Type 2 Diabetes Mellitus is a chronic and systemic metabolic disorder distinguished by high blood glucose (hyperglycemia), insulin resistance, and insulin deficiency. The individual with Type 2 Diabetes typically goes undiagnosed for years because the onset is gradual and signs of hyperglycemia is not noticed.
The long-term presence of type 2 diabetes impacts the large and small blood vessels and nerves throughout the body. The insulin signaling pathway refers to the complex biological process of insulin reacting with target cells such as muscle, fat, or liver cells and the resulting intracellular effects that result, leading to various functional effects observed at the multicellular level. Insulin works by binding its specific receptor on cell surfaces throughout the body, such as on liver, muscle or adipose cells.[5] The insulin receptor is a tyrosine kinase protein that undergoes autophosphorylation of its tyrosine residues that located on its cytoplasmic face once activated by insulin.
In total, the activation of the PI3K subpathway mediates several insulin-induced responses including GLUT4 activation, glycogen synthesis by inhibiting CSK-3 phosphorylation, and lipogenesis by up-regulation of fatty-acid synthase gene expression. MAPK is other main subpathway that is activated after IRS-1 and 2 phosphorylation that begins with small adaptor proteins Grb2 and SHP2 that lead to further substrate activation downstream. Insulin-mediated Glucose transport is primarily accounted for through the translocation of glucose transporters to the plasma membrane, most of which is GLUT4 within muscle and adipose cells. Most of glucose that enters human muscle in response to insulin is desposited as Glycogen (see Carbohydrate Storage: Glycogen for more information). The biochemical process of glycolysis reverses many of the steps of Glycogenesis with different enzymes[64]. The Immune System of the human body is comprised of two different systems, the aquired immune system and innate immune system. The innate immune system is the body’s first-line of defense against invaders including infections and physical or chemical injury. Research has shown that circulating concentrations of acute-phase reactants is increased in type 2 diabetic patients when compared to nondiabetic subjects. The Insulin Resistance Atherosclerosis Study (IRAS)[37] investigated the relationships insulin resistance, cardiovascular risk factors, and cardiovascular disease in a multiethnic population across varying statuses of glucose tolerance.
Research indicates that increased ROS levels are associated with altered mitochondrial morphology in both myotubes cultured in high glucose conditions and in diet-induced diabetic mice.[16] In addition, increased oxidative stress in mitochondria may contribute to increased lipid peroxidation and damage to cell membranes and DNA. Apoptosis is a genetically directed process of cell self-destruction marked by the fragmentation of nuclear DNA.[45] It is a form of cell death during which a programmed sequence of events leads to the elimination of cells without releasing harmful substances into the surrounding area. Evidence suggests that the release of cytochrome c from the mitochondria results from direct action of ROS on cardiolipin, a mitochondrial phospholipid which is located in the inner mitochondrial membrane.[17][52][53] During the early phase of apoptosis, mitochondrial ROS production is stimulated and cardiolipin is oxidized (loses electrons).
Although HbA1c is directly related to blood glucose levels, it is important to realize that blood glucose and HbA1c are not the same.
A portion of the metabolic stress seen in Type 2 Diabetes may originate from myocellular fat storage.
