Anatomy and physiology of t2d
Lesson Five
Today 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:
Heart
Kidneys
Brain
Eyes
Feet (limbs)
Image: Wikimedia Commons
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
Inside the cell,
glucose is converted
to a substance
(sorbitol) which
builds up because it
cannot get out.
Water flows into the
cell and can cause the
cell to burst (think of a
water balloon).
This is a key mechanism for nerve and retina damage
2. Advanced Glycation End Products (AGEs)
Glucose attaches to proteins
glucose
AGEs cross-link proteins and
contribute to tissue stiffness in
heart, bone and muscle.
protein
AGE damage can also make
small blood vessels leaky
This is a key mechanism for eye and kidney damage.
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
Inside the cell,
glucose is converted
to a substance
(sorbitol) which
builds up because it
cannot get out.
Water flows into the
cell and can cause the
cell to burst (think of a
water balloon).
Can the enzyme that
converts glucose into
sorbitol be inhibited?
Still working on it…
This is a key mechanism for nerve and retina damage
2. Advanced Glycation End Products (AGEs)
TREATMENT
Glucose attaches to proteins
glucose
AGEs cross-link proteins and
contribute to tissue stiffness in
heart, bone and muscle.
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.
This is a key mechanism for eye and kidney damage.
3. Atherosclerosis
TREATMENT
Large blood vessels also
become leaky due to AGEs
Layers of fat and cholesterol start to
accumulate along the vessel walls.
Balloon angioplasty can help
to open narrow vessels
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.
Pathways to organ damage
Chronic Elevated Blood Glucose
Nerve damage
EYES
LIMBS
Capillary damage
KIDNEYS
Large blood vessel damage
HEART
BRAIN
Pathways to organ damage
Chronic Elevated Blood Glucose
Where should money for treatment
and/or prevention be spent?
Nerve damage
EYES
LIMBS
Capillary damage
KIDNEYS
Large blood vessel damage
HEART
BRAIN
Prevention and Treatment
$$
Normal Blood Glucose Levels
Elevated Blood Glucose
=
PREDIABETES
More
Reversible
TYPE 2 DIABETES
$$$$$
with severe complications such as organ damage
Less
Reversible