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Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period.
Journal of Diabetes and islet Biology presents findings, analysis and commentary on the battle with Type I and Type II diabetes. Articles published in Journal of Diabetics and islet Biology address improvements in current therapeutics and patient compliance together with perspectives on future prospects. The journal also reflects the frontiers of current research, such as attempts to recreate pancreatic cells through stem cell technology or islet cell transplantation.
We welcome eminent manuscripts of Research/ Review/ Case Studies/ Short Communications/ Opinions/ Letter to Editors/ Mini Reviews/ Presentations/ Perspective Studies etc. for publication. The wide scope of the journal will aid in contributing a great measure of scientific information related to the advances in towards better healthcare. The Journal is using double-blind peer-review for the manuscript processing. Each article undergoes this peer review process under the aegis of an assigned Editor. To be acceptable for publication, an article should be positively considered by two individual reviewers followed by the Editor’s consent.
Pathophysiology of Diabetes:
In normal persons the hormone insulin, which is made by the beta cells of the pancreas, regulates how much glucose is in the blood. When there is excess of glucose in blood, insulin stimulates cells to absorb enough glucose from the blood for the energy that they need. In this condition the immune system attacks and destroys the insulin producing beta cells of the pancreas. There is beta cell deficiency leading to complete insulin deficiency. Thus is it termed an autoimmune disease where there are anti-insulin or anti-islet cell antibodies present in blood. These cause lymphocytic infiltration and destruction of the pancreas islets. The destruction may take time but the onset of the disease is rapid and may occur over a few days to weeks.
Globally, an estimated 422 million adults are living with diabetes mellitus, according to the latest 2016 data from the World Health Organization (WHO). Diabetes prevalence is increasing rapidly; previous 2013 estimates from the International Diabetes Federation put the number at 381 million people having diabetes. The number is projected to almost double by 2030.Type 2 diabetes makes up about 85-90% of all cases. Increases in the overall diabetes prevalence rates largely reflect an increase in risk factors for type 2, notably greater longevity and being overweight or obese.
The WHO estimates that diabetes resulted in 1.5 million deaths in 2012, making it the 8th leading cause of death. However another 2.2 million deaths worldwide were attributable to high blood glucose and the increased risks of associated complications (e.g. heart disease, stroke, kidney failure), which often result in premature death and are often listed as the underlying cause on death certificates rather than diabetes.
There are three main types of diabetes mellitus:
Type 1 DM results from the pancreas's failure to produce enough insulin. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes"] The cause is unknown.
It is caused by the immune-mediated destruction of pancreatic beta cells, leading to insulin deficiency, hyperglycaemia and the risk of ketoacidosis.
Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly.
Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses a lack of insulin may also develop. This form was previously referred to as "non-insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". The most common cause is excessive body weight and insufficient exercise.
Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.
Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. They and their children are also at increased risk of type 2 diabetes in the future.
Gestational diabetes is diagnosed through prenatal screening, rather than through reported symptoms.
Diabetic Complications includes:
Diabetic Peripheral Neuropathy
Cholesterol targets for people with diabetes and can regulate signal transduction through membrane microdomains and gene expression through cholesterol-activated transcription factors.
Hypoglycemia, also known as low blood sugar, is when blood sugar decreases to below normal levels. This may result in a variety of symptoms including clumsiness, trouble talking, confusion, loss of consciousness, seizures, or death
High blood sugar, or hyperglycemia, is a major concern, and can affect people with both type 1 and type 2 diabetes.
There are two main kinds:
Postprandial or after-meal hyperglycemia
Obesity and Diabetes:
Being overweight or obese increases the chances of developing the common type of diabetes, type 2 diabetes. In fact, being overweight can cause your body to become resistant to insulin. If you already have diabetes, this means you will need to take even more insulin to get sugar into your cells.
Diabetes and Weight Loss:
Weight loss is a common recommendation for treatment for type 2 diabetes. Many people are overweight when they’re first diagnosed, and that extra fat actually increases their insulin resistance.
In people with diabetes, insufficient insulin prevents the body from getting glucose from the blood into the body's cells to use as energy. When this occurs, the body starts burning fat and muscle for energy, causing a reduction in overall body weight.
Reversing diabetes is a term used to describe interventions that reduce dependency on type 2 diabetes medications, effectively reversing the progression of the illness.
Lipids and Diabetes:
The interrelationship between blood lipid levels and elevated blood glucose levels is compelling. The American Diabetes Association describes a pattern of lipids (diabetic dyslipidemia) that is common to both pre-diabetics and diabetics. It consists of a moderate elevation of triglyceride levels, lower HDL cholesterol levels and small, dense LDL particles. This pattern of lipoproteins has been associated with insulin resistance and has been found even before the onset of diabetes.
