Endocrinology and Diabetes
Glucose Insulin and Diabetes The basics of Type I and Type II diabetes
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- Every cell in the human body needs energy to survive and do its different functions, if we are talking
- about our brain cell it needs energy to keep stimulating other brain cells and sending on signals and
- messages. If it's muscle cell it needs energy to contract they need energy just to do the basic function of a cell
- and the place where they get that energy from or the primary source of that energy is from
- glucose, and glucose is a simple sugar. if you actually tasted glucose, it would taste sweet. And glucose
- gets delivered to cells through the blood stream. So this right here, I'm drawing some blood that's
- passing by a cell, maybe the blood is going in that direction over there and inside blood let me draw
- some small glucose molecules passing by. So in an ideal situation when the cell needs energy ,
- glucose will enter the cell. unfortunately it's not that simple for the great majority of cell in human
- body. The glucose won't enter by itself, it needs the assistance of a hormone or a molecule called insulin.
- So let me label all of these, this is glucose and it needs insulin
- so let me draw insulin here as a magenta molecule. There. that is INSULIN
- and in the surface of this cells there are insulin receptors on them
- and I've drawn a simplified version of them -- places where these magenta circles can attach
- can bind, and what happens is that in order for the glucose to be taken up by the cell
- insulin has to attach to this receptors which unlock the channels for glucose
- in order for the glucose to be taken up by the cell, insulin has to bind to the insulin receptors
- and once that happens then the glucose can be taken up by the cell
- now unfortunately things don't work always as planned. So let me draw a couple of scenarios here
- let me draw my simple version of a cell, and let me draw the blood stream going by... right over here
- and draw the glucose in the blood stream, floating by, and then I have my insulin receptors
- on the surface of the cell. Now the first thing that could go wrong here is: What if the body does not produce insulin?
- Insulin is produced in the Pancreas, what happens if the pancreas is not producing insulin properly?
- so.. no insulin. In this situation there is nothing to bind to these receptors, so the
- glucose channels won't be opened up and the glucose won't be able to enter into the cell
- This situation is "Type I Diabetes"
- where you have glucose, so there you have energy and you have properly functioning insulin receptors,
- you just don't have insulin to unlock the gates for the glucose to actually go into the cell
- the other scenario that you could imagine happening is...let me draw the cell again and the blood stream
- and obviously that is one of trillions of cells in the human body. We have an estimated ten to one-hundred trillion cells
- so this is just a simple diagram to get the point across. So, once again let me draw some glucose floating by...
- some insulin receptors on the cell, and let's have some insulin. So our Pancreas is producing insulin
- and putting it into our bloodstream, so it's there to be used.
- but a situation can arise where the receptors are not working properly,
- and they have been desensitized to insulin. In this situation, the receptors have difficulty binding to the insulin.
- and glucose does not enter the cell. Thus, in either one of these scenarios
- and let's just think in a broad sense. Oh, and I didn't even name the second scenario here
- The second one, as you can imagine, if this up here is Type 1 , this down here is Type 2 diabetes.
- Now, one way of managing Type 1 diabetes is to inject insulin into the bloodstream.
- The only problem here, and it's a big one, is that there is no insulin in the bloodstream. So, over here we can inject insulin.
- So, you'll have insulin to attach to the receptors, and so the glucose can be processed properly.
- With Type 2 diabetes, there are multiple lines of attack.
- To help Type 2 diabetes, drugs and lifestyle changes can be used to help resensitize the body to insulin and glucose.
- Just like with Type 1, insulin can also be injected into the bloodstream. Now, you might say "Wait! I already have insulin here...
- why would I add MORE insulin?". Remember, just because the cells
- are desensitized, it doesn't mean they won't bind with insulin, it just means it will take MORE insulin
- to uptake the same amount of glucose. So, if you add enough insulin, there may be enough
- to bind with the insulin receptors and cause some glucose absorption.
- But, there's multiple lines of attack here, and usually the first is drugs that help resensitize the receptors.
- The last thing I want to cover is what would happen if you didn't treat the diabetes.
- There are two major problems here: 1. Your cells can't function without glucose.
- and another problem would be that sugar in the blood -- once concentrated enough
- it can actually cause a lot of damage to the body.
- So, you don't want either one of these things happening, you don't want too much sugar flowing in your blood and harming your body.
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