Anatomy and physiology of t2d

Lesson FiveToday we will…

•Make a human body poster that shows how t2d affects organs and body systems

•Look at treatment options for different symptoms of t2d

•Evaluate costs of prevention and treatment options for t2d

Lesson 5

“If current trends continue, 1 in 3 U.S. adults will have diabetes by 2050.”

Center for Disease Control and Prevention

http://www.cdc.gov/chronicdisease/resources/publications/aag/ddt.htm

Many body organs are affected by type 2 diabetes.

Today’s lesson focuses on:

Image: Wikimedia Commons

Heart

BrainEyes

Feet (limbs)

Kidneys

Three mechanisms

Three ways type 2 diabetes damages cells and organs:

1.Polyol Pathway

2.Advanced Glycation End Products (AGEs)

3.Atherosclerosis

1. Polyol Pathway

Cells in the kidney, eye, and nerves take up glucose in the absence of insulin

Water flows into the cell and can cause the cell to burst (think of a water balloon).Inside the cell,

glucose is converted to a substance (sorbitol) which builds up because it cannot get out.

This is a key mechanism for nerve and retina damage

This is a key mechanism for eye and kidney damage.

2. Advanced Glycation End Products (AGEs)

Glucose attaches to proteins

protein

glucoseAGEs cross-link proteins and contribute to tissue stiffness in heart, bone and muscle.

prot

ein protein

AGE damage can also make small blood vessels leaky

3. Atherosclerosis

Large blood vessels also become leaky due to AGEs Layers of fat and cholesterol start to

accumulate along the vessel walls.

This makes the blood vessel stiff and narrows the channel.Atherosclerosis leads to high blood pressure, causing the heart to work harder.

This is a key mechanism for heart failure and stroke. It also contributes to kidney failure.

1. Polyol Pathway TREATMENT

Cells in the kidney, eye, and nerves take up glucose in the absence of insulin

Water flows into the cell and can cause the cell to burst (think of a water balloon).Inside the cell,

glucose is converted to a substance (sorbitol) which builds up because it cannot get out.

This is a key mechanism for nerve and retina damage

Can the enzyme that converts glucose into sorbitol be inhibited?

Still working on it…

This is a key mechanism for eye and kidney damage.

2. Advanced Glycation End Products (AGEs)TREATMENT

Glucose attaches to proteins

protein

glucoseAGEs cross-link proteins and contribute to tissue stiffness in heart, bone and muscle.

prot

ein protein

AGE damage can also make small blood vessels leaky

Drugs that inhibit the formation of AGEs have been tested, but…none have been shown to reduce kidney damage. Yet.

3. AtherosclerosisTREATMENT

Large blood vessels also become leaky due to AGEs Layers of fat and cholesterol start to

accumulate along the vessel walls.

This makes the blood vessel stiff and narrows the channel.Atherosclerosis leads to high blood pressure, causing the heart to work harder.

This is a key mechanism for heart failure and stroke. It also contributes to kidney failure.

Balloon angioplasty can help to open narrow vessels

Pathways to organ damage

Chronic Elevated Blood Glucose

Nerve damage Capillary damage Large blood vessel damage

EYES LIMBS KIDNEYS HEART BRAIN

Pathways to organ damage

Chronic Elevated Blood Glucose

Nerve damage Capillary damage Large blood vessel damage

EYES LIMBS KIDNEYS HEART BRAIN

Where should money for treatment and/or prevention be spent?

Prevention and Treatment

Elevated Blood Glucose=

PREDIABETES

TYPE 2 DIABETESwith severe complications such as organ damage

Normal Blood Glucose Levels

$$$$$

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Less Reversible

More Reversible