Pathophysiology 2 types of Diabetes

Question: Describe about pathophysiology of type 2 diabetes? Answer: Dysfunction insulin secretion: Dysfunctional insulin secretion is due to decrease in glucose action in before meal of insulin secretion and also in after meals which causes postprandial hyperglycemia. If impaired insulin secretion is continued than it causes glucose toxicity and lipo toxicity, causes the deterioration of pancreatic cells which results in permanent increase of blood glucose. Insulin resistance: In this, insulin does not show particular action in the body which is needed and proportional to blood concentration. The insulin resistance can be due to genetic factors and environmental factors such as smoking, alcohol and stress etc. Insulin receptors and insulin receptor substrates directly affect the insulin signals, thus causes insulin resistance. In environmental factors, beta cells cannot keeps on producing insulin, as its function goes down, glucose level increase after meal and liver start producing more glucose and glucagon secretion helps in sustain hyperglycemia. List of pancreatic hormones: Gastrin: helps in digestion and stimulate stomach cell to produce acid. Glucagon: it worked opposite to insulin and maintain blood glucose level. It causes liver to convert stored glycogen into glucose in blood stream. Insulin: it helps in controlling blood glucose, by initiating liver, muscles and fat cells to take in blood glucose from blood. Insulin helps cells to take in glucose and used for energy. Somatostatin: helps in maintaining proper concentration of glucagon and insulin in blood, somatostatin secrets, whenever their level rises. Vasoactive intestinal peptide (VIP): helps in controlling water secretion and absorption from intestine. GLP-1 promote glucose homeostasis and stimulate insulin secretion and suppress glucagon release. It binds to G protein coupled receptor and activate c- AMP, this c-AMP stimulates insulin secretion in pancreatic beta cells (Ma X., 2014). Use of incretin is to improve diabetes control and increase weight loss, either alone or in combination with other drugs such as metformin. Its side effect are nausea, diarrhoea, loss of appetite and dizziness. References: 1. Freinke N. 2015. American Diabetes Association Standards of Medical Care in Diabetes, diabetes care. The journal of clinical and applied research and education. Volume 38(1). https://professional.diabetes.org/admin/UserFiles/0%20-%20Sean/Documents/January%20Supplement%20Combined_Final.pdf. 2. Ma X. 2014. Glucagon-like peptide 1-potentiated insulin secretion and proliferation of pancreatic -cells. J Diabetes. 6(5): 394-402. https://www.ncbi.nlm.nih.gov/pubmed/24725840.