29/05/2021
group of metabolic diseases whose basic characteristic is chronic hyperglycemia with subsequently elevated sugar in the urine. This is where the term diabetes mellitus comes from, referring to the historic term ‘honey-sweet flow’.
Forms of Diabetes Mellitus
Insulin is at the center of this metabolic disease. This hormone is produced in the beta cells of the pancreas and ensures the absorption (as well as the storage) of glucose in different cells of the body. The insulin receptor involved in this process, a transmembrane protein with tyrosine kinase activity, causes the translocation of the glucose transporting protein GLUT4 to the surface of the cell so that glucose can increasingly be transported from the capillary bed to the intracellular compartment. The glucose level in the blood decreases. In people with diabetes mellitus, this mechanism is disrupted at different levels.
Here, we differentiate between different forms of diabetes mellitus based on their etiology:
Diabetes mellitus type 1
Due to the destruction of beta cells, an absolute insulin deficiency is created. This destruction occurs due to either idiopathic (rarer) or immunological processes.
Genetic factors play a predisposing role. A special type of this immunological form of diabetes is LADA (Late autoimmune diabetes in adults), in which the diabetogenic metabolic condition does not occur until adulthood (> 25 years). Pathological hyperglycemia usually occurs from a beta cell loss of approximately 80%. In the diagnosis of autoimmune conditions, one frequently finds antibodies against cytoplasmic islet cells, anti-glutamic acid decarboxylase (anti-GAD) antibodies, insulin autoantibodies, and anti-2A tyrosine phosphate antibodies.
Diabetes mellitus type 2
In 90% of diabetes cases, a pronounced triad consisting of insulin resistance of the target tissue, a secretory defect, or progressive apoptosis of beta cells is