1. What is Diabetes?

Diabetes Mellitus is a chronic metabolic disorder characterized by high blood glucose (hyperglycemia) resulting from defects in insulin secretion, insulin action, or both.

  • Type 1 Diabetes: Autoimmune destruction of pancreatic β-cells; little or no insulin produced.
  • Type 2 Diabetes: Insulin resistance and relative insulin deficiency; often associated with obesity.
  • Gestational Diabetes: Occurs during pregnancy; increased risk for both mother and child.

2. Glucose Regulation

  • Insulin: Hormone produced by β-cells in the pancreas; lowers blood glucose by facilitating cellular uptake.
  • Glucagon: Hormone produced by α-cells; raises blood glucose by stimulating hepatic glucose production.

Diagram: Glucose Regulation

Glucose Regulation Diagram

3. Pathophysiology

Type 1 Diabetes

  • T-cell mediated autoimmune destruction of β-cells.
  • Absolute insulin deficiency.
  • Rapid onset, usually in children/young adults.

Type 2 Diabetes

  • Insulin resistance in muscle, fat, and liver.
  • Compensatory hyperinsulinemia initially, followed by β-cell dysfunction.
  • Gradual onset, mainly in adults.

Diagram: Pathophysiology of Diabetes

Diabetes Pathophysiology

4. Symptoms & Complications

Symptoms

  • Polyuria (frequent urination)
  • Polydipsia (excessive thirst)
  • Polyphagia (increased hunger)
  • Fatigue
  • Blurred vision

Complications

  • Microvascular: Retinopathy, nephropathy, neuropathy
  • Macrovascular: Cardiovascular disease, stroke
  • Acute: Diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS)

5. Diagnosis

  • Fasting Plasma Glucose ≥ 126 mg/dL
  • HbA1c ≥ 6.5%
  • Oral Glucose Tolerance Test (OGTT): 2-hour plasma glucose ≥ 200 mg/dL

6. Treatment & Management

  • Type 1: Lifelong insulin therapy, blood glucose monitoring, diet, exercise
  • Type 2: Lifestyle modification, oral hypoglycemics, insulin (if needed)
  • Gestational: Dietary management, insulin if required

Monitoring

  • Continuous Glucose Monitoring (CGM)
  • Self-Monitoring Blood Glucose (SMBG)
  • HbA1c testing (every 3-6 months)

7. Emerging Technologies

Artificial Pancreas

  • Closed-loop system combining CGM and insulin pump.
  • Automatically adjusts insulin delivery.

Smart Insulin Pens

  • Bluetooth-enabled pens track doses and timing.

Non-Invasive Glucose Monitoring

  • Wearable sensors using sweat, tears, or interstitial fluid.

Stem Cell Therapy

  • Research into β-cell regeneration or replacement.

Recent Research

In 2021, a study published in Nature Biotechnology demonstrated successful transplantation of stem cell-derived pancreatic cells in Type 1 diabetes patients, showing promising results for insulin independence (ViaCyte, Inc., 2021).

8. Surprising Facts

  1. Diabetes affects the brain: Chronic hyperglycemia can impair cognitive function and increase risk for dementia.
  2. Diabetes can occur in animals: Dogs, cats, and even dolphins can develop diabetes.
  3. The human brain has more connections than stars in the Milky Way: There are approximately 100 trillion synaptic connections in the human brain, vastly outnumbering the estimated 100-400 billion stars in our galaxy.

9. Mind Map: Diabetes Science

Diabetes Mind Map

10. Ethical Issues

  • Access to Care: Disparities in diabetes treatment and technology availability.
  • Genetic Testing: Privacy concerns with genetic predisposition screening.
  • Data Security: Risks associated with personal health data from wearable devices.
  • Stem Cell Therapy: Ethical debates over source and use of stem cells.
  • AI in Diagnosis: Potential for bias in algorithms affecting patient outcomes.

11. References

  • ViaCyte, Inc. (2021). Stem cell-derived pancreatic cells for Type 1 diabetes. Nature Biotechnology, 39(11), 1454–1462.
  • American Diabetes Association. Standards of Medical Care in Diabetes—2023. Diabetes Care, 46(Supplement_1), S1–S154.

12. Key Terms

  • Hyperglycemia: High blood sugar
  • Hypoglycemia: Low blood sugar
  • Insulin Resistance: Reduced cellular response to insulin
  • Autoimmunity: Immune system attacking own tissues
  • β-cells: Insulin-producing pancreatic cells

13. Study Tips

  • Use diagrams to visualize glucose regulation and complications.
  • Review ethical issues and emerging technologies for current events discussions.
  • Practice explaining diabetes types and their differences.
  • Stay updated with recent research for advanced understanding.