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1. BIOCHEMISTRY
[B. Pharm – I Yr.]
Topic: Diabetes Mellitus
Umesh Kumar
Assistant Professor
Dept. of Pharm. Chemistry
Hygia Institute of Pharmaceutical Education and Research

2. CONTENTS
• Diabetes Mellitus
• Introduction
• Types
• Mechanism
• Hormonal Regulation

3. Diabetes Mellitus
Historical Perspectives
• The term is derived from the Greek words dia (=through), bainein (=to go) and diabetes literally
means pass through.
• The disease causes loss of weight as if the body mass is passed through the urine.
• The Greek word, mellitus, means sweet, as it is known to early workers, that the urine of the patient
contains sugar.
• Charaka in his treatise (circa 400 BC) gives a very elaborate clinical description of Madhumeha (=
sweet urine).
• He had the vision that carbohydrate and fat metabolisms are altered in this disease.
• In Western literature, Thomas Willis in 1670 noticed the sweet taste of diabetic urine.

4. Diabetes Mellitus
• Diabetes mellitus is a metabolic disease due to absolute or relative insulin deficiency.
• Diabetes mellitus is a common clinical condition.
• About 10% of the total population, and about 1/5th of persons above the age of 50, suffer from this
disease.
• It is a major cause for morbidity and mortality. Insulin deficiency leads to increased blood glucose
level.
• In spite of this high blood glucose, the entry of glucose into the cell is inefficient.
• Hence all cells are starved for glucose.

5. Classification
The disease may be classified as follows (WHO recommendation, 1999):
1. Type 1 Diabetes Mellitus (formerly known as Insulin-dependent diabetes mellitus; IDDM)
About 5% of total diabetic patients are of type 1.
Here circulating insulin level is deficient. It is subclassified as:
a. Immune mediated and
b. Idiopathic.
2. Type 2 Diabetes Mellitus (Formerly known as non-insulin dependent diabetes mellitus; NIDDM)
Most of the patients belong to this type. Here circulating insulin level is normal or mildly elevated
or slightly decreased, depending on the stage of the disease.
This type is further classified as:
a. Obese
b. Non-obese

6. Metabolic Syndrome (MetS) (Type – 2)
• It is a combination of abdominal obesity, atherogenic
dyslipidemia (hypertriglyceridemia and low HDL
cholesterol), elevated blood pressure and elevated
plasma glucose.
• The body cannot properly use glucose even in presence
of normal insulin level.
• In other words, body cannot use insulin efficiently.
Therefore, the metabolic syndrome is also called the
insulin resistance syndrome.
• People with MetS are at increased risk of coronary heart
disease and type 2 diabetes.

9. Hormonal regulation of Blood Glucose level
Pancreatic Hormones:
• Regulation of blood glucose is largely done through the endocrine
hormones of the pancreas.
• The main hormones of the pancreas that affect blood glucose
include insulin, glucagon, somatostatin, and amylin.
• Insulin (formed in pancreatic beta cells) lowers BG levels, whereas
glucagon (from pancreatic alpha cells) elevates BG levels.
• Somatostatin is formed in the delta cells of the pancreas and acts as
the “pancreatic policeman,” balancing insulin and glucagon. It
helps the pancreas alternate in turning on or turning off each
opposing hormone.
• Amylin is a hormone, made in a 1:100 ratio with insulin, that helps
increase satiety, or satisfaction and state of fullness from a meal, to
prevent overeating. It also helps slow the stomach contents from
emptying too quickly, to avoid a quick spike in BG levels.

10. Overview of Hormonal effects on blood glucose level

11. Hormonal regulation of Glycogen Metabolism

13. THANK YOU
HYGIA GROUP OF INSTITUTIONS
GHAILA ROAD, GAAZIPUR BALRAM,
FAIZULLAHGANJ, LUCKNOW