Diabetes mellitus Zhao-xiaojuan
Diabetes Mellitus Zhao-xiaojuan
Introduction Diabetes mellitus is a heterogeneous group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion insulin action or both
Introduction Diabetes mellitus is a heterogeneous group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both
Introduction The chronic hyperglycemia of diabetes is associated with long term damage, dysfunction and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels
Introduction The chronic hyperglycemia of diabetes is associated with longterm damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels
Symptoms Polyuria Polydipsia( thirst) Weight loss Weakness Polyphagia Blurred vision Recurrent infection Impairment of growth
Symptoms Polyuria Polydipsia (thirst) Weight loss Weakness Polyphagia Blurred vision Recurrent infection Impairment of growth
Criteria for diagnosis of diabetes (HO1999 Symptoms of diabetes Casual plasma glucose 1.mmo/(200mg/dl) Or FPG≥70mmoM(126mg/d) Or 2-hPG≥11.1mmo
Criteria for diagnosis of diabetes (WHO1999) Symptoms of diabetes + Casual plasma glucose ≥ 1.1mmol/l(200mg/dl) Or FPG ≥ 7.0mmol/l (126mg/dl) Or 2-hPG ≥ 11.1mmol/l
Diagnostic Criteria WHO1999 IGT FPG<7mmol/L -2-h PG278mmol/ and <11.1 mmol/L IFG -FPG26. 1 mmol/L and <7.0mmol/L
Diagnostic Criteria WHO1999 IGT -FPG<7mmol/L -2-h PG≥7.8mmol/L and <11.1mmol/L IFG -FPG≥6.1mmol/L and <7.0mmol/L
Laboratory Findings Urinary glucose Urinary ketone Blood glucose(FPG and 2-hPG) HbAlc and FA(fructosamine) OGTT Insulin/cp releasing test
Laboratory Findings Urinary glucose Urinary ketone Blood glucose (FPG and 2-hPG) HbA1c and FA(fructosamine) OGTT Insulin / CP releasing test
classification (1) Type 1 diabetes B-cell destruction, usually leading to absolute deficiency Immune-mediated diabetes ldiopathic diabetes Type 2 diabetes Ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance
Classification (1) Type 1 diabetes β-cell destruction, usually leading to absolute deficiency Immune-mediated diabetes Idiopathic diabetes Type 2 diabetes Ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance
Classification(2) Other specific types of diabetes Due to other causes, e.g. genetic defects in insulin action diseases of the exocrine pancreas, drug or chemical induced Gestational diabetes mellitus(GDM) diagnosed during pregnancy
Classification (2) Other specific types of diabetes Due to other causes, e.g.,genetic defects in insulin action, diseases of the exocrine pancreas, drug or chemical induced Gestational diabetes mellitus(GDM) diagnosed during pregnancy
Etiologic classification of diabetes mellitus(1) IType 1 diabetes( B-cell destruction, usually leading to absolute insulin deficiency A immune mediated B Idiopathic Il Type 2diabetes( may range from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defectwith insulin resistance) lll.Other specific types A genetic defects of B-cell function 1. Chromosome 12, HNF-1a MODY3 2. Chromosome 7, glucokinase(MODY2) 3. Chromosome 20, HNF-4a(MODY1) 4. Mitochondrial dNA 5. others B. Genetic defects in insulin action 1. Type A insulin resistance 2. Leprechaunism 3. Rabson-Mendenhall syndrome 4. Lipoatrophic disease 5. Others C Diseases of the exocrine pancreas 1. Pancreatitis 2. Trauma/ pancreatectomy 3. Neoplasia Cystic fibrosis 5. Hemochromatosis 6. Fibrocalculous pancreatopathy 7. Others
Etiologic classification of diabetes mellitus(1) I.Type 1diabetes ( -cell destruction, usually leading to absolute insulin deficiency ) A. immune mediated B. Idiopathic II.Type 2diabetes ( may range from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with insulin resistance ) III.Other specific types A. genetic defects of -cell function 1. Chromosome 12, HNF-1 (MODY3) 2. Chromosome 7, glucokinase (MODY2) 3. Chromosome 20, HNF-4 (MODY1) 4. Mitochondrial DNA 5. Others B. Genetic defects in insulin action 1. Type A insulin resistance 2. Leprechaunism 3. Rabson- Mendenhall syndrome 4. Lipoatrophic disease 5. Others C. Diseases of the exocrine pancreas 1. Pancreatitis 2. Trauma / pancreatectomy 3. Neoplasia 4. Cystic fibrosis 5. Hemochromatosis 6. Fibrocalculous pancreatopathy 7. Others