Diabetes is how was it? ?

More sugar would have diabetes? Pathogenesis of diabetes has not yet been fully elucidated. Clinical research so far, agreed that the cause of diabetes is more than a comprehensive symptoms. The main reason its incidence with the following factors. �� ��Genetic factors: a family history of diabetes susceptibility. However, this genetic effect of external factors still need to, such factors include obesity, reduced physical activity, diet structure is irrational, the virus infection. �� Obesity: Obesity is a major cause of diabetes. Particularly vulnerable to lead to type 2 diabetes. Especially abdominal obesity. The mechanism of obesity itself is obvious hyperinsulinemia, and hyperinsulinemia can reduce the affinity of insulin to its receptor, causing insulin blocked, lead to insulin resistance. This requires the secretion of pancreatic ��-cells and release more insulin, which in turn lead to hyperinsulinemia. This was glucose metabolism and ��-cell function in a vicious cycle of inadequate, leading to serious deficiencies in ��-cell function, causing type 2 diabetes. Abdominal sensitivity of cells to insulin than other parts of the already low, and patients with abdominal obesity, primarily an increase in adipose tissue, this increase in cell volume is increased, but did not increase the number of fat cells, resulting in reduced number of membrane receptors caused by insulin resistance. So that the glucose clearance rate was significantly lower, leading to high blood sugar, causing diabetes. �� ��Inactivity: physical activity can increase tissue insulin sensitivity, reduce weight, improve metabolism, reduce insulin resistance, hyperinsulinemia to ease and reduce cardiovascular complications. Therefore, reduced physical activity in type 2 diabetes has become an important factor. �� ��Diet: Whether in China or in the West, people's diets are high calorie, high fat-based. The over consumption of excessive caloric intake, the resulting accumulation of body fat to obesity. Meanwhile, the high fat diet can inhibit the metabolic rate to weight gain and obesity. Obesity, type 2 diabetes caused by eating meat eaters annual incidence of diabetes was significantly higher than the annual vegetarian. Mainly meat contains fat, protein, high heat related. Therefore, the diet should be diversified in order to maintain nutritional balance and avoid excess nutrients. Neuropsychiatric factors ����: In diabetes, the development process, the spirit of neural factors play an important role is recognized by the Chinese and foreign scholars in recent years. Because of mental tension, emotional excitement, mental stress can cause a significant increase in the secretion of certain stress hormones, and these hormones are glycemic and insulin hormone is also against the hormone. The release of large quantities of these hormones, is bound to cause endocrine regulation of metabolism disorders, caused by high blood sugar, resulting in diabetes. �� ��Virus infection: Some I-diabetic patients, in patients suffering from the flu, mumps and other viral infectious diseases after the onset. The mechanism is that the virus enters the body, direct invasion and islet ��-cells, a large number of damaged ��-cells, and inhibition of ��-cell growth, leading to a lack of insulin secretion, and ultimately lead to type I diabetes. �� ��Autoimmunity: I diabetes is an autoimmune disease, can be found in the serum autoimmune antibodies. The mechanism mainly, viruses and other antigens into the body, so that the internal body dysfunction of the immune system, resulting in a series of islet ��-cells for antibody substances. These antibodies are substances that can directly cause pancreatic ��-cell damage, resulting in a lack of insulin secretion, causing diabetes. �� ��Chemicals and drugs: There are several chemical substances have been identified to cause diabetes. Fight off Ling Li (rat poison), can trigger type 1 diabetes. Two clinical use, Shu dual microphone (used for treatment of pneumonia) and L-asparaginase (an anticancer drug) can cause diabetes. �� ��Pregnancy: pregnancy, the mother produces a large number of various hormones. These hormones on the healthy growth of the fetus is very important, but they can also block the mother's insulin, causing insulin resistance. Although the causes of diabetes are complex, but ultimately it is the absolute lack of insulin as ��, �� the relative lack of insulin, �� lack of insulin effect (ie insulin resistance: refers to the role of insulin to carry out its normal biological effects of inadequate performance of peripheral tissues, especially muscle , adipose tissue glucose utilization barriers) Thus, �� in ��-cells to produce insulin, �� the blood circulation system of insulin delivery, �� insulin target cells and play a physiological role in any of the three steps problems, can cause diabetes. 1, islet ��-cell level. The insulin gene mutations, ��-cell insulin synthesis variability, or the synthesis of ��-cells to change the original structure of insulin, can not be hydrolyzed, can lead to type 2 diabetes. If ��-cell autoimmunity were or chemical damage to cells was significantly reduced, little or no synthesis of insulin synthesis of insulin, Type I diabetes occurs. 2, blood transport level. Substances in the blood increases insulin resistance, can cause diabetes. These substances can be confrontational insulin receptor antibodies, receptors and their binding and can not be combined with insulin, so insulin does not play a physiological role. Hormonal substances may also be against the role of insulin, such as catecholamines. The concentration of cortisol in the blood abnormally high, they can cause hyperglycemia. 