Dendritic cells and macrophages in insulin dependent diabetes mellitus

Abstract

The onset of diabetes mellitus is characterized by various symptoms, all the result of a disturbed glucose metabolism. The main symptoms are thirst and polydypsia, polyuria, glucosuria, and weight loss. The faster the onset of diabetes, the more prominent these symptoms will be. The disturbed glucose metabolism underlying these symptoms, is due to an absolute deficiency of insulin secretion, a reduction in its biologic effectiveness or both. Diabetes mellitus is nowadays classified in two major types: Type 1, or insulin-dependent diabetes mellitus (100M), occurs most commonly in juveniles. It is a catabolic disorder in which circulating insulin is virtually absent, since the pancreatic p-cells, due to their absence, cannot respond to any insulinogenic stimulus. Administration of exogenous insulin is therefore required to reverse the catabolic state, to prevent ketosis and to bring the elevated blood glucose level down. Type 2, or non-insulin·dependent diabetes mellitus (NIDDM). represents a group of milder forms of diabetes that occur predominantly in adults. Circulating endogenous insulin is almost always sufficient to prevent ketoacidosis, but is often either subnormal or relatively inadequate in the face of the increased needs owing to tissue insensitivity. The longer diabetes mellitus exists, the greater the chance of developing the characteristic complications: micro- and macroangiopathy, and neuropathy. Microangiopathy may cause retinopathy and nephropathy, while macroangiopathy gives rise to an elevated incidence of coronary heart disease, cerebro-vascular accidents, and ischemic complications in the legs. The quality of life of diabetic patients can be profoundly reduced by these complications, while also the life-expectancy is considerably shorter for diabetic patients. Therefore, preven