Insulin Regulation Disorder Causing Diabetes Mellitus: An Overview of Hormonal Imbalance
Diabetes Mellitus, a chronic metabolic disorder characterized by high blood sugar levels, continues to be a global health concern. The disease, categorized into Type 1 and Type 2, poses significant challenges due to its complexities.
In Type 1 diabetes, the immune system attacks the cells in the pancreas that produce insulin, leading to insulin deficiency. As a result, people with Type 1 diabetes must take insulin injections for life. On the other hand, Type 2 diabetes occurs when the body becomes resistant to insulin or doesn't produce enough insulin. Treatment for Type 2 diabetes usually begins with lifestyle changes such as healthy eating, regular physical activity, and weight loss.
Research is ongoing to find better treatments for both forms of diabetes. Innovative approaches include artificial pancreas systems, immunotherapies, stem cell therapy, gene therapy, and smart insulin formulations. Smart insulin formulations, for instance, only activate when blood glucose levels are high and remain inactive when glucose levels are normal, potentially reducing the risk of hypoglycaemia and improving the quality of life for patients who are insulin-dependent.
Ongoing research aims to provide more personalized, targeted therapeutic approaches based on individual differences in genetics, hormone levels, and metabolic profiles. For example, gene therapy involves modifying or correcting the genetic causes of diabetes, focusing on altering the genes that are involved in diabetes.
Diabetes is diagnosed through blood tests, including fasting blood glucose, HbA1c, oral glucose tolerance tests, and autoantibody screening for Type 1 diabetes. In Type 2 diabetes, the effect of incretin hormones, such as GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic peptide), is abolished, reducing the body's ability to release insulin efficiently after meals.
The problems with diabetes are related to insulin, a hormone that regulates blood sugar. In a healthy person, insulin is produced by the beta cells of the pancreas after meals in response to rising blood glucose levels. Insulin helps the body cells to take in glucose for energy and stores excess glucose in the liver as glycogen.
However, in both forms of diabetes, other hormones such as glucagon, cortisol, growth hormone, and adrenaline counteract the effects of insulin. Elevated cortisol levels, often linked to chronic stress, can increase blood glucose by stimulating gluconeogenesis in the liver in people with diabetes. Excess growth hormone can worsen insulin resistance in people with diabetes.
Glucagon plays a significant role in the pathophysiology of both Type 1 diabetes (T1DM) and Type 2 diabetes (T2DM) primarily through its effects on glucose metabolism and its dysregulation. In T1DM, characterized by autoimmune destruction of pancreatic beta cells and therefore insulin deficiency, there is often an excess of glucagon secretion by alpha cells. This hyperglucagonemia contributes to increased hepatic glucose production by stimulating glycogenolysis and gluconeogenesis, leading to hyperglycemia despite insulin deficiency.
In T2DM, glucagon also contributes to hyperglycemia but in the context of insulin resistance and varying degrees of insulin deficiency. Dysregulated glucagon secretion exacerbates hepatic glucose output, worsening hyperglycemia. Additionally, glucagon influences other metabolic pathways such as amino acid metabolism, lipid oxidation, and bile acid turnover, disruptions of which contribute to T2DM pathogenesis as well as related conditions like non-alcoholic fatty liver disease (NAFLD).
Therapeutically, agents like GLP-1 receptor agonists (GLP-1RA) help restore the balance by enhancing glucose-dependent insulin secretion and suppressing glucagon release, thereby improving glycemic control in T2DM and potentially T1DM.
Continuous glucose monitors (CGMs), insulin pumps, and mobile health apps are transforming diabetes self-management, making it easier for patients to monitor their condition and adjust their treatment plans accordingly. The global rate of diabetes mellitus is continuing to rise, underscoring the need for continued research and development in this field.
- Science is exploring more effective treatments for both Type 1 and Type 2 diabetes, including artificial pancreas systems, immunotherapies, stem cell therapy, gene therapy, and smart insulin formulations.
- A healthy person's insulin, a hormone that regulates blood sugar, is produced by the beta cells of the pancreas in response to rising blood glucose levels after meals.
- In Type 2 diabetes, the effect of incretin hormones like GLP-1 is reduced, affecting the body's ability to release insulin efficiently after meals, making treatment options like GLP-1 receptor agonists (GLP-1RA) significant in restoring balance.
- Mental health plays an essential role in managing diabetes, as chronic stress can elevate cortisol levels, increasing blood glucose by stimulating gluconeogenesis in the liver.
- Continuous glucose monitors (CGMs), insulin pumps, and mobile health apps are revolutionizing diabetes self-management, enabling patients to monitor their condition and adjust their treatment plans accordingly, contributing to better health and wellness.