3, the target cell level. Reduce the number of receptors or receptor and insulin receptor affinity and reduced defects, can cause insulin resistance and compensatory hyperinsulinemia. ��-cells gradually ultimately failure, plasma insulin levels. Insulin resistance in the pathogenesis of type 2 diabetes plays an important role. Diabetes can be divided into two categories, reasons not clear, we call primary diabetes; and those with diabetes have special causes, such as pancreatic disease, not caused by insulin synthesis, secretion does not appear, or because of other causes of endocrine hormone secretion of insulin are too many antibiotics and so on, which are strands of the scope of the diabetes. Although the primary etiology and pathogenesis of diabetes has not yet entirely understood, but for now to say the least, cause diabetes, there are two basic reasons: first, genetic factors, that diabetes is hereditary, and tarsal is easy to diabetes genes. For example some people believe that genetic insulin-dependent diabetes mellitus is prone to autoimmune destruction of islet gene; for non-insulin-dependent diabetes, generally considered as a multi-genetic, genetic is prone to obesity, insulin resistance and insulin secretion lack of genes. However, if the light has a genetic tendency inherent factors, is still not have diabetes, also need to have acquired factors, or environmental factors, and this is the second factor of diabetes, prevention and treatment of diabetes is also more worthy Note that the factors, including calorie intake too much, decreased activity, obesity, smoking and psychological pressure and so on. Of these two factors, interaction, to make people had diabetes. Pathogenesis of diabetes etiology and pathogenesis of diabetes is very complex and not yet fully understood that the following factors. First, the genetic factors of diabetes is the genetic disease, genetic studies have shown that the incidence of diabetes in the blood relatives and non-blood relatives were significantly different, the former is 5 times higher than the latter. In type 1 diabetes, the importance of genetic factors in the etiology of 50% in type 2 diabetes more than 90% of its importance, thus causing the genetic factors in type 2 diabetes was significantly higher than that of type 1 diabetes. Second, psychological factors in diabetes mental factors, the role of development that accompanied the spirit of the tension, excitement and a variety of emotional stress, elevated blood sugar can cause a large number of hormone secretion, such as growth hormone, norepinephrine , glucagon and adrenal cortex hormones. Third, the obesity factor in obesity is an important predisposing factor of diabetes, about 60% to 80% of adult patients with diabetes in the pathogenesis of diabetic patients are obese, the degree of obesity and diabetes incidence was proportional. Fourth, long-term food intake too much rather than too much control, excess nutrients, so that the already low potential of functional overload of insulin B cells, and induced diabetes. The pathogenesis of type 1 diabetes, diabetes type I is still unknown etiology, including genetic factors is yes, but not diabetes itself genetic, but the susceptibility to diabetes, and only in the external environment and in vivo effect of environmental change, diabetes was only induced, and therefore the etiology of patients with type I diabetes, genetic factors and environmental factors in each half. First, the genetic susceptibility According to statistics, the heritability of diabetes was 44.4% ~ 73.8%, of which the heritability of type I diabetes, 44.4% ~ 53.7%, less than 60%. Type II diabetes, 51.2% ~ 73.8%, generally higher than 60%. 10% of patients with type I diabetes with family history of diabetes, the heritability of three generations of relatives of 6%. II histocompatibility antigen HLA histocompatibility antigen (HLA) is the major histocompatibility complex (MHC), these antigens are glycoproteins located in the plasma membrane of body cells, which control gene located on chromosome 6 short arm, based in the vicinity of the immune response. In patients with type I diabetes associated with certain HLA antigen distribution in the frequency of change, but not diabetes HLA disease genes. Type I diabetes, HLA typing of family, brothers and sisters if the two haplotypes are identical with the first patient, the opportunities for diabetes type I is 15%. If only one haplotype same chance to 5%. If the two haplotypes are different with the first patient, the opportunities to 1%. Third, autoimmune 1. Islets class 2. Type I diabetes and their relatives often accompanied by other autoimmune diseases 3.HLA system antigens in patients with type I diabetes, this is unique to the genetic and autoimmune-related evidence. 4. Islet cell antibodies (ICA) ICA clinical diabetes in the first 3 to 8 years or earlier, found in the blood. ICA diminishes with the disease, type I diabetes within 1 year after diagnosis of ICA-positive rate as high as 60%, 2 to 5 years was 20%, 10 to 20 years to 5%, suggesting that type I diabetes is an autoimmune syndrome. Fourth, external factors 1. Viral infection of diabetes after viral infection is possible, but rare. Virus infection leads to destruction of islet B cells may have three ways: �� the virus enters B cells and long-term stay, affecting cell growth, cell shortened life expectancy, B cells decreased, while stimulating its own immune system, after a few years diabetes, such as rubella virus in fetal sneak in, may be a few years after birth and even after more than ten years of diabetes. �� the virus into the genetic susceptibility of individuals with pancreatic B cell membrane, through viral receptors into B cells, some B cell acute necrosis, followed by cell lysis. Such as myocarditis virus. �� After the virus enters B cells, the nucleic acid into the primary B cell gene reduced, so that the synthesis and secretion of insulin abnormal, this process is called latent infections, such as monkey kidney virus SV4. 