@Saleh123 16 September 2020

Journey inside disease(Diabetes Mellitus-1)

Hello learners Before I start my journey I wanna thank 2 great writers in read cash from whom I really got inspiration to write about diseases. First one is @Jane from whom i took advice at first. And second one is @Hanzell because reading hanzells articles brought be inspiration to start writing academic articles. Today i am going to travel inside a most common disease from which most of us or our parents, our relatives suffers a lot. May be some of you can guess which disease I wanna mean. The dangerous *****Diabetes Mellitus*****. Many people says that diabetes mellitus is the root of many many principal diseases. Again many of them wanna refer it as a morbid disease. So lets proceed in.... The diabetes mellitus

**Definition of diabetes mellitus**: A group of metabolic disorders of carbohydrate metabolism in which glucose in underutilized producing hyperglycemia. Or Lets see another definition Diabetes mellitus is a heterogenous group of multifactorial, polygenic syndromes charecterized by elevation of blood glucose caused by a relative or absolute deficiency in insulin. **Note**:here ***multifactorial*** means mixture of different differnet causes genetic and environmental. Examples of some diseases are diabetes mellitus, hypertension etc. ***Polygenic*** means multiple genes involved. ***Syndromes*** means not a single problem together many problems ***Insulin deficiency*** may be absolute or relative. Absolute deficiency means decreased insulin secretion from pancreas(normally 250-300 unit secretes) normally tgese type of diabetes is type 1 diabetes. Relative deficiency means insulin resistance normally these types of diabetes is called type 2 diabetes.(usually after age 60 type 2 diabetes occurs) Now come to the classification of diabetes ****Classification of diabetes mellitus****: 1. Type-1 diabetes mellitus 2. Type-2 diabetes mellitus 3. Other specific types of diabetes mellitus 4. Gestational diabetes mellitus (Who doesnt have diabetes mellitus before but in pregnancy 1st diabetes recongnized ) Now lets collaborare each types of diabetes 1. **Type- 1 diabetes mellitus** **Causes**: a. absolute deficiency of insulin caused by autoimmune attack on beta cells of pancreas. b. Some have no evidences of autoimmunity and classified as type 1 idiopathic (cause is unknown) **Charecteristics**: - They have insulinopenia( deficiency in insulin) -seventy five percent occurs before the age of eighteen -five to ten percent of all cases of diabetes are in this group.

2. **Type-2 diabetes mellitus** 90% of all cases of diabetes are in this group. **Causes of type- 2 diabetes mellitus** 1. Insulin deficiency 2. Dysfunctional beta cells of pancreas May be many of you ask me what is isnulin resistance. Is it fighting against insulin. Ha ha ha. May be something like that. Let me clear it to you **Insulin resistance** **Definition of insulin resistance** Its is the decresed abilty of the target tissues such as liver adipose tissue and muscles to respond properly to normal or elevated circulating concentrations of insulin. Its is **charecterized** by uncontroled hepatic glucise production and decrese glucose uptake by muscle and adipose tissue. ( because of decreased insulin dependent glut 4 -Source lipincott of biochemistry) **Causes of insulin resistance**: 1. Obesity 2. Gestational diabetes mellitus 3. PCOS ( poly cystic ovary disease) 4. Growth hormone excess 3. Other types of diabetes mellitus Important Causes of them : 1. Genetic defects if beta cell function 2. Geentic defects in insulin action. 3. Disease of the exocrine pancreas. 4. Endocrinopathies A. Cushing syndrome ( steroid increses drastically ) B. Acromegaly ( increased growth hormone) C. Glucagonoma ( glucagon secreting tumor ) 5. Administrations of hormones of drugs known to induec beta cell dysfunction (dilatine, pentamadine ) or impair insulin action. ( 1. Glucocorticoids, thiazides, beta adrenergics or beta agonist ) 6. Infection 7. Uncommon forms of immune mediated diabetes. 8. Other genetic conditions( example: down syndrome, kline filter syndrome) I think you are bored today, let me continue it tomorrow. thanks for patience. yeah, **if you dont want to miss my writing please subscribe** **and if you have think there is some correction needed please feel free to say in comment box.** (All these informations provided here are taken from the academic note I made it under care of my respected teacher assistant prof. Dr. Md. Rezaul Qader-Head of the Department, Biochemistry)