best predictive power for T1DM is the presence of antibodies to multiple

Best predictive power for t1dm is the presence of

This preview shows page 29 - 34 out of 35 pages.

best predictive power for T1DM is the presence of antibodies to multiple pancreatic antigens at the same time... suggests that some damage has been done to the pancreas by the time this antibody ‘cocktail’ is detected” ( Chervonsky 2012:311).
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type 1 and type 2 diabetes “Type 1 and type 2 diabetes have long been viewed as two diseases , the first auto-immune with a large genetic component , the second metabolic , linked to obesity and a sedentary lifestyle [research is now showing that] each type has more in common with the other than once believed: both involve a faulty immune system and share some mechanisms that ultimately kill the insulin-producing beta cells in the pancreatic islets. Yet in neither type 1 diabetes (T1D) nor type 2 diabetes (T2D) does genetics or behaviour fully explain why some people get the disease and others don’t… scientists have implicated epigenetic and environmental influence in each type of diabetes.” ( Jonietz 2012:s10)
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Pathogenesis of IDDM (type 1) ~2/3 of beta-cells in the pancreas hare have been destroyed by an autoimmune response before the disease manifests itself (DeWeerdt 2012) genetic disposition to the disease runs in families…About 60% of the genetic risk comes from a few specific variants in the human leukocyte antigen (HLA) genes . .. encode the proteins that present antigens to immune cells and are involved in the misguided immune response in T1D… Normally, cytotoxic T cells destroy only infected cells T cells that react to [self] …are eliminated before they mature…In type 1 diabetes… T cells primed to recognize beta cells enter circulation A number of factors appear to be involved, including variations in the gene encoding insulin, diet , and the presence or absence of certain bacteria in the gut flora “ ( Jonietz 2012:s10) environmental event (monozygotic twins) initiates the process (e.g., viral infection )
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Pathogenesis of NIDDM (type 2) beta cell defects ( mass intact ) and insulin resistance in target cells “The statistical connection between T2D and a high-calorie diet and sedentary lifestyle is well established…[causality not established]… The data from genome-wide association studies (GWAS)…have identified more than 40 genes associated with T2D , most of them having to do with beta-cell function . But…account for only about 10% of the apparent genetic causes . Some genes implicated by GWAS are expressed only in adipocytes (fat cells )… Adipose tissue stores excess lipids , which are otherwise toxic to the body. When fat cells malfunction and aren’t able to store away the extra lipids generated by overeating, lipids begin to accumulate in muscle tissue and in the liver…. aberrant build-up triggers insulin resistance[?] Another consequence of abnormal adipose growth is inflammation… Insulitis plays a role in type 2 diabetes [how?] ‘ ( Jonietz 2012:s11)
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type 2 Diabetes: Thrifty Genotype Socio-cultural changes Nomadic
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