Diabetes Mellitus(中国医大7年制《内科学》课件).ppt

Diabetes Mellitus Zhao XiaoJuan Department of Endocrinology The First Hospital of China Medical University 2007.10.23 Prevalence of Diabetes Mellitus Outline Definition Diagnosis Classification Complications Management 1.Definition Diabetes mellitus is characterized by chronic hyperglycemia with disturbances of carbohydrate, fat, and protein metabolism resulting from defects in insulin secretion, insulin action, or both. 1.Definition 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. Outline Definition Diagnosis Classification Complications Management 2. Diagnosis Diagnostic Criteria (WHO 1999) Symptoms of diabetes + Casual plasma glucose ? ? 11.1mmol/L（ 200mg/dl) or Fasting plasma glucose（FPG） ? ? 7.0mmol/L （ 126mg/dl ）or 2h-Post load plasma glucose(2h-PG) ? ? 11.1mmol/L（ 200mg/dl ） If positive, confirm diagnosis with 7days Symptoms thirst polyuria polyphagia unexplained weight loss weakness (fatigue) Criteria for the diagnosis of DM Laboratory Findings Blood glucose (FPG and 2-hPG) Urinary glucose Urinary ketone HbA1c and FA (fructosamine) OGTT Insulin / CP releasing test Others (Blood lipid/ UAER/ Immune markers (anti-GAD,ICA,IAA) Insulin releasing test Outline Definition Diagnosis Classification Complications Management 3. Classification (1999WHO) Type1 diabetes (T1DM) Immune mediated Idiopathic Type 2 diabetes (T2DM) Other specific types Genetic defects of ?-cell function Genetic defects of insulin action Disease of the exocrine pancreas Endocrinopathies Drug - or chemical-induced Infections Anti-insulin receptor antibodies Other genetic syndromes sometimes associated with diabetes Gestational diabetes mellitus (GDM) 3.1