Updated on 14 August 2012
Inadequate concentrations of PUFA during the third trimester of pregnancy to two year post term will pose to higher Tumor necrosis factor- α Concentration. In turn, higher TNF α may damage the VMH neurons that leads to type 2 diabetes at a later stage of life. Research also suggested that low grade systemic inflammation also plays a significant role in pathogenesis of type 2 diabetes. It is a well known fact that decrease in the number of insulin receptors, defects in the function of insulin receptors, and insulin lack or resistance in the brain leads to the development of type 2DM, even when pancreatic β-cells are normal.
Diabetes mellitus is very common and is a fast emerging epidemic in India. Deficiency of BDNF and PUFA is well documented in type 2 diabetic conditions by several groups throughout the world. PUFAs such as AA (Arachidonic acid), EPA (Eicosapentaenoic acid), and DHA (Docosahexaenoic acid) can give rise to anti-inflammatory and cytoprotective compounds, such as lipoxins (LXs), resolvins and protectins that could protect pancreatic β cells from the cytotoxic action of chemicals such as alloxan and streptozotocin. Recent studies at my laboratory on Indian diabetic patients indicated low BDNF levels in them. Both Insulin and PUFA forms a potent neurotransmitter which carries the information from VMH neurons to the pancreatic β-cells and thus control their insulin secretion.
Adequate amount of insulin and insulin receptors in the brain control obesity, Hyperphagia and helps maintaining normal glucose levels and controlling inflammation. This surely opens up a new arena "to control type 2 diabetes mellitus, brain can play an important role since hypothalamus of brain is known to have good amount of insulin receptors".
Insulin therapy is often an important part of diabetes treatment in around 30 percent cases of diabetes patients. Duration of diabetes decides the date of insulin treatment. Patients with prolonged history of diabetes are more likely to start insulin treatment at some point of time. In the early stages, diabetic patients are managed with modified lifestyles such as feeding habits, initiating exercises, etc. and oral hypoglycemic agents or injections of a Glucagon-like peptide-1 (GLP1) analogue either alone or in combination with oral medication. Some percentage of patients later will be dependent on insulin therapy like the type 1 diabetes patients. Insulin is inactivated by the digestive enzymes in the gut and can't be taken by mouth therefore most commonly it is given as a subcutaneous injection into the thigh, buttocks, abdomen or upper arm. Patients with advanced diabetic condition and fluctuating glucose levels are at higher risk of hypoglycemia with a risk of complications like falling and accidents.