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1、Diabetes MellitusDiabetes Mellitus definition types symptoms diagnosis Laboratory findings treatment complicationsDefinition-WHO (4/2000)The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and
2、protein metabolism resulting from defects in insulin secretion, insulin action, or bothDefinition A metabolic condition characterised by high plasma glucose levels and chronic vascular complications A vascular disease affecting small and large arteries with coexistent metabolic disturbance particula
3、rly high plasma glucose levelsDiabetes Mellitus definition types symptoms diagnosis Laboratory findings treatment complicationsAetiological Classification of Disorders of Glycaemia Type 1 (betacell destruction, usually leading to absolute insulin deficiency) : Autoimmune: Idiopathic Type 2 (may rang
4、e from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with or without insulin resistance) Other specific types Genetic defects of betacell function Genetic defects in insulin actionDiseases of the exocrine pancreas Endocrinopathies Drug or chemi
5、calinduced Infections Uncommon forms of immunemediated diabetesOther genetic syndromes sometimes associated with diabetes Gestational diabetesType 1 diabetes Previously known as IDDM(Insulin dependent diabetes) Ketosis prone:Usually diagnosed in younger age group(30 years) (Peak incidence 11-13 yr)
6、Prevalence highly variable but approximately 0.20% with an incidence of 15-20 per 100000 population aged less than 21 Seasonal variation- with lowest rate in spring and summerType 1 diabetes mellitus Immune-mediated type 1 diabetes acute LADA latent autoimmune diabetes in adults Idiopathic type 1 di
7、abetes mellitusType 1 diabetes mellitus Genetics Environmental factor Viruses Chemical agents Autoimmune Auto-antibodies: islet cell cytoplasm antibody (ICCA) islet cell surface antibody (ICSA) glutamic acid decarboxylase antibody GADA(64KD) Insulin antibody (IAA) Type 1 diabetes This presentation is the end point of recent and continuing beta cell function resulting in near total loss of Insulin production Hyperglycaemia itself begets further beta cell destruction as treatment with insulin often results in a “honeymoon” period when the patient can often manage without insulin