The urea cycle as a source of nitric oxide implicated in the pathogenesis of insulin-dependent diabetes mellitus

Diabetes mellitus has long been considered an autoimmune disorder whereby the immune system attacks pancreatic tissue, destroying the insulin-producing cells of the pancreas. In this way, diabetes mellitus may be the only metabolic disorder in which the disease state is in no way related to any metabolic pathway. The specific role that nitric oxide plays in the pathogenesis of diabetes mellitus has yet to be established. However, researchers have shown that nitric oxide will independently destroy the beta cells (insulin-producing cells) of the pancreas in the absence of any pathogenic mediators. It is my hypothesis that a breakdown in the urea cycle (via activation of nitric oxide synthase (NOS)), a primary metabolic pathway, whereby nitric oxide production is competitively favored over urea production, is responsible for generating the major source of pathogenic nitric oxide resulting in the death of the beta cells of the pancreas.