DiabetesKelly Goodwin, BS, MPS

February 29, 2012

Science Club for Girls

What we are going to talk about…

• Questionnaire• The Basics of Diabetes• My research:• Lifestyle impacts• Treatments• What is insulin?• Presentation of treatment methods• The future of insulin delivery

• Prevention

Questionnaire

• What do you know about diabetes?• At what age does someone tend to be diagnosed with

diabetes? (type 1, type 2, or both) • What is the organ in diabetes that malfunctions? • What is insulin resistance? • What is the treatment for diabetes?

The Facts

• Seventh leading cause of death in the United States (2010).

• Affects about 8.3% of the population or 25.8 million children and adults (2011 National Diabetes Fact Sheet). • 18.8 Diagnosed, 7 undiagnosed.

• Two types: type 1 and type 2• Type 1 diabetes makes up 5-10% of all cases• Diagnosed at an early age.

• Type 2 diabetes makes up the other 90-95%• It is also known as adult onset.

The Basics

• The pancreas is an organ located behind the stomach and is the organ that is directly involved in diabetes.

• It’s function in the body is to assist in the break down of food in the small intestine by releasing digestive enzymes and the storage and release of glucagon and insulin.

The Basics

• The islets of Langerhans: • Alpha (α) cells- glucagon• Beta (β) cells- insulin • Delta (δ) cells- somatostatin• F cells (PP cells)-  pancreatic

polypeptide• Epsilon (ε) cells- ghrelin

• In type 1 diabetes the body attacks the β cells, thus destroying the pancreas’s ability to produce insulin. This is known as an autoimmune response.

• In type 2 diabetes the cells in the body become resistant to insulin.

The Basics

Type 1 diabetes Symptoms

• Excessive thirst• Urination• Hunger• Loss of weight• Slow healing infections

Type 2 diabetes Symptoms

• Blurred vision• Tingling/numbness• Excessive thirst• Urination• Hunger• Loss of weight• Slow healing infections

The Basics

Regimens• Blood glucose monitoring• Administering insulin shots• Taking additional medications

to treat or prevent complications

• Doctors visits• Exercise• Managing diet

Complications• Blindness• Kidney disease• Heart disease• Neuropathy• High blood pressure

What happens in the body

Video

Lifestyle

• The best way to understand the daily requirements and hardships of those living with diabetes is to either talk to those living with the disease or read illness memoirs written by people living with the disease.

Illness Memoirs

• Showdown with Diabetes, Deb Butterfield• Sweet Invisible Body: Reflections on a Life with

Diabetes, Lisa Roney• Cheating Destiny: Living with Diabetes, America's

Biggest Epidemic, James S Hirsch• Needles: a Memoir of Growing up with Diabetes,

Andie Dominick • After the Diagnosis: Transcending Chronic Illness,

Julian Seifter• Bittersweet: Diabetes, Insulin, and the

Transformation of Illness, by Chris Feudtner

“Perceptions of Diabetes in American Culture in the 20th and 21st Centuries”

Themes:• Change in self-identity over time• Stigma/fear of isolation• Financial Hardships• Interactions between patients and physicians• Difficulties in managing diabetes: drug therapy, medical

complications, and life style effects. • Reading and writing stories/narratives/memoirs to

understand chronic illness

My research

Treatments

Type 1

• Insulin therapy• Diet• Medication• Blood Glucose

Monitoring• Transplantation

Type 2

• Diet• Exercise• Medication• Blood Glucose

Monitoring• Insulin therapy

Insulin

• It is a hormone produced in the pancreas by beta (β) islet cells. The type of biological molecule is a protein.

• It is a key hormone in the metabolism of carbohydrates into glucose. It does so by helping the cells take up the glucose in the blood to use for energy.

My research

Insulin

• It was first discovered in 1921, and January 11, 1922 the first injection of insulin was given.

• Up until 1980, the insulin given was animal based. In 1980 recombinant human DNA insulin was produced and given to patients.

• 3D Image

Production of insulin

• Production in Bacteria• Production in Yeast

My research

Too much Insulin

• Leads to hypoglycemia, or a lack of glucose in the blood. • Less than 72 mg/dL. • Symptoms include: • Shaking, confusion, sweating, hunger, difficulty speaking,

glassy eyes. • If not treated: coma, brain damage, and/or death.

Too little Insulin

• Leads to hyperglycemia, or too much glucose in the blood.

• Above 200 mg/dL. • Symptoms include:• Excessive thirst, urination, hunger, fatigue, sleepiness. • If not treated: damage to major organs, nerves, blood

vessels, weight loss, coma, brain damage, and/or death.

