Glucose homeostasis

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Research and produce a short report on glucose homeostasis, and the cause and treatment of diabetes mellitus

Homeostasis stems from a Greek work that means to "stand equally". The human body uses this to control it's conditions for its own survival. All sorts of factors contribute to homeostasis such as, temperature, energy requirements which is glucose that is the main source energy that has to be regulated at all times, ion and sugar. All these need to be stable and regulated for us to live. Various chemical reactions are taking place within our bodies that can get easily imbalanced. So we have to monitor and control these conditions for our bodies to function properly. (Field, B (2009). Lecture notes [Description of homeostasis Monday 21st September 2009]).

We as humans use "Regulators" in our bodies that help us to maintain a constant internal environment, that is what homeostasis is all about. We are made up of millions of cells, each individual cell helps maintain homeostasis and thus id dependant of it also overall. All our major body systems are made up of cells and these systems maintain control of our body through homeostasis. That is necessary to keep the cells healthy. All our cells are surrounded by an extra-cellular fluid environment "The internal milieu". which is protective environment that gives stability for tissues and organs of multi-cellular living organisms. (Field, B (2009) Lecture notes [What is homeostasis and the internal milieu. Student handout Monday 21st September 2009])

With in our body we have 3 components that make up the Homeostatic System :

  1. The receptor, this detects the problem.
  2. The control center, that makes the change to rectify the problem founded
  3. The effector, this brings back the body to a set point.

(Field, B (2009) Lecture notes [Necessary components of a homeostatic system. Student handout Monday 21st September 2009])

We use negative-feedback regulation that is a homeostatic mechanism, that makes the body go back to a normal state when we have put it under abnormal stress that it is not used to and in order to keep our body homeostasis.

This is what happens to glucose homeostasis. Because the body produces glucose for cells energy, if there is an imbalance that the human body cant control diabetes can occur. it's vital the levels of glucose is strictly regulated. Otherwise if there is too much glucose in the blood it turns the cells toxic, while if there is too little glucose the cells starve as they have little energy. The levels of blood glucose can either be high or low due to digestion of food and production of insulin by the liver which can increase it. While the transport of sugar in to cells and loss of glucose in urine can lower the blood glucose. Glucose homeostasis relies on lots of different molecules, cell types and organ for it to work. ( Internet source 1)

We use 2 hormones insulin and glugacon that regulate the strength of glucose in our blood. These are both antagonistic pancreatic hormones. Glucose is detected in the blood stream by the glucose transporter receptors that are in the pancreatic cells found in the Islet of Langerhans in the pancreas known as alpha and beta cells. The beta cells release the hormone insulin when high levels of blood glucose is detected. The insulin then lowers the level of blood glucose to normal in the body by sending signals to the bodies organs and tissues, to use the glucose as energy, such as the liver, muscle and fat cells when insulin is released the liver converts more of the excess glucose into glycogen, that makes the blood sugars lower due to it being stored in the liver as glycogen. But if there is an instance of low levels of glucose in the body the alpha cells of the pancreas release the hormone glucagon to stimulate the liver to break down the glycogen in to glucose. Glucagon also makes the liver make glucose out of the bodies natural glycerol. Because any excess glucose is stored in the liver as glycogen, when blood sugar levels fall the glycogen is remade back in to glucose and released in to the blood to higher the levels back up. All these reactions work together to raise levels back to a normal state in the body. (internet source 2) (Field, B (2009) [lecture notes wrote in class Monday 21st September 2009])

This is what glucose homeostasis is, where the body encounters an imbalance either too high or low levels of glucose in the blood, it can naturally balance itself out so it can go back to a natural level or as the Greek word says "stand equal" but in some cases due to medical reasons and if the body cant produce insulin, or can but cant use it effectively type 1 and type 2 diabetes mellitus can occur.

Type 1 diabetes is a autoimmune disease. That means the bodies immune system for some reason turns on itself, begins to attack and destroy beta islet cells of the pancreas that releases insulin. Type1 form of diabetes is created when enough of these beta cells are destroyed and the body cant produce insulin at all to regulate its blood sugar. It was previously called "Juvenile diabetes" because it was usually diagnosed mostly in children and young adults.( internet source 3) ( internet source 4)

We are left then with too high levels of glucose ultimately because our muscle and fat tissue cells are not receiving signals to use the glucose as energy in our body. There are various factors that can trigger type 1 diabetes

Its genetic, that other family members already have it

  • Poor diet
  • Environment, you could have had a virus that has been affecting the pancreas, thus not producing insulin.

You was born with diabetes, or with it genetically in your bodies chemistry.

