Biomedical Engineering Reference
In-Depth Information
symptoms usually lead to fast diagnosis. Daily insulin treatments of type
1 patients are crucial. Type 1 is also known as insulin-dependent diabetes
mellitus, IDDM.
Type 2 diabetes is a metabolic disorder affecting blood glucose, among
other things. b-cells and insulin production are still (partially) intact in
type 2, but the insulin sensitivity in the peripheral tissue is lower than
normal [14]. The low insulin sensitivity leads to moderately raised blood
glucose levels, typically 10-15 mM. There are often no clear symptoms
for years of type 2 progression, but the raised glucose levels nevertheless
give rise to increased levels of protein glycations, i.e. covalent reactions
between protein amino groups and the aldehyde function of glucose
(Figure 7.2). Glycations proceed via Amadori rearrangement to form
advanced glycation end-products
(AGEs) [15-17], which include protein
crosslinks and other plaque, all of which result in sedimentations in blood
vessels and organ damage. Type 2 diabetes is often only diagnosed after
years of progression, when late complications like heart or kidney
problems appear.
OH
O
O
OH
HO
proteins
HO
HO
OH
HO
OH
OH
OH
Glucose
hemiacetal
Glucose
H
OH
N
protein
OH
protein
HO
HO
Amadori
rearrangement
HO
O
HO
OH
OH
OH
Imine
Fructosamine
N
COOH
N
+
protein
protein
H
OH
protein
H
protein
N
N
carboxymethyl amines
imidazolium cross-links
fluorescent pyrimidines
Figure 7.2 Protein glycation reactions and a few of the known end-products
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