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Pathogenesis of Diabetes Mellitus – Hyperglycemia

by Carlo Raj, MD
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    Let’s talk about the pathogenesis. This is the most important called non-enzymatic glycosylation. What does that mean? With all that glucose that’s circulating, it will then bind to protein. It will cause and wreak havoc up and down the body through depositing in the capillary membrane. When it does so, it will cause arteriolosclerosis. If it’s in the capillary, it will then cause non-enzymatic glycosylation therefore compromise proper exchange of nutrients. Altered carbohydrate metabolism and a second pathogenesis here is that you want to know about sorbitol and that’s because with all that glucose instead of going through the glycolytic pathway, might end up going through what’s known as aldose reductase. With that aldose reductase and sorbitol, specifically in the lens, remember what I told you? If you start a patient with diabetes over long period of time, what colour could that lens be? In Greek, cataract means waterfall. When you take a look at the waterfall, what colour is that water when it’s falling over the cliff? Opaque and white, that’s what cataract means in Greek, you find whiteness over the lens. That’s because sorbitol accumulating in the lens is going to cause waterfall, ha-ha, into the lens. In other words, increased osmotic pressure. Unregulated glucose intake by these tissues partially explains why these are the main diabetes mellitus targets. The increased glucose metabolized by the enzyme aldose reductase to sorbitol. That’s an important point, make sure you pay attention to that enzyme. Two major pathogeneses that I just walked you through. The most important would be non-enzymatic glycosylation neg or you might have heard of AGE, advanced glycosylate end-product, one and the same; capillary membrane destruction. Remember the arteriolosclerosis that you find with diabetes, that’s called hyaline arteriolosclerosis and do not forget about the sorbitol pathogenesis. Quickly, type...

    About the Lecture

    The lecture Pathogenesis of Diabetes Mellitus – Hyperglycemia by Carlo Raj, MD is from the course Pancreatic Disease & Diabetes.


    Included Quiz Questions

    1. Aldose reductase
    2. Insulin
    3. Glycosylation
    4. Lactate dehydrogenase
    5. Glucose oxidase
    1. Unregulated glucose uptake by nerves leading to increased sorbitol
    2. Capillary basement membrane thickening
    3. Arteriosclerosis
    4. Decreased levels of of aldose reductase
    5. NEG
    1. Highly variable glycemic patterns
    2. Insulin resistance
    3. Obesity
    4. High C-peptide levels
    5. A first degree relative with the disease

    Author of lecture Pathogenesis of Diabetes Mellitus – Hyperglycemia

     Carlo Raj, MD

    Carlo Raj, MD


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