The symptoms of type 1 diabetes include

  • Dehydration
  • Urinating frequently
  • Tiredness
  • Weight loss
  • Blurred vision
  • Blackouts

Muscle loss (wasting away). This is due to because the body is not producing insulin, the body uses muscle stores for energy.

And most importantly ketoacidois. This is the 1st indicator you have type1 diabetes in most cases because of ketones that are acid compounds form in the blood.

If it is not treated it can lead to serious complications and even death. All these symptoms develop over weeks, even days but type 2 diabetes is totally different, not the symptoms but as the cause of why people get it.

(internet source 5)

Type 2 diabetes is more common in older people, because it takes a much longer time for type 2 diabetes to show up in people. It is a Metabolic disorder that is found in people who eat a rich Carbohydrates and high glygemic diet. It is most common form of diabetes because the body either doesn't produce enough insulin, or the body cells ignore it. This is called insulin resistance. We need insulin for the body to use glucose for energy. Which is fuel for cells in our body. The peripheral tissues become insulin resistant, because the body no longer responds to the insulin signal to use the glucose for it to get into our body cells. Therefore after we eat meals the glucose that has been ingested remains in our body at a high concentration even if insulin is present because the body won't respond for it to be used. The liver is also resistant to the insulin so it cant synthesize it. When insulin cant take sugar from the blood in to cells problems occur straight away, cells are starved of energy, and over time the high blood sugar levels can damage the eyes, kidneys, nerves and the heart. If not treated and regulated properly with the right medication diabetics have a risk of having a hyperglygemic and hypoglygemic attacks. The difference between the two is with a hyperglygemic attack it means you have a too high blood sugar level that needs to be lowered, and a hypoglycaemic attack is when the blood sugar is too low and needs to be highbred, so the levels are back to normal. People who have a poor diet, high chloeresterol and is overweight/obese have a high chance of type 2 diabetes. But also old people too, because ageing makes the body less tolerant to sugars. (internet source 6)

The symptoms of type 2 diabetes is a lot like type 1 diabetes except for a few,

Dehydration, because of the build up of sugar in the blood, this causes the person to urinate a lot, and because the kidneys lose glucose through urine and large amounts of water is lost. No matter how much liquid is consumed you always feel thirsty.

This can cause,

  • A diabetic coma, this occurs when a person is so dehrated and is not capable of replacing fluid lost quickly enough.
  • Damage to the body, damage to the nerves, in the kidneys and eye vessels. It can also cause hardening of the arteries that can cause a stroke or heart attack.

But because you are not born with type 2 diabetes people don't realise they have it till they go to receive medical treatment because they feel ill, as it can take a while for it to happen to you.

Treatments for type 1 and type 2 diabetes

There are various treatments that can help both forms of diabetes from insulin injections, tablets, better diet, exercise and to the more extreme treatments of double transplants of the kidneys and pancreas, the pancreas alone or islet transplantation.(internet source 7)

In type 1 diabetes you will have diabetes all your life and will be insulin dependant. You will need to maintain control of your blood sugar, take regular exercise, have planned meals to suit your diet and have intense insulin therapy. You have to make regular adjustments to check your blood sugar levels. The insulin Lantus Sub Q is a man-made insulin, identical to human insulin, that helps the sugar go in to cells, also its longer lasting. Because it works more slowly than regular insulin which you need to monitor more regular. They do prick tests, where they test a drop of on blood on a piece of paper and use a special chemical to see what level of glucose is in the body. They then can decide how to act, to either higher or lower it. As well as injections patients can use a an insulin pump, that pumps insulin in to the stomach through planned and continuous times. But they have to eat a healthy diet that spreads carbohydrates through out the day to prevent high blood sugar ingested after meals. ( internet source 8).

They have to have regular checkups, so treatment and does of insulin can be adjusted accordingly and exercise so the body can use insulin more effectively. That also lowers the risk of heart disease that can occur in type 1 diabetes.

