Trigger 5: T1 diabetes Flashcards
T1 diabetes is
on the rise
how much of diabetes is t1
8-10%
why is the rise of T1DM not due to genetics
due to the rate that T1DM it cannot be attributed to change in genetics of populations and must be attributed to environmental factors
cause of t1DM- simple
triggering of autoimmune response again beta cells which causes beta cell destruction and impaired insulin secretion
strategies to prevent or reverse diabetes
beta-cell protection
regeneration
replacement
very little is know about the
aetiology of the disease- making designing therapies hard
how many people have t1DM
422million
how much spent on t1DM a day
£22m
how much of NHS budget spent on diabetes
10% (although 90% are T2)
symptoms of T1DM
Thirst
Thin
Tired
Tilet
how quickly is T1Dm increased
at a rate of 4%/year
what has been implicated as responsible for the onset of t1DM
virus
why have virus been hypothesised as causing T1DM- simple
due to seasonal pattern of onset- specifically entervorisuses
which type of virus’ have been implicated
enterovirus’
animal models and virus
in animal models enterovirus have been found to accelerate the disease
example of enterovirus
Cocksaxie
virus- other argument
♣ under certain conditions they were also able to protect against disease
Blood tests used to research/ monitorT1DM
- genetic variants
- autoantibodies
- c-peptide
- immune cell subsets
- cytokine response
why are blood tests not very practical
most patients are children, limited by the frequency of withdrawals- children don’t like needles
research on the pancreas is
rare- major obstical for diabetic research
how many pancreas’ have been studies
150
why have so few pancreas’ been studies
- verry inaccessible
- not routinely biopsied
- risky procdure
the pancreas produces
digestive enzymes and hormones
how much of the pancreas produces digestive enzymes
98%
how much produces hormones
2%
which hormones does the pancreas produce
glucagon and insulin
what ca be used to visualise the islets of langerhans e.g. detecting glucagon and insulin
immunostaining
what does immunostaining show
that in T1DM B cells are selectively targeted
in non diabetic immunostaining shows
that most cells make insulin, only a few make glucagon
in diabetic immunostaining shows
no insulin production
glucagon cells still work and are functional
progression fo T1 throughout life
individuals start with some B cells. however at some point overt diabetes ensures due to not having enough b cells
potential for an intervention if
individuals at risk of T1DM are identified
what is the main animal model for T1D
NOD mice
NOD mice
non-obese diabetes mice
NODs are used to
study autoimmune diseases such as T1D
- mice spontaneously develop autoimmune diabetes
strengths of NOD mouse
- existence of spontaneous autoimmunity and T1D
- similar to human condition e.g. producing autoantibodies and increase in circulating auto reactive T cels prior to onset of T1D
weaknesses of NOD mouse
- different pathogenic process to humans
- therefore therapeutics may not be relevant to humans
- difference in appearance of insulitis