A four month study investigating the relationship between insulin sensitivity (IS) and IMCL content in Zucker diabetic fatty rats (ZDF) confirmed the relationship between IS and IMCL content seen in humans.
AMPK is a protein kinase, that combines signals to monitor and balance both systemic and cellular energy.
At times of high energy demand the ? subunit rapidly responds to changes in the AMP to ATP ratio to maintain energy balance. AMPK is activated by physical activity in such a way that increased intensity results in increased activation. Reduction of AMPK activity promotes the development of insulin resistance and glucose intolerance, disturbs muscle energy balance during exercise, and decreases mitochondrial biogenesis (mitochondria’s ability to make ATP).[33] In insulin-resistant rodents, increased AMPK activity has been linked with improved blood glucose homeostasis, lipid profile and blood pressure.
What is the difference between type 1 and type 2 diabetes (and what if I don't fit either type)?
As you can see in the preceding graph, every day starting at about 3am this person’s glucose levels started to go up. One colourful term for the liver’s tendency to release glucose into the blood overnight is a liver leak.
Rebounding (the so-called Somogyi phenomenon) is commonly cited by diabetes health care practitioners as a cause of high morning blood glucose readings.
Gee, I could get writer’s cramp listing every possible cause for erratic blood glucose readings. It is important to be aware that A1C levels are measured in different units and on a different scale than is blood glucose; hence an A1C level of 7 is not the same as saying that your average blood glucose is 7.
Typically, type 1 diabetes in children, adolescents or teenagers and require immediate institution of insulin. Typically, type 2 diabetes develops in middle-aged or older persons who are overweight and can – at least initially - be managed with lifestyle therapy and non-insulin medications. There are also a large number of adults who, based on their age (and, often, based on their body size) are thought to have type 2 diabetes, but who don’t get their blood glucose levels down despite usual therapy with lifestyle and non-insulin medications and, soon after diagnosis, require insulin therapy. One helpful way to distinguish type 1 from type 2 diabetes is to do a blood test for a special protein called a GAD antibody. As you can see, if you have type 2 diabetes then at the time you were diagnosed your pancreas was only making ½ of the insulin it was supposed to and, as time passes, it progressively loses more and more of its ability to make insulin.
If you have type 2 diabetes and are on insulin therapy you still have type 2 diabetes, not type 1 diabetes.
ACE inhibitors and ARBs (I list the various types below) are medications that were created years ago to help control high blood pressure, but medical research subsequently discovered that even if a person with diabetes does not have high blood pressure, taking an ACE inhibitor or ARB will still reduce the risk of having a heart attack or stroke if you are at high risk for these complications. Statins are medicines that improve cholesterol levels in your blood and they do this very well indeed.
Prediabetes is a condition in which blood glucose (sugar) or A1C levels are higher than normal but not high enough to be diagnosed as diabetes. Unfortunately, since there are typically no signs or symptoms, nine out of ten people with prediabetes don’t know they have it.
Despite these alarming statistics and broad risk factors, research indicates that individuals can cut their risk of getting type 2 diabetes by more than half through lifestyle modifications.
Several research studies suggest that lifestyle measures are the best way to dodge the diabetes bullet.

