1. What is the pancreas, and where is it located?
The pancreas is a long, flat gland located in the abdomen, behind the stomach. It extends horizontally from the duodenum to the spleen.
2. What are the endocrine functions of the pancreas related to diabetes mellitus?
The endocrine pancreas consists of clusters of cells known as the islets of Langerhans, which regulate blood sugar levels. The major cell types involved are:
Beta cells: Secrete insulin, which decreases blood sugar levels.
Alpha cells: Secrete glucagon, which increases blood sugar levels.
Delta cells: Secrete somatostatin, which regulates both insulin and glucagon secretion.
3. What is diabetes mellitus, and how is it defined?
Diabetes mellitus refers to a group of metabolic disorders characterized by chronic hyperglycemia (high blood sugar levels) due to defects in insulin secretion, insulin action, or both.
4. What are the common complications associated with chronic hyperglycemia in diabetes?
Chronic hyperglycemia can lead to damage in multiple organs, especially the kidneys, eyes, nerves, and blood vessels, leading to conditions like end-stage renal disease, adult-onset blindness, and non-traumatic amputations.
5. How prevalent is diabetes globally, and which countries contribute the most to the global burden?
As of 2015, about 8.5% of adults aged 18 years and older had diabetes, affecting roughly 422 million people. India and China are the largest contributors to the global diabetic population.
6. What are the diagnostic criteria for diabetes mellitus?
According to the American Diabetes Association (ADA) and World Health Organization (WHO), diabetes is diagnosed when any of the following are present:
Fasting plasma glucose ≥ 126 mg/dL
Random plasma glucose ≥ 200 mg/dL with symptoms of hyperglycemia
2-hour plasma glucose ≥ 200 mg/dL after a 75g oral glucose tolerance test
HbA1c (glycated hemoglobin) ≥ 6.5%
7. What is pre-diabetes, and how is it diagnosed?
Pre-diabetes is a state of dysglycemia that often precedes type 2 diabetes. It is diagnosed when:
Fasting plasma glucose is between 100 and 125 mg/dL (impaired fasting glucose)
2-hour plasma glucose is between 140 and 199 mg/dL (impaired glucose tolerance) after a 75g oral glucose tolerance test
8. How is diabetes mellitus classified?
Diabetes mellitus is broadly classified into two types:
Type 1 Diabetes: An autoimmune disease where beta cells in the pancreas are destroyed, leading to absolute insulin deficiency. It is more common in individuals younger than 20.
Type 2 Diabetes: Characterized by insulin resistance and relative insulin deficiency. It is more common in adults but can also occur in adolescents and children.
9. What are some causes of Type 2 diabetes mellitus?
Type 2 diabetes can be caused by:
Genetic defects in beta cell function or insulin action
Exocrine pancreatic diseases like chronic pancreatitis or pancreatic trauma
Endocrinopathies (e.g., Cushing’s syndrome, acromegaly)
Viral infections (e.g., cytomegalovirus)
Drugs like glucocorticoids or thyroid hormone supplements
10. What is gestational diabetes mellitus (GDM)?
Gestational diabetes mellitus is a type of diabetes that occurs during pregnancy. It is similar to type 2 diabetes but occurs only during the gestational period.
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