Diabetic Retinopathy And Non Endocrine Fibroblast Growth Factor 21 ( Fgf21 )

Diabetes is a growing concern and health challenge for the American people (b). Diabetes is a condition in which the body cannot react to insulin appropriately or either cannot produce insulin efficiently (w). “Without a properly functioning insulin signaling system, blood glucose levels become elevated and other metabolic abnormalities occur, leading to the development of serious, disabling complications” (w). There are numerous forms of diabetes amongst the nation, however, there are three main forms of diabetes. Most people have heard of type one diabetes, type two diabetes, and gestational diabetes because they are common. Type two diabetes deals with a resistance to insulin, while

Type 2 diabetes is a polygenic, complex disease that has become a worldwide health crisis. According to the World Health Organization over 422 million people in the world had this disease in 2014 (1), the Center for Disease Control and Prevention stated that in the United States alone 29 million people had diabetes in 2014 (2). While the genetic predisposition contributing to the diabetes phenotype is not fully understood to date it still remains an area of active research. There are also various environmental factors that contribute stress to the glucose homeostasis system that provide a different approach in understanding this disease. Comprehending the pathogenesis of the disease has been an area of constant research for decades. There is hope that pharmaceutical developments can follow along and find medical treatments that can target the key pathogenic elements of this disease.

This article goes in detail about the complications of Type 2 Diabetes, on how hyperglycemia damages the vascular system leading to microvascular disease and macrovascular disease. The complications of microvascular disease are diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. On the other hand, with macrovascular disease includes Cardio Vascular Disease (CVD), such as Atherosclerosis. Furthermore, the article gives recommendations of treating Type 2 Diabetes and the prevention of its health related complications with medication, screening, diet, and exercise.

Type II diabetes mellitus (DM), also referred to as non-insulin dependent diabetes, is a relative, rather than absolute, deficiency of insulin (ADA, 2004). It is global problem and has been identified as one of the “most challenging contemporary threats to public health” (Schauer et al., 2012). One is at risk for developing type II diabetes if they are overweight, over the age of 45, have a relative with type II diabetes, are sedentary, gave birth to a baby over 9 pounds, or had gestational diabetes (Center for Disease Control and Prevention [CDC], 2016).

Diabetes has become a widespread epidemic, primarily because of the increasing prevalence and incidence of type 2 diabetes. Diabetes is an endocrine disease in which the body has either a shortage of insulin or a decrease ability to use insulin or both. Insulin is a hormone that allows glucose to enter the cells and be converted into energy. Diabetes can be characterized as a prevailing, incapacitating, and deadly disease. There are a number of risk factors that increase a person’s tendency toward developing type II diabetes. Modifiable risk factors include obesity, physical inactivity and poor dietary habits are just a few. The

According to the Centers for Disease Control and Prevention national diabetes statistics reported in the United States approximately 5% of the population has type 1 diabetes that’s roughly 1.25 million American children and adults. By 2050 5 million people in the US are expected to have type 1 diabetes. Diabetes kills more Americans every year, more than AIDS and breast cancer combined

Type 2 diabetes is the most common form of diabetes which affects 90% to 95% of the population. In the United States, approximately 1.7 million new cases of diabetes were identified in 2012 and the disease affects 29 million Americans or 9.3 percent of the population (Statistics About Diabetes, 2014). In 2012, the total financial burden of diabetes was estimated to be $245 billion which included $176 billion in direct medical costs and $69 billion in reduced productivity (American Diabetes Association, 2013). Those who have type 2 diabetes are unable to control insulin levels resulting in a condition called insulin resistance. In the first stages of the disease your body

Type 2 Diabetes Mellitus (T2DM) is the most common form of diabetes in the U.S., and it is a severe disease with numerous life-threatening consequences. T2DM occurs when insulin, which is a hormone released by the pancreas for sugar metabolism, becomes low or cannot be utilized by cells. In the normal condition, insulin circulates in the bloodstream and enables to convert starch, sugar, and all polysaccharides complex into glucose, which cells use for energy; however, in T2DM, there is continuously too much glucose in the bloodstream. When cells don’t interact appropriately with insulin, blood sugar increases, and this phenomenon is called insulin resistance that leads to many health problems,

