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Related Concept Videos

Insulin: Biosynthesis, Chemistry, and Preparation01:25

Insulin: Biosynthesis, Chemistry, and Preparation

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The endoplasmic reticulum (ER) of pancreatic β-cells synthesizes preproinsulin, which consists of a signal peptide, A and B chains, and a C-peptide. Preproinsulin is then cleaved and folded into proinsulin, which translocates to the Golgi apparatus for sorting and packaging into secretory granules. In these granules, enzymatic clipping generates insulin and C-peptide.
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Tissue Renewal without Stem Cells01:23

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After cellular or tissue damage, the resident stem cells present in the human body can locally repair and regenerate the damaged tissue or organ. However, even though some tissues do not have stem cells, they can repair and regenerate with the help of pre-existing cells. For example, beta cells of the pancreas and hepatocytes of the liver can divide to renew and regenerate the tissue. Here, both cell division and cell death are well regulated by homeostasis.
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Insulin Secretory Vesicles01:05

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Insulin secretory vesicles release insulin to stimulate blood glucose uptake and regulate carbohydrate metabolism. When the blood glucose levels increase, glucose enters the pancreatic β-islet cells through glucose transporters. Once inside, glucose is metabolized through glycolysis, the citric acid cycle, and the electron transport chain, producing ATP. This increase in ATP concentration closes ATP-sensitive potassium channels, leading to depolarization of the membrane and the opening of...
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Carbohydrate Metabolism01:36

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Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
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Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

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The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
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Diabetes Mellitus: Overview and Type I Subtype01:22

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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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An unmet need: Pancreatic beta cell replacement.

F Mohamed1, C Adams2, B Mansfield3

  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa. farzahna.mohamed@wits.ac.za.

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|July 23, 2024
PubMed
Summary
This summary is machine-generated.

Pancreas and islet transplants offer potential for treating insulin-deficient diabetes mellitus (DM). This review examines progress and challenges in transplantation to improve options for DM patients.

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Area of Science:

  • Endocrinology and Metabolism
  • Transplantation Surgery
  • Public Health

Background:

  • Diabetes mellitus (DM) is a significant global health issue, particularly in South Africa, with insulin therapy presenting challenges like hyperglycemia and hypoglycemia.
  • Despite insulin's discovery a century ago, exogenous insulin remains the primary treatment for type 1 DM, highlighting the need for alternative solutions.
  • Pancreas and islet transplantation are viable treatments for insulin-deficient DM, offering sustained euglycemia and complication prevention, yet global transplant rates are declining.

Purpose of the Study:

  • To review recent advancements in pancreas and islet transplantation for DM.
  • To identify challenges and opportunities for expanding these treatments.
  • To provide insights for improving options for patients with insulin-deficient DM.

Main Methods:

  • Literature review of recent progress in pancreas and islet transplantation.
  • Analysis of global and South African transplant trends.
  • Examination of surgical risks and immunosuppression requirements.

Main Results:

  • Global decrease in pancreas transplant numbers due to surgical risks and immunosuppression needs.
  • Limited pancreas and islet transplants performed in South Africa.
  • Donor scarcity and immunosuppression remain significant barriers for islet transplantation.

Conclusions:

  • Pancreas and islet transplantation hold promise for managing insulin-deficient DM.
  • Addressing surgical risks, immunosuppression, and donor scarcity is crucial for expanding transplant options.
  • Further research and innovation are needed to make transplantation more accessible and effective for DM patients.