浅析1型糖尿病的治疗途径及诊断和筛查方法

Rida Tanveer, Iqra Fasih, Syed Ahmad, Samreen Riaz
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摘要

糖尿病是一种以血糖水平异常升高为特征的内分泌系统疾病。1型糖尿病(T1DM)是一种早发的自身免疫性疾病,而2型糖尿病(T2DM)是一种晚发的非自身免疫性疾病。小动脉和大动脉并发症是糖尿病长期并发症的两大类。由于高血糖的致病作用,线粒体电子传递链(ETC)产生过量的超氧化物,导致氧化应激。在T1DM视网膜病变的情况下,新生血管是脆弱和高渗透性的。已知T1DM是由β细胞破坏导致高血糖和胰岛素缺乏引起的。在第三阶段T1DM通常被诊断出来,在这个阶段,这种疾病会导致危及生命的疾病,即糖尿病酮症酸中毒。为了尽量减少严重并发症的可能性,有必要通过早期筛查或使用诊断工具来诊断生命最初几年存在的自身免疫。测量空腹血糖或标准OGTT用于筛选2期T1DM患者,这些患者有1个或多个针对β细胞的自身抗体。1型糖尿病的管理是必要的,以鼓励健康的生活方式和控制血糖状况,以避免严重的并发症。药物治疗是治疗T1DM最广泛使用的方法,包括注射胰岛素和葡萄糖共转运蛋白2 (SGLT2)抑制剂、基因治疗和干细胞治疗。这些应该有助于提供终身免于T1DM的自由,但在这方面仍有争论的余地。
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Brief analysis of Therapeutic Approaches of Type 1 Diabetes Mellitus along with Diagnosis and Screening Methods
Diabetes is an endocrine system disease which is characterized by abnormal elevated glucose levels. Type I Diabetes Mellitus (T1DM) is an autoimmune disorder with early onset, whereas Type 2 Diabetes Mellitus (T2DM) is non-autoimmune form with late onset. Small and large artery complications are the two main categories of diabetes mellitus long term complications. Overproduction of superoxide by the mitochondrial electron transport chain (ETC), leading to oxidative stress, occurs because of pathogenic effects of hyperglycemia. New vessels are fragile and hyper permeable in case of retinopathy in T1DM. T1DM is known to be occurred by beta cell destruction which leads to hyperglycemia and insulin scantiness. In phase 3 T1DM is normally diagnosed, the stage at which the disorder has led to life threatening condition known as diabetic ketoacidosis. To minimize the possibility of serious complication it is necessary to diagnose autoimmunity which is present during first years of life through early screening or by using diagnostic tools. Measuring fasting blood glucose or standard OGTT’s are performed for screening of phase 2 T1DM in the persons which have 1 or more autoantibodies targeting β-cell. The management of type 1 diabetes mellitus is necessary to encourage healthy lifestyle and to control glycaemia conditions in order to avoid severe complication. Pharmacological approaches are the most widely used method for the treatment of T1DM including injectable insulin and sodium glucose cotransporter 2 (SGLT2) inhibitors, Gene therapy and stem cellbased therapies. These are supposed to help in providing life-time freedom from T1DM but there is still a room for debate in this regard.
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