Age related macular degeneration (AMD) is the leading cause of blindness in people over the age of 50. Every ten years after the age of 50 the prevalence of this disease increases exponentially. Many different factors contribute to the development of AMD including genetic, environment, and metabolic functions. Aside from smoking, abnormal blood pressure, and an unhealthy diet low in fruits and vegetables, many more studies are concluding that similar inflammatory and oxidative processes seen in other age related diseases are also playing a key role in the development of AMD. This disease affects the central areas of the retina and choroid. In return central vision is impaired while peripheral vision is usually not lost. AMD is seen in two different forms, the earlier nonneovascular (dry) type and the more advanced neovascular (wet) type. Each form has its own specific pathology and unique characteristics that set them apart. Fatty, protein deposits called drusens may be the key risk factor in understanding dry AMD pathology, progression, and treatment. Once the more advanced wet AMD is diagnosed, pathology and treatment are targeted around the formation and destruction of abnormal blood vessels, characteristic of the wet AMD eye. The increasing prevalence of AMD has influenced more investigation into what factors can be modulated to prevent the onset or to stop the progression of AMD. This text will discuss the pathology of drusens and the role of inflammation and

Proliferative: This is where new blood vessels grow on the surface of the retina which cause

Obesity and Type 2 diabetes are inextricably linked. In many cases obesity contributes to Type 2 diabetes. Not only this but both conditions lead to other health problems, both render high costs to the individual and the health care cost both are increasing dramatically in the United States. According to the National Diabetes Statistics Report, 2014 stated that Stated that obesity now affects over one in five adults in the United States. 29.1 living with diabetes and 21.0 million people are diagnosed with diabetes in the United States. Also, data estimate there are further 8.1 million people who have the condition but don’t know.

Diabetic retinopathy is caused by blocked blood flow to the eye, causing ischemia or increased permeability of the blood vessels in the eye. Macular edema is caused by swelling in the eye due to the increased permeability, and both of these are common causes of vision loss of those with diabetes. Some factors that can be seen in the retina from a fundoscopic exam that can cause these issues (all of which were detected in our patient), are micro-aneurysms, intrarenal hemorrhages, and hard exudates. All three of these can disrupt the blood-retinal barrier, causing issues with blood flow and swelling. Additionally, lipids and proteins both play important roles in the eye, and if there is improper breakdown of these molecules, they can make deposits in the outer layer eye. The more deposits (hard exudates) a patient has, the larger affect it can have on their vision.

New stem cell treatment has the potential to restore vision once lost. Researchers have developed a new treatment that prevents irreversible vision loss brought on by end-stage retinal disease. The new technique involves the use of stem cells that are grown in a lab. During trails, scientist's were able to grow new retina tissue and then transplant the tissue into the mice who had end-stage retinal degeneration. During the study skin cells are taken from an adult mouse and converted with induced pluripotent stem cells (iPSCs). During this experiment, researchers from RIKEN Center for Developmental Biology in Japan used iPSCs since they can act like embryonic stem cells. Coupled with a shuttle avoidance test researchers determined whether the

Diabetes Mellitus is “a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both. It is a disease which is caused by the insufficient insulin secretion or decrease in the peripheral effects of insulin. It is a serious problem in terms of morbidity and mortality. The hyperglycemia is associated with long term damage, dysfunction and failure of various organs especially the eyes, kidneys, nerves, heart and blood vessels. It’s associated with many complications which includes blindness of the eyes and amputations of the extremities. It is also associated with neuropathy, retinopathy, and cardiovascular diseases which lead to mortalities.

Diabetes is a systemic disease caused by a decrease in the secretion of insulin or reduced sensitivity or responsiveness to insulin by target tissue. (Beale, et al., 2011) The incidence of diabetes is growing rapidly in the United States and worldwide. An estimated 347 million people around the world are afflicted with diabetes. (Whalen, et al., 2012) According to World Health Organization (WHO), Diabetes prevalence among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014. It is the major cause of blindness, kidney failure, heart attack, stroke and limbic amputation. World Health Organization (WHO) projects that diabetes will be the 7th leading cause of death in 2030. It is a complex and costly disease that can affect nearly every organ in the body and result in devastating consequences. The leading cause of non-traumatic lower extremity amputations, renal failure, and blindness in working-age adults, diabetes is also a major cause of premature mortality, stroke, cardiovascular disease, peripheral vascular disease, congenital malformations, perinatal mortality, and disability. (Cefalu, 2000) Insulin therapy and oral hypoglycemic agents have demonstrated improvement in glycaemic control. However, Insulin therapy has some disadvantages such as ineffectiveness following oral administration, short shelf life, of the need for constant refrigeration, and fatal hypoglycaemia, in the event of excess dosage.