed signs of diabetes before
their pregnancy
Affects about 3-10% of pregnancies
It is believed that hormones released during
pregnancy increase insulin resistance
Gestational Cont…
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Babies are at increased risk of complications
Mothers are at increased risk of developing type 2
diabetes after pregnancy
It is a treatable condition by controlling diet,
monitoring glucose, and giving insulin when
necessary
Mental Break 3
• Who can name the hormone that regulates
glucose?
• Which diabetes is treatable with diet and
exercise?
• What is the largest planet in the solar
system?
Presentation in Animals
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Diabetes is a growing problem in both dogs and cats
Dogs are most often
found to have type 1
diabetes, while cats
have a combination
Symptoms
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Symptoms are similar to those in humans
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Sudden weight loss or gain
Excessive drinking or urination
Appetite is either excessive or absent
Dogs are highly sensitive to eye problems such as blurred
vision and cataracts
In cats, the back legs become weak and their gait may
become wobbly or stilted
Thinning of the skin can also occur
Dehydration can finally lead to death
Treatment

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If left untreated, diabetes is life-threatening in
pets.
However, diagnosis and treatment by a veterinarian
can control the disease, prolonging life, and can
even lead to remission in cats.
Diet
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A simple change of diet can go a long ways in
helping to reduce the effects of diabetes.
A low-carbohydrate diet reduces the amount of
insulin needed and stabilizes blood sugar levels in
cats.
A high-fiber, moderate-carb diet has been
recommended for dogs.
Medications
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The most common form of treatment in pets is
insulin injections similar to those used in humans.
Oral medications in the form of pills are available,
but are not often recommended because they are
much less effective.
Ongoing Research
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Type 1 Treatment
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Islet Cell Encapsulation – transplant of insulin-producing
Islet cells encapsulated in permeable membrane to get
around the immune system
Islet Cell Regeneration – Involves a protein that is
responsible for the regeneration of Islet cells and other
important hormones in the pancreas – in clinical trials
Islet cell development from stem cells
Ongoing Research
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Type 1 Treatment
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Gene Therapy – an oral medication consisting of viral
vectors containing the insulin gene is digested and
delivered to the upper intestines where it is reproduced
Type 1 Prevention
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Immunization – a biochemical mechanism is being
researched that prevents the immune system from
attacking beta cells
Ongoing Research
Islet Cell
Nanotechnology
Any Questions?
References
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http://www.diabetes.org/home.jsp
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http://en.wikipedia.org/wiki/Diabetes
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http://www.idb.hr/diabetologia/05no4-1.pdf
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http://chinese-school.netfirms.com/diabetes-history.html
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http://blogs.wsj.com/health/2008/08/13/the-michael-phelps-dietdont-try-it-at-home/