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Monthly Archives: May 2018

May 22, 2018

We preach good health, lean body muscle mass, exercise, and weight control to our patients, but at times we actually have patients who do too good a job. A good example of this can be seen in this week’s Disaster Averted. Our patient, the picture of perfect health and body …

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Once a Pump, Always a Pump? Wrong!

A man, lean and muscular, with type 1 for over 25 years, has been pumping for 15 years and wearing a sensor for the past five years. Glucose levels have been very erratic. We checked his sites and were concerned that the erratic glucose levels were mostly related to lack of subcutaneous fat and scar tissue, so he was actually getting insulin into his muscle, scar tissue, or subcutaneous tissue at various times. Also, the patient wears an OmniPod and thought it could only be in one particular direction.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #126: Beta-Cell Mass and Function in Human Type 2 Diabetes Part 2

The role of beta-cell death and regeneration: The loss of beta-cells in T2DM has been mainly attributed to increased beta-cell death due to apoptosis and other forms of cell death, possibly driven by adverse environmental conditions and probably mediated by several intracellular mechanisms. Apoptosis is a type of programmed cell death morphologically characterized by cell rounding up, bleb formation and chromatin condensation. As a matter of fact, in autoptic pancreatic samples apoptosis has been shown to be significantly increased in both obese and lean type 2 diabetic cases as compared to BMI-matched, nondiabetic controls.

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