Complications of Hyperglycemia and Management of Type 2 Diabetes

Question 1
In a normal individual, beta cells found in islets of Langerhans in the pancreas upon sensing
hyperglycemia, synthesize insulin a hormone that breaks down the excess glucose into harmless
glucagon. Furthermore, the insulin binds on tissue receptors and sends signals to stimulate
cellular uptake of glucose. In an individual with type 2 diabetes like McRoberts, the beta cells do
not synthesize insulin upon hyperglycemia due to insensitivity brought about by the initial
overproduction of insulin. The available insulin on the other hand binds on receptors but doesn’t
transmit the signal to increase cellular uptake of glucose. This two conditions makes it difficult
to control glucose in blood.
Question 2
Accumulation of glucose in blood to toxic levels is referred to as hyperglycemia. This condition
is associated with diverse complications. Neuropathy and myocardial infarction are just the
notable complications. When glucose builds up to toxic levels, it destroys nerves in the body
such that there is impaired relay of signals within the body. This condition is defined as
neuropathy. Similarly, damage of nerves that coordinate contraction and relaxation of muscles of
the heart leads to irregular or abnormalities in contraction thus leading to myocardial infarction.
Question 3
The drug of choice for type 2 diabetes is metformin. It works by stimulating cellular metabolism
through the action of AMP-activated protein kinase. Metformin normally inhibit production of
mitochondrial ATP. This leads to an elevated cytoplasmic ADP: ATP and the AMP: ATP ratios
that in return activate the enzyme that increase cellular metabolism.

Question 4
a)
In different studies examining the relationship between adiposity and the risk of type 2 diabetes,
results indicate that obesity increases the risk of type 2 diabetes. The studies found out that
accumulation of adipose tissue under the viscera leads to production of retinol binding protein 4
that increases insulin resistance within the cells of the body.
b)
HbA1c is a combination of glucose and hemoglobin. Measuring or estimating the level of
HbA1c is the best approach during management of type 2 diabetes. HbA1c provides an average
amount of glucose in the body for a period of around 10 weeks. This measure can therefore be
used to evaluate how the patient responds to medication. If for example the level of glucose
remains high, then that means the therapy hasn’t worked while low levels indicate the therapy is
effective.