The basics of diabetes mellitus

• Diabetes mellitus comes in two types: type 1 diabetes (autoimmune, leads to prolonged periods of hyperglycemia where the pancreas is unable to release enough insulin - genetically-influenced so may be inherited from generation to generation) and type 2 diabetes (non-insulin dependent, leads to cells being less responsive to insulin which can permanently damage organs - not genetically-influenced so may be acquired during one’s lifetime)

• It’s recently been reported that 29.1 million people living in the USA have been diagnosed with this disease (90% of whom have type 2 diabetes, 10% of whom have type 1) - around the world it’s less prevalent in Latin America and sub-Saharan Africa than in Asian countries

• Some of the most extreme consequences of diabetes (especially when uncontrolled) include limb amputations, kidney failure, and blindness

• Some of the risk factors of type 2 diabetes mellitus include obesity, lack of regular exercise, high-sugar diets, genetic origin (more likely if Asian/Afro-Caribbean), and family history

• Some common treatments include insulin injections/pumps, transplants of the pancreas, and islet cell transplants

Changes in the urine due to diabetes mellitus

• Usually after a carb-containing meal all the glucose gets reabsorbed into the blood via the proximal convoluted tubule leading to the urine containing no glucose at all

• If blood glucose levels become diabetic the glucose can’t be reabsorbed at all which leads to glucose-containing urine + increased feelings of thirst + a bigger urge to urinate

• As a result of diabetes mellitus the slower cellular glucose uptake increases the cellular keto-acid level (which leads to pH level decreases as well)

Urine testing

• Urine tests can be helpful for diagnosing ill people with specific diseases + spotting pregnancies + providing evidence of drug misuse due to the dissolution of metabolic waste products in urine

• Urine testing using dipsticks involves 2 separate immobilized enzymes (glucose oxidase and peroxidase) to display bladder urine sugar levels (NOT blood sugar levels) - any glucose level higher than 180 mg/dL implies diabetes (same goes for any ketone level higher than 1.6 mmol/L)

• The higher the glucose level the darker and more reddish the color on a dipstick becomes - this is due to the immobilized peroxidase in the dipstick forming a brown chemical compound as it hydrolyzes hydrogen peroxide

Biosensors

• Biosensors are a more digital form of testing for diabetes that involve impregnated pads releasing the immobilized glucose oxidase in them via a tiny electric current

• Electrodes detect the electric current released by the pads and calibrate them with known glucose concentrations for the glucose oxidase