DIABETES TYPE 1 epidemology and pathogenisis short way

diabetes type 1 epidemology and pathogenesis in a short way and easy way to understand

1. Subtitle Title Layout Presented by Muneesh Group -1 Zaporozhzhye state medical and pharmaceutical university DIABETES TYPE 1

2. WHAT IS DIABETES MELLITUS Diabetes mellitus is a chronic disorder characterized by persistent hyperglycemia Due to defective insulin secretion,insulinactionor by both. It leads to disturbances in carbohydrate,fatand protein metabolism .

3. Epidemology >The total number of people with diabetes worldwide was estimated to be between 151 million and 171 million at the turn of the century, and is expected to rise to 366 million by 2030. >The prevalence of diabetes in the developing world are due to sedentary life styles, with India and China being the largest contributors to the world's diabetic load. >The chronic hyperglycemia and metabolic dysregulation may be associated with secondary damage in multiple organ systems, especially the kidneys, eyes, nerves, and blood vessels.

4. HOW TO FIND DIABETES The diagnosis of diabetes is established by elevation of blood glucose by any one of three criteria: 1. A random glucose concentration greater than 200 mg/dl, with classical signs and symptoms 2. A fasting glucose concentration greater than 126 mg/dl on more than one occasion. 3. An abnormal oral glucose tolerance test, in which the glucose concentration is greater than 200 mg/dl hours after a standard carbohydrate load.

5. What is Pre diabetes Fasting glucose concentrations greater than 100 mg/dl but less than 126 mg/dl, or OGTT values greater than 140 mg/dl but less than 200 mg/dl, are considered to have impaired glucose tolerance, also known as "pre-diabetes.“ • It is defined as elevated blood sugar that does not reach the criterion accepted for an diagnosis of diabetes.

6. Pre diabetes Individuals with pre-diabetes have an elevated risk for developing frank diabetes. Frank diabetes, either of the ketosis-prone or ketosis-resistant type. Fasting hyperglycemia is present. Symptoms of hyperglycemia and glucosuria may be present. pre-diabetes patients have an elevated risk for developing cardiac diseases also.

7. CLASSIFICATION OF DIABETES (DM) Mainly it is divided into 4 categories 1.Type 1 diabetes a.Auto immune (type1A) b.Non autoimmune/idiopathic (Type1B) 2.Type 2 diabetes 3.Gestational diabetes 4.Other special type of DM

8. Other special type of DM A.Specific defined gene mutations For examples of GENES like MODY-1,MODY-2,MODY-4,MODY-X B.Insulin gene mutation C.Insulin receptor gene mutation D.Exocrine pancreatic defect E.Diabetes associated with genetic syndromes like prader willi syndrome F.Diabetes associated with drug therapy.

9. 1.Type 1 diabetes a.Auto immune (type1A) This is the most common form of T1DM and is driven by an autoimmune attack against insulin-producing β-cells in the pancreas Pathogenesis of Type 1A DM is explained on the basis of 3 mutually-interlinked mechanisms: 1.Genetic susceptibility. 2.Autoimmune factors. 3.Certain environmental factors. Pathogenesis of Type 1B DM remains idiopathic.

10. a.Auto immune (type1A) 1.Genetic susceptibility. > The HLA class gene on chromosome 6p21 is the most critical genetic precursor of T1D risk, accounting for 50% of genetic susceptibility. Examples : HLA-DR3, HLA-DR4 >Non-HLA genes contribute to approximately 30-40% of genetic susceptibility and are involved in immune regulation, β-cell function, and inflammation. Example : INS, PTPN22,IL2RA and CTLA-4

11. a.Auto immune (type1A) 2.Autoimmune Factors Activation of auto-reactive T-cells against β- cell antigens (e.g., insulin, GAD65, IA-2, ZnT8). > CD8+ cytotoxic T cells directly destroy β- cells. >CD4+ T cells stimulate B cells to produce autoantibodies. >Chronic inflammation and cytokine release (e.g., IFN- γ, TNF- α, IL-1 β) exacerbate β- cell destruction.

12. a.Auto immune (type1A) 3.ENVIRONMENTAL FACTORS > Environmental factors especially viral infections involved triggering islets cell destruction type 1 diabetes Type 1 diabetes and infection with mumps, rubella, coxsackie B, or cytomegalovirus, among others. Most autoimmune diseases, the pathogenesis of type 1 diabetes represents interplay of genetic susceptibility and environmental factors.

13. 2.IDIOPATHIC TYPE (TYPE1B) This form is less common and primarily observed in African and Asian populations. It lacks clear autoimmune markers. Pathogenesis: • No Autoantibodies: Unlike Type 1A, patients do not exhibit β- cell autoantibodies. • Genetic Factors: The underlying genetic basis is poorly understood, but some non-HLA genes may play a role. • Periodic β- Cell Dysfunction: Some patients exhibit episodic ketoacidosis with intermittent insulin dependence. • Possible Environmental or Metabolic Triggers: Unlike autoimmune T1DM, triggers remain unclear but could involve metabolic stress or unknown inflammatory processes.