1、Diabetes Mellitus,Diabetes Mellitus,definition types symptoms diagnosis Laboratory findings treatment complications,Definition-WHO (4/2000),The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat a
2、nd protein metabolism resulting from defects in insulin secretion, insulin action, or both,Definition,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 parti
3、cularly high plasma glucose levels,Diabetes Mellitus,definition types symptoms diagnosis Laboratory findings treatment complications,Aetiological Classification of Disorders of Glycaemia,Type 1 (betacell destruction, usually leading to absolute insulin deficiency) : Autoimmune: Idiopathic Type 2 (ma
4、y range 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 action Diseases of the exocrine pancreas Endocrinopathies Drug o
5、r chemicalinduced Infections Uncommon forms of immunemediated diabetes Other genetic syndromes sometimes associated with diabetes Gestational diabetes,Type 1 diabetes,Previously known as IDDM(Insulin dependent diabetes) Ketosis prone:Usually diagnosed in younger age group(30 years) (Peak incidence 1
6、1-13 yr) 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 summer,Type 1 diabetes mellitus,Immune-mediated type 1 diabetesacuteLADA latent autoimmune diabetes in adults Idiopathic t
7、ype 1 diabetes mellitus,Type 1 diabetes mellitus,Genetics Environmental factorVirusesChemical agents AutoimmuneAuto-antibodies: islet cell cytoplasm antibody (ICCA)islet cell surface antibody (ICSA)glutamic acid decarboxylase antibodyGADA(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,
