Diabetes Mellitus

Glucose transportation either insulin dependent or insulin independent. Adipose tissues and skeletal muscle are insulin dependent whereas retina, nerve cells and kidney are insulin independent. In long standing DM less amount of glucose are taken by the a

Glucose Transporters

Binding of glucose into their transmembrane receptors stimulate the fusion of internally stored glucose transporters into the cell membrane. After completing its function the insulin hormones leave the receptors, as a result the glucose transporters are d

Insulin Preparations

There are four types of insulin preparations. Rapid or ultrashort insulin such as insulin aspart or lispro. Short acting or regular insulin. Intermediate insulin such as NPH. Long acting insulin such as detemer and glaragine.

Insulin Receptors

Transmembrane insulin receptors are composed of two α subunits and two cytoplasmic β subunits. Binding of insulin molecules to α subunits activates the insulin receptors which in turn phosphorylate and activate the tyrosine kinase enzyme residues of β sub

Insulin Regimens

There are various insulin regimens. Three regular insulin injections before each meal followed by intermediate insulin at evening. A more intensive approach include three rapid or ultrashort insulin injections before each meal boosted by two injections of

Insulin Resistance

In normal person elevated level of glucose in the blood is immediately followed by release of insulin hormone. As a result the blood glucose remain in normal levels. In patient with insulin resistance there is large increase in insulin level to keep the b


Metformin is oral antidiabetic drug. It reduce the intestinal absorption of glucose. Metformin might decrease the insulin receptor resistance. Additionally metformin inhibit glycogenolysis.


In normal blood glucose level the glucose is metabolized through hexokinase pathway to TCA cycle to produce ATP. However in hyperglycemic state the hexokinase pathway is saturated and more glucose is diverted into aldose reductase enzyme pathway to produc


The glucose molecules transported into the β cells of islets of Langerhans are rapidly metabolized to produce ATP which in turn close the ATP sensitive potassium K channels. Closure of K channels results opening of voltage sensitive calcium Ca channels. C