a lateral view of diabetes from the caribbean the hon. errol y. st. a. morrison, oj md, phd, frcp...
TRANSCRIPT
A LATERAL VIEW OF DIABETES FROM THE CARIBBEAN
The Hon. Errol Y. St. A. Morrison, OJMD, PhD, FRCP (Glasg), FACP, FRSM (UK)
Professor of Biochemistry and EndocrinologyPro Vice Chancellor and DeanSchool for Graduate Studies and ResearchUNIVERSITY OF THE WEST INDIESMona Campus, Jamaica W.I.
THE WORLD
THE CARIBBEAN AND CENTRAL AMERICA
Hugh Jones 1955
Zuidema 1956
Morrison 1981
Atypical Diabetes; Undernutrition;
Bush teas (CAM)
& Staple root crops
Atypical Diabetes
- hyperglycaemic & aglycosuric
- asymptomatic hyperglycaemia
- intermittent insulin requirement
- aketonuric
- 13% of Diabetes Outpatient Clinic at UHWI, Mona, Jamaica
Francis Bacon
If a man will begin with certainties,He shall end in doubts;
But if he will be content to begin with doubts,He shall end in certainties!
AN HYPOTHESIS FOR THE AETIOLOGY OF DIABETES MELLITUS
FREE RADICALS
FOOD “TOXINS”, UNDERNUTRITION
Level 1 DAMAGE TO CELL MEMBRANE
FR
AN HYPOTHESIS FOR THE AETIOLOGY OF DIABETES MELLITUS (contd.)
DAMAGE TO CELL MEMBRANE
VIRAL INFECTIONS
EXPOSED ANTIGENS INDUCED ANTIGENS
AN HYPOTHESIS FOR THE AETIOLOGY OF DIABETES MELLITUS (contd.)
Level 2 ANTIBODIESDIRECT TOXICITY
INSULIN RECEPTORS
GLUCOSE TRANSPORTERS
ISLET CELLS
EA IA
AN HYPOTHESIS FOR THE AETIOLOGY OF DIABETES MELLITUS (contd.)
Level 3
OBESITY
INSULIN RESISTANCE
INSULIN INSUFFICIENCY
ICIR GT
AN HYPOTHESIS FOR THE AETIOLOGY OF DIABETES MELLITUS (contd.)
INSULIN RESISTANCE
INSULIN INSUFFICIENCY
TYPE 2NON-INSULINDEPENDENT
DIABETES MELLITUS
PIDDMPHASIC INSULIN
DEPENDENTDIABETES MELLITUS
TYPE 1INSULIN DEPENDENTDIABETES MELLITUS
AN HYPOTHESIS FOR THE AETIOLOGY OF DIABETES MELLITUS (contd.)
Level 1: Membrane damage
Level 2: Antibody production
Level 3: Insulin resistance & insufficiency
AN HYPOTHESIS FOR THE AETIOLOGY OF DIABETES MELLITUS (contd.)
If the processes at levels 1, 2 or 3 remit, then TEMPORARY DIABETES would result!
N.B.:
AN HYPOTHESIS FOR THE AETIOLOGY OF DIABETES MELLITUS (contd.)
GESTATIONAL DIABETES (GDM) IMPAIRED GLUCOSE TOLERANCE (IGT)……possible manifestations of
level 3 activity.
N.B.:
AN HYPOTHESIS FOR THE AETIOLOGY OF DIABETES MELLITUS (contd.)
The Unitarian Hypothesis
HERESY TODAY?
FACT TOMORROW!
THE UNITARIAN HYPOTHESIS FOR THE AETIOLOGY OF DIABETES MELLITUS
OVERNUTRITION
UNDERNUTRITION
CONSENSUS ON THE AETIOLOGY OF TYPE 2 DIABETES MELLITUS
Increase in type 2 DM in childhood and adolescence
Low birth weight increase in type 2 DM
SRI LANKA, JULY 2002
There is a strong association between:
Truncal ObesityDiabetes MellitusImpaired Glucose ToleranceCardiovascular Disease
CONSENSUS ON THE AETIOLOGY OF TYPE 2 DIABETES MELLITUS (contd.)
Hugh Jones 1955
Zuidema 1956
Morrison 1981
Atypical Diabetes; Undernutrition;
Bush teas (CAM)
& Staple root crops
ROOT CROPS
a case study.
E.g. Linamarin, lotaustralin (toxic cyanide radical)
Found in root crops:
Cassava, yucca (Manihot esculenta),
Yams (Dioscorides group)
CYANOGLUCOSIDES
CASSAVA (manihot esculenta)
YAM (Dioscorides GROUP)
YAM (Dioscorides GROUP)
ENZYMATIC DEGRADATION OF LINAMARIN
MAIN METABOLIC PATHWAY OF CYANIDE WITH RHODANESE
ES
S+ (S —SO3)
2- ES
S —S —SO3
CN
+ +SO32- SCNE
S
S
rhodanese thiosulphate
thiocyanate
METABOLIC PATHWAY OF CYANIDE WITH 3 - MERCAPTOPYRUVATE
L – CYSTEINE [SHCH2CH(NH2)COOH]
3 MERCAPTOPYRUVATE [HSCH2COCOOH]
TRANSAMINATION
CN – SULPHUR TRANSFERASE
+SCN PYRUVATE
Louis Pasteur
Chance favours the prepared mind!