Notes
Outline
Type 1 DM
Goals
   To present a broad, low-power overview of type 1 diabetes with selected views in varied magnification and sundry light
Kylie Middleton Calls her GP Out
What is Diabetes Mellitus?
  The
Final Common
Pathway of Expression of
 Elevated Blood Glucose (Hyperglycemia)  where
  Small Vessel Complications =
 Σ([blood glucose],time)
Normal Retinal Fundus
Diabetic Proliferative Retinopathy
Diabetic Nephropathy
Diagnosis of Diabetes Mellitus
The Clinical Spectrum of Diabetes Mellitus
Type 1 Diabetes Mellitus
Type 1 Diabetes in 1922
Stages in the Development of Type 1 Diabetes
Normal Pancreas Histology
Normal Islet
What’s
What and
Where in the Islet?
Progression to Diabetes vs Number of Autoantibodies (GAD, ICA512, Insulin)
Insulitis
Antigen presentation
Antigen presentation-2
Gene Frequencies - DQ-ß and DM-1
Antigen presentation-3
Antigen presentation-4
Lack of Progression to DM of ICA+ 0602+ Relatives
Type 1 Diabetes Data
Geography of DM-1
What Characterizes the Spectrum of Type 1 Diabetes?
Incomplete penetrance
Nordic predominance
Increased glycosylation
Glycosylation and Arctic Survival
Annu. Rev. Physiol. [2001] 63:359­90
ANTIFREEZE PROTEINS OF TELEOST FISHES
Garth L Fletcher, Choy L Hew, and Peter L Davies  1Ocean Sciences Centre, Memorial University of Newfoundland, St.  John's, Newfoundland A1C 5S7, Canada
Type 1 Diabetes
What Goes Wrong?
Intermediary Metabolism
Insulin Message
Insulin
Insulin Secretion-1
Insulin Secretion-2
Insulin Secretion - 3
Insulin Secretion-4
Normal Glucose
Regulation
Insulin Action-1
Insulin Action-2
Counter-regulatory hormones
Endocrine Causes of Diabetes Mellitus
Glycolysis-1Insulin
Glycolysis-2Insulin
Mitochondrial Metabolism -
The Tricarboxylic Acid Cycle (Krebs)
Liver and Muscle
Hepatocyte – A Purveyor of Glucose
Gluconeogenesis-1 counter-regulatory
Gluconeogenesis-2 counter-regulatory
LipogenesisInsulin
Lipolysis counter-regulatory
Insulinoprivic or Counter-Regulatory Lipolysis
Diabetic Pathophysiology - Liver
Diabetic Pathophysiology - Muscle
Diabetic Keto-Acidosis  (DKA)
Kylie Middleton Calls her GP Out
Type 1 Diabetes in 1923