With just a few lifestyle adjustments, prediabetes can be reversible for some individuals, returning their blood glucose levels back to normal. Carbohydrate: About 40 percent of calories should come from carbohydrates, including at least 20-35 grams of fiber. For the greatest benefit, aim for 60-90 minutes of moderate-intensity physical activity on most days of the week.
Lemon - supports immune system, aids in digestion, reduces appetite, repairs skin, balances pH levels, freshens breath, helps absorb iron. Molasses (unsulphured blackstrap) - has a low glycemic index, and is chock full of minerals like calcium, magnesium, manganese, copper, zinc, iron and potassium.
Cayenne - Contains many anti-irritant properties and may aid with upset stomach, sore throat, diarrhea, ulcers, etc. Ceylon Cinnamon - (True cinnamon) While ceylon cinnamon is typically more expensive then cassia, it is worthwhile purchasing as it is associated with more potential health benefits. Include "rawfully tempting" in Shipping Comments, and Medicine Flower will send you a Special Bonus Sample with any purchase.
SPECIAL BONUS : Mention Rawfully Tempting™ in shipping comments, and receive a FREE PRODUCT SAMPLE with your order! I develop recipes because I LOVE being in the kitchen, however a little "dough" is always appreciated (and helpful)!Please consider a Heartfelt Donation. Individuals commonly experience visual blurring, neuropathic complications, infections, fatigue and significant blood lipid abnormalities.[2][12] Type 2 Diabetes is typically diagnosed when the patient is receiving medical care for another problem.
Chronic hyperglycemia can lead to macrovascular disease, which affects the arteries supplying the heart, brain, and lower extremities.[2] Type 2 diabetes is also associated with the development of microvascular pathologies in the retina, renal glomerulus, and peripheral nerves. Through PKB’s isoforms ?, ?, and ?, it plays role in mediating glycogen synthase kinase-3, metabolic actions of insulin, and Glut4 translocation.[8][66] It is debated whether PKB plays a significant role in insulin resistance with diabetes. Mounting evidence has shown that PI3k and PKB activation participate in the stimulation of p70 S6k.
Insulin increases the transporters’ cycle to and from the cell surface by promoting exocytosis and inhibiting endocytosis. Insulin causes stable Glycogen Synthase (GS) activation by causing dephosphorylation at multiple sites within the enzyme. Through these three subpathways, the insulin signaling pathway promotes GS and glycogen synthesis. The aquired immune system is your immunity your body build up from being exposed to foreign invaders, and the innate immune system is the body's natural unspecific defense against new foreign invaders that the body has not built up immunity against.
Participants demonstrated normal glucose tolerance (NGT), impaired glucose tolerance (IGT), or type 2 diabetes mellitus.[37] Measures of insulin sensitivity and insulin secretion were obtained from all participants during two 4-hour visits, occurring approximately one week apart. Increased levels of ROS are a likely cause in a variety of pathophysiological conditions, including type 2 diabetes.[16] Oxidative stress to the mitochondria can come from many sources. The amount of hemoglobin that forms HbA1c depends on the amount of glucose that hemoglobin is exposed to over time.[22],[23] For example, hemoglobin exposed to high levels of glucose for long periods of time results in greater amounts of glycation. The Diabetes Control Card is a quick reference for patients diagnosed with diabetes to assess glucose control. In muscle tissue, lipids are stored as either extramyocellular lipids (EMCL) or intramyocellular lipids (IMCL). An obese Zucker diabetic fatty rat has significantly higher IMCL concentrations than its lean counterpart.
AMPK phosphorylates TBC1D1 which increases activity of GLUT4, resulting in increased glucose uptake.
The dawn phenomenon is the rise in blood glucose levels in the dawn (that is, the morning) due to excessive release of glucose from the liver into the blood. This individual, like so very many others living with diabetes who have high blood glucose levels first thing in the morning, blamed themselves and attributed their elevated morning blood glucose to having overeaten or snacked the night before. Not so!
This is particularly likely to be the case if you are taking NPH insulin at supper or Levemir insulin (only) in the morning. If you are rebounding it means that you had a very low blood glucose overnight, slept through it, and your liver poured out so much glucose into your blood to bring your blood glucose back up that it ended up making too much and overshot the mark and as a result your blood glucose was high when you awakened.
The idea is that a certain amount of carbohydrates is likely to raise your blood sugar level by a predictable amount and thus, you can take an amount of insulin proportional to your carb intake to prevent this rise in blood glucose from occurring. Indeed, there are many middle-aged people who develop type 1 diabetes and there are increasing numbers of children who develop type 2 diabetes. Such people often have a form of type 1 diabetes called LADA (Latent Autoimmune Diabetes in Adults).
This antibody is almost always present if a person has type 1 diabetes and is almost always absent if someone has type 2 diabetes. Well, often it doesn’t, but there is at least one situation where it does; that is, the instance where a person with LADA is unsuccessfully treated with oral medicine after oral medicine in a fruitless attempt to control their blood glucose levels when what they really need is insulin!
One of the most significant was The Diabetes Prevention Program (DPP), a major clinical research study, that found lifestyle modifications reduced the risk of developing type 2 diabetes by 58% over a 3 year period, while the drug metformin reduced risk by 31% overall. The best sources include fish, skinless chicken or turkey, nonfat or low-fat dairy products, and legumes (beans and peas).
Physical activity is an important component to any healthy lifestyle, but those with prediabetes can especially benefit. If you are unable to start there, try to walk briskly for at least 30 minutes a day, 5 days a week.
If you are overweight, losing 5-10% of your total weight is beneficial for improving insulin sensitivity and regulating glucose control.
It also reduces triglycerides, LDL cholesterol and overall cholesterol levels of people in this same group. Raf phosphorylates MEK, a dual-specificity kinase of tyrosine and threonine that activates mitogen-activated protein kinase (MAPK).
It has been shown that tyrosine kinase activity and IRS-1-protein phosphorylation are two essential processes in normal glucose transport.

