Diabetes Mellitus

The pancreas is an organ in the abdominal area that contributes to hormone secretion involved in blood glucose (sugar) regulation. When food enters the gastrointestinal system, signals prompt release of these hormones from selected cells in the pancreas. These selected cells (pancreatic islet cells) are scattered throughout the pancreas.

The pancreatic islets (also known as Islets of Langerhans) contain both alpha and beta cells.

Beta cells secrete INSULIN that go into the blood stream and allow the glucose (sugar) to be transported into all of your cells for “cell life and survival.” The glucose can be from food eaten or from the body itself.

DIABETES MELLITUS occurs when there is no insulin production (Type 1 Diabetes) or when insulin does not work well or there is resistance (Type 2 Diabetes)

Symptoms of diabetes mellitus include

  • Excessive thirst (polydipsia), excessive urination (polyuria), hunger (polyphagia), blurry vision, numbness in feet, weight loss, agitation, difficulty thinking or focusing, feeling tired, recurrent yeast infections or upper respiratory infections (cold).

Some drugs used to increase insulin production in Type 2 Diabetes are

  • Sulfonylureas (Glipizide, Glibenclamide, Glibornuride, Gliclazide, Chlorpropamide, Glimepiride)
  • Meglitinides derivatives (Repaglinide, Nateglinide)

Other drugs used to treat Type 2 Diabetes are as follows

  • Biguanide (Metformin)
  • Thiazolidinediones (Rosiglitazone)
  • Alpha-glucosidase inhibitors (Acarbose, Miglitol)
  • Dipeptidyl peptidase IV inhibitors [DPP IVi] (Sitagliptin, Saxagliptin, Linagliptin)
  • Bile Acid Sequestrant (Colesevelam)
  • Glucagon like peptide -1 mimetic (Exenatide, Liraglutide)
  • Amylin Analog (Pramlintide)

Predominantly Type 1 Diabetes and some of Type 2 Diabetes are treated with following Insulin

  • Rapid acting (Aspart, Lispro, Glulisine)
  • Regular acting (Regular)
  • Intermediate acting (NPH = Neutral Protamin Hagedorn)
  • Long acting ( Detemir, Glargine, Degludec)

Alpha cells secrete hormone called glucagon which signal the liver to release storage of glucose in form of glycogen (bundle of glucose = starch). Glycogen is what you use when you are fasting (not eating) and need the quick burst of energy. Glucagon is very important treatment in cases of hypoglycemia (low blood sugar).

Symptoms of HYPOGLYCEMIA can be considerably variable between individuals and include:

Adrenergic hypoglycemia symptoms:
Hunger, trembling, pallor, sweating, shaking, pounding heart, anxiety

Neuroglycopenic hypoglycemia symptoms:
Dizziness, poor concentration, drowsiness, weakness, confusion, lightheadedness, slurred speech, blurred vision, double vision, unsteadiness, poor coordination

Behavioral hypoglycemia symptoms:
Tearfulness, confusion, fatigue, irritability, aggressiveness

Diabetes Mellitus Complications include the following:

  • Kidney problems leading to dialysis (nephropathy)
  • Vision problems leading to blindness (retinopathy)
  • Nerve and sensation problems leading to dysfunction/infections/amputation (neuropathy)
  • Severe complications can lead to
  • Heart problems (myocardial infarction = heart attack)
  • Stroke (cerebral vascular attack)

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Disclaimer: This page is intended for general information and does not substitute for medical recommendations from your health care provider.