Hormonal communication: (f) the potential treatments for diabetes mellitus.

The idea

Diabetes mellitus arises when blood glucose control fails. In Type 1 diabetes the pancreas does not secrete enough insulin, so treatment is insulin therapy, commonly injected because insulin is a protein digested in the gut. In Type 2 diabetes receptors respond poorly to insulin or secretion is insufficient; treatment begins with lifestyle measures such as diet and exercise, then drugs such as metformin, which reduce blood glucose, and insulin may be added later. Potential treatments also include monitoring blood glucose, transplanting pancreatic tissue or islet cells, and using insulin pumps or genetically engineered human insulin. Candidates should evaluate these options: insulin relieves symptoms but requires careful dosing to avoid hypoglycaemia, while transplants risk rejection and need immunosuppressants. Treatments manage the condition rather than curing it.

What earns the marks

• Type 1 diabetes is treated with insulin therapy, often by injection because insulin is a protein and would be digested if taken orally.
• Type 2 diabetes is managed first with lifestyle changes such as diet and exercise, then with drugs such as metformin that lower blood glucose.
• Insulin may be added to treatment for Type 2 diabetes when other measures are insufficient.
• Monitoring blood glucose allows doses to be adjusted and reduces the risk of hypoglycaemia.
• Pancreatic or islet cell transplants can restore insulin secretion but carry risks of rejection and require immunosuppressant drugs.
• Treatments control blood glucose and relieve symptoms but do not cure diabetes mellitus.

Common mistakes and how to put them right

• Thinking insulin can be taken as a tablet.

  Put it right by explaining that insulin is a protein and would be digested, so it is injected.

• Assuming Type 1 and Type 2 have identical treatment.

  Put it right by distinguishing insulin therapy for Type 1 from lifestyle and drug management first for Type 2.

• Believing treatment cures diabetes.

  Put it right by stating that treatments manage blood glucose rather than cure the condition.

• Ignoring the risk of hypoglycaemia.

  Put it right by explaining that excess insulin can lower blood glucose too far.

Exam tips

• Name the diabetes type before describing its treatment so the answer stays precise.
• Explain why insulin is injected rather than swallowed, linking to protein digestion.
• Evaluate treatments by giving both a benefit and a limitation, such as transplant rejection risk.