2. Chemical toxins in the pathogenesis of Type I diabetes diabetes susceptibility genes in the genetic basis of virus infection in the external environment or chemical damage, inducing cell-mediated autoimmune response, selective destruction of B cells. In general, 90% of the islet B cells are damaged only to diabetes, and the remaining 10% will be destroyed in two to three years. Type II diabetes, the pathogenesis of type II diabetes in genetic and environmental factors, genetic factors accounted for an important position, the importance of more than 90%. First, the performance of genetic factors to have obvious family, and its prevalence rate as high as 85% of the parents, the parents are all type 2 diabetes, half of the children may have diabetes. Type II diabetes is generally believed that multiple genes are recessive genetic chromosome, with a basal insulin secretion and insulin sensitivity based on the exception. Part Type II diabetes occurs in children or adolescents, diabetes, genetic factors such families may be dominant. Patients with type II diabetes, there is generally no abnormal distribution of HLA antigens. Second, obesity and type II diabetes, eating the living environment can be divided into obese and non-obese, including type II diabetes, obesity accounts for 85% to 90%. Type II diabetes, the incidence of the major environmental factor is obesity a long time, but not the only triggers obesity, genetic predisposition itself sufficient to cause Type II diabetes. Obesity itself has a high degree of genetic, appetite, eating habits are governed by genetic factors. Obesity, lifestyle and environment and type II diabetes mellitus and impaired glucose tolerance were considered as significant relationships. Third, barriers to insulin secretion, insulin antagonistic hormone imbalance in insulin secretion in type II diabetes dysfunction manifested in the absence of the first phase and secretion peak shift. Early insulin secretion is normal or increased, but compared with the ratio of elevated blood sugar or low. The first phase insulin secretion reflects the storage of B cell insulin secretion; while the second phase reflects the newly synthesized glucose stimulation of insulin secretion. Type II diabetes is often a lack of first phase, leading to the relative lack of insulin and less sensitive, causing postprandial hyperglycemia. Long-term high blood glucose stimulates the secretion of insulin to increase the second phase, the formation of hyperinsulinemia and insulin resistance. High concentrations of glucose on the islet is also toxic substances, namely glucose toxicity, B cell function gradually decreased, and the second phase insulin response is also reduced. A cell secretion in diabetic patients with glucagon is not inhibited by high glucose and insulin, showed increased secretion of autonomy. Normal blood sugar rose to 6.66mmol / L (120mg/dl), the glucagon is suppressed. However, patients with type II diabetes, glucagon significantly increased, particularly when in ketosis, can be 2 to 4 times the base value, which is also a \glucagon caused increased interaction. In addition, D cells secrete somatostatin (SS) reduction in islet D cells produced an increase in amylin and islet amyloid polypeptide deposition, the occurrence and development of diabetes play a role in both. Fourth, obesity and insulin resistance in non-obese patients with type II diabetes, when insulin levels are often higher decline in the number of insulin receptors, insulin was not the clinical sensitivity, said resistance. It actually includes two aspects: the inhibition of the release of glucose and glycogen decreased peripheral tissues (especially muscle) glucose uptake capacity. Defects in insulin receptor number and affinity of type II diabetes the major exception, in addition, �� subunit (part of the insulin receptor broke into the cell) abnormalities may aggravate the insulin resistance, due to ��-subunit tyrosine kinase activity and insulin role in the regulation is closely related to the exception is due to primary defects or secondary to diabetes status is not yet certain. Many obese non-diabetic patients with type II, a marked insulin resistance, that insulin resistance must be accompanied by abnormal insulin secretion in type II diabetes only. V. neuroendocrine neuroendocrine factors can cause high blood sugar factors, obesity, hyperinsulinemia, insulin secretion impairment and insulin resistance. Hypothalamic regulation of insulin secretion, as the middle lateral hypothalamus or paraventricular nucleus lesions can cause polyphagia, obesity and hyperinsulinemia. Ventromedial hypothalamic stimulation in the sympathetic approval of excitement, so that reduced insulin secretion. Hypothalamic area stimulation of the vagus nerve by increasing the excitement and increased glycogen synthesis and insulin secretion. The pathogenesis of type II diabetes may be: �� genetic factors; �� obesity and poor eating and lifestyle habits; �� primary insulin secretion and insulin antagonistic hormone imbalance. Primary obstacle to increased glycogen output of glucose into the surrounding tissue increased �� �� �� islet B cells in insulin resistance dysfunction; �� insulin resistance (decreased insulin sensitivity) �� �� high blood sugar damages islet B cell function.