Diabetes, Alcohol, and Social Drinking:
People with diabetes should be particularly cautious when it comes to drinking alcohol because alcohol can make some of the complications of diabetes worse. First of all, alcohol impacts the liver in doing its job of regulating blood sugar. Alcohol can also interact with some medications that are prescribed to people with diabetes.
Advances of Diabetes Cure:
Continuous Glucose Monitoring (CGM) is a relatively new technology which has the potential to assist people living with type 1 or type 2 diabetes and treated with insulin to achieve the goal of optimum control of blood glucose.
Current Research on Diabetes:
April 23, 2018: A particular protein that affects the healing of foot and lower leg wounds in people with diabetes has been identified, this study shows that thrombospondin-2 (TSP2) could be a target for a specific therapy for diabetic wounds.
March 27, 2018: An artificial pancreas has shown to result in fewer hypos in women during pregnancy. The study believes the lack of significant improvement in time spent in range could be attributable to the small number of participants or varying levels of familiarity with the technologies
November 28, 2018: Diabetes and obesity together responsible for nearly 800,000 cancers worldwide, For the first time researchers have quantified the number of cancers likely to be caused by diabetes and high body mass index (BMI).
Diagnosis and treatment:
The diagnosis is based on measurement of A1C level, fasting or random blood glucose level, or oral glucose tolerance testing. Although there are conflicting guidelines, most agree that patients with hypertension or hyperlipidemia should be screened for diabetes. Diabetes risk calculators have a high negative predictive value and help define patients who are unlikely to have diabetes. Tests that may help establish the type of diabetes or the continued need for insulin include those reflective of beta cell function, such as C peptide levels, and markers of immune-mediated beta cell destruction (e.g., autoantibodies to islet cells, insulin, glutamic acid decarboxylase, tyrosine phosphatase [IA-2α and IA-2β]). Antibody testing is limited by availability, cost, and predictive value.
Prevention, timely diagnosis, and treatment are important in patients with diabetes mellitus. Many of the complications associated with diabetes, such as nephropathy, retinopathy, neuropathy, cardiovascular disease, stroke, and death, can be delayed or prevented with appropriate treatment of elevated blood pressure, lipids, and blood glucose.
Pancreatic islet physiology:
The pancreatic islets constitute 1 to 2% of the pancreas volume and receive 10–15% of its blood flow. The pancreatic islets are arranged in density routes throughout the human pancreas, and are important in the metabolism of glucose
Individual islets consist of three major types of electrically excitable cells, namely β‑cells that secrete insulin, α‑cells that secrete glucagon and δ‑cells that secrete somatostatin. Islets develop from the gut endoderm and a set of transcription factors including PDX1, PAX4 and PAX6, play important roles in determination of the cell types and their functions.
The islets of Langerhans, endocrine micro-organs within the pancreas, are at the center of multiple metabolic diseases, from hyperinsulinism to diabetes. Islets elaborate the key hormones, glucagon and insulin that control glucose homeostasis, and their dysfunction in diabetes causes severe morbidity in more than 300 million people worldwide, with associated healthcare costs in the hundreds of billions of dollars annually.
Advances in Islet Cell Biology:
During the past 10 to 15 years, there has been significant progress in our understanding of pancreatic islet development and islet biology. This knowledge has been complemented and accelerated by major advances in diverse fields including islet transplantation, stem cells, small molecule screening, high-throughput sequencing, epigenetics and human genetics.
The new era of pancreatic islet transplantation was opened by the successful restoration of euglycemia in patients with type 1 diabetes by the Edmonton group in Alberta, Canada. Their successes have been reproduced by several other transplant centers and have increased in every aspect of islet transplantation. To reflect this, two-thirds of the 2002 Levine symposium program provided updated information on pancreas development, differentiation of islet and/orcellsand gene expression, islet cell signaling networks, and ex vivo generation ofcells. The remaining one-third of the program covered issues related to clinical islet transplantation, including recent advances in islet isolation and culture technologies, strategies in immune tolerance induction, update of the Immune Tolerance Network (ITN) Trial, and regulatory issues in islet transplantation.
Advances in islet encapsulation technologies:
Although islet transplantation has proved to be successful for some patients with type 1 diabetes, its widespread use is limited by islet donor shortage and the requirement for lifelong immunosuppression. An encapsulation strategy that can prevent the rejection of xenogeneic islets or of stem cell-derived allogeneic islets can potentially eliminate both of these barriers. Although encapsulation technology has met several challenges, the convergence of expertise in materials, nanotechnology, stem cell biology and immunology is allowing us to get closer to the goal of encapsulated islet cell therapy for humans.
Blood glucose level
Fasting blood glucose
Oral glucose tolerance test
stem cell encapsulation