PKB has also been shown to directly inhibit GSK-3, a well-known inhibitor of GS, thereby promoting GS. Ezymes responsible for Glycogenolysis 1 through 3 respectively: Glycogen phosphorylase, Phosphoglutomutase, Phosphoglutomutase, and Glucose-6 Phosphotase. ROS are produced in larger amounts by islet cells from patients with type 2 diabetes than by those from non-diabetic patients.[17] Although some ROS are produced in the peroxisomes, the major source of ROS production in cells is the mitochondria.
This is directly related to continuous breakdown and replacement of erythrocytes in the body. EMCL is metabolically static, but IMCL stores are built up, mobilized, and used within hours.
The usual best way to deal with the dawn phenomenon is to take a dose of NPH, Lantus, or Levemir insulin at bedtime.
There is always a reason for erratic blood glucose levels and if you’re having this problem, you and your health care providers need to play Sherlock Holmes and find out what is the cause!
But if stress is part and parcel of your life (as it is of so many lives) your blood glucose levels can still be well controlled so long as your treatment program is tailored appropriately to your needs.
Therefore, even if you aren't yet at the target A1C (and indeed even if you never reach target) it is important that you know that any reduction in your blood glucose (and, hence, your A1C) will substantially reduce your risk of diabetes damaging your body.
But, if you don't keep a log book then you are not going to be able to recognize trends and patterns in your readings. Carbohydrate counting is essential if you are using an insulin pump and is often of major value if you are taking injections of rapid-acting (Humalog, NovoRapid, Apidra) before meals; especially if you have type 1 diabetes. Those with prediabetes have an increased risk of developing type 2 diabetes, heart disease, and stroke. Not only does exercise help lower blood sugar levels, but it aids in weight loss which is another helpful factor in reducing your risk of developing diabetes. Again, if that is too challenging to start, just try to be more active throughout the day, such as parking further from the store entrance or taking the stairs.
Clinical Nutrition Guideline For Overweight and Obese Adults with Type 2 Diabetes, Prediabetes Or Those at High Risk For Developing Type 2 Diabetes. Medicine Flower has inspired me greatly in my recipe development, by offering an amazing array of high quality, cold-extracted flavors. The MAPK pathway is well known within the insulin signaling cascade, but is not very sensitive to insulin or involved in most of the hormone’s important metabolic responses.[8] The MAPK subpathway has some evidence showing it functions to exert feedback regulation on the PI3k subpathway and is involved in the process of insulin resistance. The PI3k subpathway functions to mediate glut4 activation, glycogen synthesis, and lipogenesis. Within these pathways, PI3k, PKB, and the atypical PKCs play an particularly key roles in the process of glucose uptake into cells. MAPK has been implicated in activating GS through phosphorylation of p90 Ribosomal S6 kinase 2 (p90 rsk2) and glycogen bound protein phosphatase-1 (PP1G) downstream.
The later branch is implicated GS promotion by inhibition of the well-established inhibitor of GS, GSK-3.
During times of high glucose uptake, increased amounts of glucose-6-phosphate (G6P) leads to an increase in glycogen synthesis. If you are already taking one of these insulins at bedtime then it may be that your dose needs to be adjusted.
Except that recent medical studies suggest this doesn’t actually happen and that rebounding doesn’t even exist! If you are able, try to have a straight shift (regardless whether this is days, nights, or something else).
So if your A1C was 10 and you get it down to 9 pat yourself on the back; you've just reduced your risk of eye and kidney damage by almost 40%! Speak to your diabetes educators (in particular, your dietitian) to see if this would be a helpful technique for you. The Joslin Diabetes Center recommends achieving this goal by losing just one pound every one to two weeks through a reduction of 250 to 500 calories per day.
However, I do love the taste of coffee and have found a new way to enjoy a warm, welcoming morning mineral tonic, that can be coffee-ish, if I so choose. In contrast, the downstream constituents of PKB such as p70 S6k have been shown to have no immediate effects on glucose uptake.
PP1G has many phosphorylation sites that insulin has been shown to augment, but its exact role in GS promotion is not fully understood. My strong expectation is that within the next few years we will have conclusive evidence for the non-existence of rebounding. If this is not possible, your blood glucose control can still be maintained but your insulin schedule may need to be overhauled.
It reveals the patterns and provides the clues as to what changes to make to your therapy, be they dietary, insulin or otherwise. The MAPK subpathway may serve to regulate the PI3k subpathway and may be involved in insulin resistance, but more research is needed to prove this. Indirect activators (metformin, dinitrophenol (DNP), and rotenone) work by increasing AMP:ATP ratio, compound C works by inhibiting activation of AICAR. My preferred strategy for my patients with type 1 diabetes who perform shift work is for them to use an insulin pump or, failing that, using Lantus (or Levemir) insulin once daily (given at the one time of day they are always certain to be awake) and a rapid-acting insulin (Apidra, Humalog, or NovoRapid) before meals (whenever those meals happen to be for a particular shift). A log book is not meant to simply be a historical record and it is most definitely not a report card. It is an interactive tool to assist you in deciding how much insulin to give every time you are due for an insulin injection.

Treatment of hypoglycemia newborn baby
Reading your blood sugar quickly


  1. 24.02.2014 at 10:47:17

    If blood glucose falls below people who are on steroids for their disease, and.

    Author: POZETIF_KIZ
  2. 24.02.2014 at 19:30:21

    And fastest way to lower your blood sugar monitor your blood.

    Author: FENERBAHCE
  3. 24.02.2014 at 10:14:20

    This morning and was also before having blood cholesterol tests (lipid test.

    Author: Love