But if all fails and last resorts are needed then type 1 diabetics can have a whole pancreas or a double kidney and pancreas transplant. This provides a long term success rate for type 1 diabetics. These operations help prevent damage to the kidneys further and some show it could reverse existing damage. Immunosuppressive drugs are needed for the rest of the patients life, so the body doesn't reject the donor organs. But the experts say if diabetes poises a bigger threat to life than the transplant would the transplant is recommended. The final way to help treat type 1 diabetes is through the Edmonton Protocol. Which is in clinical trials being a fairly new treatment which uses Islet transplantation. This treatment is allowing more patients to come off insulin or reduce their intake of it. With the Edmonton Protocol they use beta cells from donor pancreases to transplant in to their patients. The only downfall is they need sufficient numbers of pancreases to isolate the islet beta cells.to have efficient insulin production. This is why the procedure is limited. Once the beta-cells are isolated they are injected directly into a major vein in to the patients liver. The livers capillaries carry the islets to produce insulin, the bodies immune system is suppressed so the islets are not destroyed. Regular transplantation drugs destroy islet cells, so Rapamure or Tacrolimus immunosuppressant drugs are used, because they don't contain steroids which destroy the islet cells. This procedure is repeated 2 or 3 times over 3 months, that's why its limited due to the number of donor pancreases needed to isolate sufficient beta cells to complete independence of insulin therapy. But research up to press are looking at using pig islets as the donor source for production for use in children's treatment and not using immunosuppressant drugs on them. But the most recent is using stem cells or cells from embryo's to produce insulin, but this type of research is many years away from completion. (internet source 9)

The various treatments for type 2 diabetes does include insulin therapy, but is mainly all about change of the patients life style. Because type 2 diabetes can be brought on by a rich diet they need to eat more healthy. Also like type 1 diabetes they need to check their blood sugar levels regular and drink plenty of fluids to avoid dehydration, and take a low dose of aspirin if needed. If through diet there blood sugar cant be regulated there is oral medicines available to non-insulin dependant diabetics and also insulin. Actosis is one example of a oral non-insulin dependant diabetic drug, but if you don't follow the above advice with it can hinder the effect. These medications help to release the bodies natural insulin and help the body to restore proper response to it. Because type 2 diabetics do not respond to their own insulin.

You have to in both type1 and type 2 diabetes self blood monitor, look after yourself and recognise and treat symptoms of high/low blood sugar immediately. It is also best to wear an I.d bracelet that can identify you as a sufferer of diabetes, if u ever collapse in a public place so emergency treatment and help can be given.

Finally:

New research

A new drug to help treat type 2 diabetes has been brought out. its called Onglyza. It stimulates the pancreas through a one a day tablet to produce more insulin after eating. But again u have to combine this with exercise and a controlled diet so you can manage your blood sugar levels. The action of the onglyza is to increase the number of insulin produced so it be's an effective transporter of the sugar in to the bodies cells, so the sugar doesn't build up in the blood.(internet source 10).

Also there has been a Alzheimer's disease and a type 3 diabetes hypothesis, that could link Alzheimer's disease with diabetes. Because they say diabetes is a recognized risk factor of the beginning of Alzheimer's disease. Even though it hasn't been proven there has been a rapid amount of evidence leading to believe Alzheimer's disease is present in some of the patients that are insulin resistant or have low insulin in the brain. This makes them believe to approach Alzheimer's disease as a " disease of the brain", type 3 diabetes. (internet source 11)

Bibliography

Internet

  • Internet source 1 www.ehow.com http://www.ehow.com/how-does_5101742_describe-regulation-blood-glucose-levels.html
  • Internet source 2 www.ehow.com http://www.ehow.com/how-does_5101742_describe-regulation-blood-glucose-levels.html
  • Internet source 3 www.diabetes.org http://www.diabetes.org/type-1-diabetes.jsp
  • Internet source 4 http://www.diabetes.co.uk/diabetes-symptoms.html http://www.diabetes.co.uk/diabetes-symptoms.html
  • Internet source 5 www.healthmad.com http://healthmad.com/conditions-and-disease/what-causes-diabetes
  • Internet source 6 www.healthmad.com http://healthmad.com/conditions-and-disease/what-causes-diabetes
  • Internet source 7 www.diabetes.org/type-2-diabetes.jsp http://www.diabetes.org/type-2-diabetes.jsp
  • Internet source 8 www.webmd.com http://diabetes.webmd.com/features/type1-diabetes-prevention
  • Internet source 9 www.healthcentral.com http://www.healthcentral.com/diabetes/type-I-diabetes-000009_11-145_2.html http://www.healthcentral.com/diabetes/type-I-diabetes-000009_11-145.html
  • Internet source 10 www.ehow.com http://healthmad.com/conditions-and-diseases/onglyza-saxagliptin-new-drug-for-type-two-diabetes-approved-by-the-fda/
  • Internet source 11 www.ehow.com http://www.ehow.com/how-does_5101742_describe-regulation-blood-glucose-levels.html

Lectures

  • Field, B. (2009). Lecture notes. [Description of homeostasis Monday 21st September 2009].
  • Field, B. (2009). Lecture notes. [Necessary components of a homeostatic system. Student handout Monday 21st September 2009].
  • Field, B. (2009). Lecture notes. [What is homeostasis and the internal milieu. Student handout Monday 21st September 2009].

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