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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. The Symptoms of juvenile diabetes or type 1 diabetes are basically very similar to adult diabetes or type 2 diabetes. Slowly when the blood sugar level rises these early symptoms of diabetes will grow into more serious conditions and symptomsLike we already said the symptoms of type 1 diabetes are basically very similar to the type 2 diabetes symptoms.
The American Diabetes Association has devised a very small and fast online tool with which you can determine if you run a higher risk of getting diabetes.
For those who are already checking their blood sugar levels, there are no clear cut criteria but the next are considered as general guidelines. After these signs and symptoms we're going to take a look at what causes diabetes to see if your circumstances fit the description.
The type 2 diabetes symptoms are similar to that of Type 1 and Gestational Diabetes, so to better understand why those things happen to the body, let’s learn what Type 2 Diabetes is and then learn how it is different. When a patient is informed that he has Type-2 diabetes the doctor is saying that the patient’s body is not producing enough insulin or the body cannot use whatever is produced to properly support a healthy immune system.
In very severe circumstances a patient who is very ill or has been recently very ill or if the person has become dangerously dehydrated to the point that intravenous rehydration is essential to survival may fall into a diabetic coma, medically referred to as hyperosmolar coma. If other family members have it a person may also develop T-2 through due to shared environment, including dietary habits, or genetic predisposition. Diabetes, as a disease, is known from as early on as 1500 BCE, with its description found in an Egyptian manuscript. Various treatments for the disease have been put to practice since the time of antiquity, but its pathogenesis was not comprehended until 1900.

Although the first discovered cases of diabetes corresponded to Type 1 diabetes, today, both Type 1 and Type 2 diabetes are prominent among the respective age brackets.
Type 1, also called as insulin-dependent diabetes is rare and develops in adolescence or after, before the age of 40 while Type 2 commonly develops over the age of 40, it being the most common disease type. In Type 1 diabetes, lack of insulin in the body is the reason behind raised glucose levels because the insulin producing cells are damaged by the body’s own immune system. Type 2 diabetes occurs due to the resistance the body cells form against insulin being produced. Both Type 1 and Type 2 diabetes are symptomatic, although symptoms of Type 1 diabetes are more prominent and severe.
The excess urinary discharge leaves you dehydrated, generating periods of dry mouth and recurring thirst.
These two symptoms go hand in hand, relieving the body of excess sugar and managing the spike in blood glucose levels.
Gradual weight gain can be the result of increased intake of food owing to a surge in hunger spasms. Of the many contributing factors to fatigue and crankiness, repetitive urge to urinate accompanied by hunger bursts is what leaves most diabetics irritated.
Body’s reduced ability to use sugar for energy leaves the body tired and fatigues more than usual. If you observe occasional light flashes or a partial vision, it could be a result of high blood sugar. A classic symptom of Diabetes, decelerated healing of cuts and bruises usually occurs due to the continuous damage being done to the blood vessels by the increased blood glucose, which restricts the reach of blood to various body parts, an essential element to healing optimally.
If you notice repetitive infections cropping up, it could be a significant sign of diabetes. It is important to bear in mind that these symptoms may be mistaken for an ailment in themselves or for some other disease. 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. Here we'll focus on the early symptoms of diabetes mellitus type 1 and 2 and gestational diabetes, because they are the most common typesBe alertIn the early stages there are just a few diabetes symptoms, or they look like symptoms of other health conditions. The difference is that the development of type 2 diabetes symptoms is normally slow and can take many yearsBut symptoms of type 1 diabetes progress fast over weeks or months.
With blood tests he will be able to tell you if you have DiabetesOnly in 40% of the diabetes patients these symptoms of diabetes are observed. One way to test it is by a fasting glucose test, where you're not allowed to eat and drink 8 hours before the test.
In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. We hear a lot about this type of diabetes in today’s media  when they are doing news stories about how America has become an overweight or obese country, but in truth although Type 2 can occur due to being overweight, people who are perceived as being healthy and “thin” can just as likely to develop T-2.

Doctor’s refer to this as “Insulin Resistance.” Essentially speaking, the glucose cannot get into the cell tissue and instead builds up in the person’s blood. It was in 1889 that Joseph von Mering and Oskar Minkowski learnt that pancreas had a pivotal role to play in Diabetes. Both forms lead to surplus glucose levels in the blood, leaving body cells deficient of the same. Symptoms for Type 2 diabetes can be easily overlooked, given their gradual onset and commonplace nature.
In time, your kidneys fail to keep up with the rigorous overtime process, making you excrete the excess sugar through urinary discharge. Sleep disruption due to repeated bathroom rounds during the night can cause maximum grouchiness.
Since excess blood sugar tweaks tissue fluids, inclusive of your eye tissues, it leaves your vision with an impaired focus. Diabetes usually leaves the body vulnerable to a host of infections since fungi and bacteria easily prosper in sugar-rich conditions. The symptoms associated with this condition can escape one’s notice very easily but the disease itself is wrecking enough to leave some of the most vital body functions severely impaired. 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. This may turn your attention in a different direction but always be aware of this possibilityYou also have to be very aware that in the beginning a lot of people with type 2 diabetes have no type 2 diabetes symptoms yet. Sometimes it can go so fast that a child will get medical treatment only after an emergency situation has occurred like a coma. The other is a hemoglobin test that examines the average sugar levels over a two to three day period. They found that dogs, when made incapable of pancreatic function and the organ itself, developed diabetic symptoms, leading to their death. This is the reason why the body gives out these symptoms, to manage and correct the imbalance created. With sugar levels taking a nosedive, the body is left feeling unfed for hours, triggering a need for glucose for cells to function. 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. 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.
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.

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