Diabetes Mellitus Type 2 is a complex chronic metabolic disorder characterised by increased insulin resistance and impaired insulin secretion by pancreatic beta cells and involving an interplay of various genetic and environmental factors. This report discusses the pathogenesis and long term complications of type 2 diabetes as well as several pharmacological treatments.
Pathogenesis of Type 2 Diabetes Genetic predisposition contributes to the pathogenesis of Type 2 diabetes as evidenced by a disease concordance rate greater that 90% in monozygotic twins. Environmentally, the most important risk factor is obesity, with 80% of type 2 diabetes patients being obese, and the global incidence of diabetes rising proportionally with obesity rates.
Insulin resistance is the decreased response of peripheral tissues, especially adipose and liver tissue, and skeletal muscle to insulin. Beta cell dysfunction is the failure of pancreatic cells to secrete insulin when …show more content…
Glucotoxicity due to chronic hyperglycaemia.
The abnormal incretin effect resulting in reduced levels of GIP and GLP-1, which promote insulin release.
Amyloid deposits within the islets of beta cells, which may be either a cause or effect of long-standing type 2 diabetes.
Many of the genetic polymorphisms which are associated with a lifetime increase in type 2 diabetes risk occur in genes regulating insulin secretion.
Pathophysiology and Long Term Consequences of Hyperglycaemia
Long term complications of diabetes involve four potential mechanisms caused by sustained hyperglycaemia:
Formation of Advanced Glycation End Products (AGEs) due to non-enzymatic reactions between intracellular glucose-derived dicarbonyl precursors and amino groups of both intra- and extracellular proteins is accelerated in a hyperglycaemic state. These AGEs bind to RAGE receptors on inflammatory cells, endothelium, and vascular smooth
Pathogenesis of Type 2 Diabetes Genetic predisposition contributes to the pathogenesis of Type 2 diabetes as evidenced by a disease concordance rate greater that 90% in monozygotic twins. Environmentally, the most important risk factor is obesity, with 80% of type 2 diabetes patients being obese, and the global incidence of diabetes rising proportionally with obesity rates.
Insulin resistance is the decreased response of peripheral tissues, especially adipose and liver tissue, and skeletal muscle to insulin. Beta cell dysfunction is the failure of pancreatic cells to secrete insulin when …show more content…
Glucotoxicity due to chronic hyperglycaemia.
The abnormal incretin effect resulting in reduced levels of GIP and GLP-1, which promote insulin release.
Amyloid deposits within the islets of beta cells, which may be either a cause or effect of long-standing type 2 diabetes.
Many of the genetic polymorphisms which are associated with a lifetime increase in type 2 diabetes risk occur in genes regulating insulin secretion.
Pathophysiology and Long Term Consequences of Hyperglycaemia
Long term complications of diabetes involve four potential mechanisms caused by sustained hyperglycaemia:
Formation of Advanced Glycation End Products (AGEs) due to non-enzymatic reactions between intracellular glucose-derived dicarbonyl precursors and amino groups of both intra- and extracellular proteins is accelerated in a hyperglycaemic state. These AGEs bind to RAGE receptors on inflammatory cells, endothelium, and vascular smooth