Diabetes mellitus

Type 1, IDDM, juvenile DM

2 types1. Insulin dependent (autoimmune mediated)

2. Non- Insulin dependent (non-autoimmune mediated)

Endocrine PancreasProduce and secretes:1. Insulin2. GlucagonImportant in glucose homeostasis

Insulin dependent (autoimmune mediated)Results from autoimmune destruction of insulin-producing beta cells of the pancreas The subsequent lack of insulin leads to increased blood and urine glucose. Eventually, type1 diabetes is fatal unless treated with insulin.

Cause Diabetes type I is induced by a combination of genetic susceptibility, a diabetogenic trigger and exposure to a driving antigen.MHC : DRB1 0401, DRB1 0402, DRB1 0405, DQA 0301, DQB1 0302 and DQB1 0201

Process of Immune destruction

Environmental2. Viruses: (Coxsackie virus & Rubella virus)3. Diet: (through influencing gut flora, intestinal permeability, and immune function in the gut) 4. Chemicals and drugs:(Pyrinuron, a rodenticide streptozotocin, an antibiotic and antineoplastic agent used in chemotherapy for pancreatic cancer)

Diagnosis1. Clinical2. Biochemical (high blood sugar, H 1 C)3. Auto-Abs against pancreatic islet

Treatment -Replacement with insulin. -Islet graft ?

Adrenal glandsSuprarenal Glands

Adrenal glands

The cortices produce:

Cortisol Aldosterone. Addisons disease occurs when adrenal glands do not produce enough Cortisol and sometimes Aldosterone. Production of Cortisol is regulated by the pituitary gland's secretion of ACTH

Autoimmune Addisons diseaseIt is an autoimmune inflammation of adrenal glands, resulting in their gradual destruction and inability to make sufficient amounts of adrenal hormones.

Addisons disease occurs when more then 90% of adrenal gland tissue is destroyed.

Presence of Addisons disease or other autoimmune diseases in families.Commonly associated with polyglandular syndromesPresence of autoantibodies

ClinicalsManifested as:HypotensionFatiguePoor appetites,Nausea Dizziness Weight loss

DiagnosisClinicalCortisol levels in blood. ACTH Stimulation Test Insulin-Induced Hypoglycemia Test CT scan of abdomen NMRI (nuclear magnetic resonance imaging)

TreatmentHormonal replacement