which type of diabetes takes insulin shots

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Nutr Hosp. 2013 Mar;28 Suppl 2:78-87. doi: 10.3305/nh.2013.28.sup2.6717.

which type of diabetes takes insulin shots Treatments (‚ėĎ recipes) | which type of diabetes takes insulin shots by racehow to which type of diabetes takes insulin shots for Author information

1
Department of Endocrinology, Hospital de Cl√≠nicas, Av. Pante√≥n, Urb. San Bernardino, Caracas, Venezuela. [email protected]

Abstract

in English, Spanish

El desarrollo de la DMT2 está provocado principalmente por dos mecanismos patogénicos: (a) un progresivo deterioro de la función de las células de los islotes pancreáticos que provoca una disminución de la síntesis de insulina y (b) una resistencia de los tejidos periféricos a la insulina que da como resultado un descenso de la respuesta metabólica a la insulina. Esta interacción entre la secreción y resistencia a la insulina es esencial para el mantenimiento de una tolerancia normal de la glucosa. El desarrollo de la diabetes mellitas tipo 2 puede describirse como una serie de alteraciones celulares y metabólicas que afectan y deterioran la homeostasis de la glucosa. La transición desde el control normal del metabolismo de la glucosa a la diabetes mellitus tipo 2 se produce a través de estados intermedios alterados de dicho metabolismo que empeoran con el tiempo. El primer estado de la enfermedad se conoce como prediabetes, y consiste en un conjunto de desordenes metabólicos caracterizados por una gran hiperglucemia, suficiente para incrementar la incidencia de retinopatías, nefropatías y neuropatías. Cuando avanzamos en la secuencia temporal de la DMT2 encontramos una notable alteración en la población de células del páncreas que componen los islotes de Langerhans, provocada principalmente por la acumulación sobre estas células de fibras de amilina procedentes de la hormona polipeptídica llamada polipéptido amiloide de los islotes o IAPP. Esta hipersecreción de IAPP y deposición de fibras de amilina junto al estrés del retículo endoplásmico provocado por el exceso de carga de trabajo debido a la sobreproducción en la biosíntesis de insulina e IAPP dan como resultado la apoptosis de las células ?. A todas estas alteraciones debemos sumar las observadas en los perfiles de incretinas como GIP (glucose-dependent insulinotropic polypeptide) y GLP-1 (glucagon-like peptide 1) relacionados directamente con el mantenimiento de la homeostasis de la glucosa. Los factores de riesgo que predisponen a una persona sana a desarrollar la DMT2 son varios, pero sobresale por encima de todos la obesidad. El índice de masa corporal (IMC) ha sido utilizado en numerosos estudios epidemiológicos como un potente indicador del riesgo de padecer DMT2. La lipotoxicidad causada por el aumento de ácidos grasos libres circulantes, el cambio en los perfiles de las lipoproteínas, la distribución de la grasa corporal y la glucotoxicidad provocada por la sobre-estimulación de las células son otros de los factores de riesgo a tener en cuenta en el desarrollo de la DMT2.

T2DM involves at least two primary pathogenic mechanisms: (a) a progressive decline in pancreatic islet cell function resulting in reduced insulin secretion and (b) peripheral insulin resistance resulting in a decrease in the metabolic responses to insulin. This dynamic interaction between insulin secretion and insulin resistance is essential to the maintenance of normal glucose tolerance (NGT). The transition from the normal control of glucose metabolism to type 2 diabetes mellitus occurs through the intermediate states of altered metabolism that worsen over time. The first state of the disease is known as prediabetes, and consists of a set of metabolic disorder characterized by a great hyperglycemia, enough to increase of retinopathies, nephropathies and neuropathies incidence. If we advance in the T2DM temporal sequence we found a remarkable change in the pancreatic cells population that form the Langerhans islets, mainly caused by amylin fibers accumulation over these cells from polypeptide hormone called amyloid polypeptide or IAPP. The IAPP hypersecretion and amylin fibers deposition attached to the endoplasmic reticulum stress caused by excessive workload due to biosynthesis overproduction of insulin and IAPP result in ?-cell apoptosis. In addition to these alterations, we must also consider the changes observed in incretins profiles like GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide 1) directly related to glucose homeostasis maintenance. Risk factors that predispose to a healthy individual to develop T2DM are several, but the most important is the obesity. The body mass index (BMI) has been used in numerous epidemiological studies as a powerful indicator of T2DM risk. Lipotoxicity caused by circulating free fatty acids increased, changes in lipoprotein profiles, body fat distribution and glucotoxicity caused by cells over-stimulation are other risk factors to consider in T2DM developing.

Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

PMID:
23834050
DOI:
10.3305/nh.2013.28.sup2.6717
[Indexed for MEDLINE]
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