**The optimal range for blood glucose is 80-120 mg/dL.

Devices

• Blood Glucose Monitor• Syringe• Pen• Pump (w/ Continuous Glucose Monitor)• Pod

The future of insulin delivery

Oral delivery:• There are some major drawbacks to oral delivery of

insulin. • Sensitive to the pH and enzymes located in the stomach and

intestine. • It is a large molecule so it cannot easily pass though the

wall of the intestine.

• Nanoparticles and microbeads

My Research

The future of insulin delivery

The artificial pancreas• the medical equipment approach - using an insulin pump and

real-time data from a continuous blood glucose sensor.• the bioengineering approach - the development of a bio-

artificial pancreas consisting of a biocompatible sheet of encapsulated beta cells.

• the gene therapy approach - the therapeutic infection of a diabetic person by a genetically engineered virus which causes a DNA change of intestinal cells to become insulin-producing cells.

Prevention

• Type 1• Type 2

Bibliography

•American Diabetes Association. "American Diabetes Association." American Diabetes Association. Web. 22 Feb. 2012. <American Diabetes Association>.•Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general

information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.•Cold Spring Harbor Laboratory. "How Insulin Is Made Using Bacteria." DNA Learning Center. Web. <http://www.dnalc.org/view/15928-How-insulin-is-made-using-bacteria.html>. •Cold Spring Harbor Laboratory. "How Insulin Is Made Using Yeast." DNA Learning Center. Web. <http://www.dnalc.org/view/15929-How-insulin-is-made-using-yeast.html>. • Continuous Glucose Monitoring System (CGMS) Set-Up. YouTube.com. Diydiabetic, 7 July 2011. Web. <http://www.youtube.com/watch?v=yq-Nj9hsrNk&context=C4f6f24bADvjVQa1PpcFN3zBSQZUwuxnvRls27C1PxK93ieh6qfnc=>.  •Diabetes Animation. YouTube.com. Isaaq01, 19 May 2010. Web. <http://www.youtube.com/watch?v=NnIWDxuZKUo&feature=related>. •Elayat, A. A., M. M. El-Naggar, and M. Tahir. "An Immunocytochemical and Morphometric Study of the Rat Pancreatic Islets." Journal of Anatomy 186 (1995): 629-37.PubMed Health. Web. 21 Feb. 2012. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1167020/?page=1>.•Harrison, Karl. "Insulin @ 3DChem.com." 3D Chem. June 2005. Web. <http://www.3dchem.com/molecules.asp?ID=196>. • "History of Insulin." Web. 24 Feb. 2012. <http://content.karger.com/ProdukteDB/Katalogteile/isbn3_8055/_83/_53/Insulin_02.pdf>.

Bibliography

•How to Test Your Blood Glucose (sugar) Levels. YouTube.com. Diabetescouk, 3 Dec. 2010. Web. <http://www.youtube.com/watch?v=rMMpeLLgdgY&feature=related>. • How to Use an Insulin Pen. YouTube.com. Atomrph, 13 Oct. 2009. Web. <http://www.youtube.com/watch?v=sv3C6Nl1VUc>.  •Insulin Pump 101: Setting Up the Pump. YouTube.com. Diydiabetic, 20 Mar. 2011. Web. <http://www.youtube.com/watch?v=__QdsFc62eY&context=C493eaafADvjVQa1PpcFN3zBSQZUwuxkJ_2bgy1FvN6ONQfmzHYMM=>.  •Insulin Structure. Photograph. Control of Genetic Systems in Prokaryotes and Eukaryotes. University of Illinois at Chicago, 2004. Web. 4 Dec. 2011. <Control of Genetic Systems in Prokaryotes and Eukaryotes>.•Mayo Clinic Staff. "Diabetes Treatment: Medications for Type 2 Diabetes." Mayo Clinic. 22 Oct. 2011. Web. <http://www.mayoclinic.com/health/diabetes-treatment/DA00089>. • Nazario, Brunilda MD. Type 1 Diabetes. Digital image. MedicineNet. WebMD, Oct. 2004. Web. 15 Feb. 2012. <http://www.medicinenet.com/script/main/art.asp?articlekey=42943>.•Nazario, Brunilda MD. Type 2 Diabetes. Digital image. MedicineNet. WebMD, Oct. 2004. Web. 15 Feb. 2012. <http://www.medicinenet.com/script/main/art.asp?articlekey=42940>.•"See How It Works: OmniPod Has Just Three Simple Steps to Delivery." OmniPod. Web. <http://www.myomnipod.com/about-omnipod/see-how-it-wo