Different forms of diabetes mellitus Different Forms of Diabetes mellitus General-genetic and other factors not precisely Diabetes secondary to pancreatic disease defined Ch pa Type I diabetes mellitus(formerly called insulin- Surger pendent diabetes mellitus, or IDDM) Tropical diabetes(chronic pancreatitis associated autoimmune type 1 dial factor Non-autoimmune or idiopathic type I diabetes Diabetes secondary to other endocrinopathies mellitus(type IB Cushings disease Type 2 diabetes mellitus(formerly called non-insulin Glucocorticoid administration dependent diabetes mellitus or NIDDM) Acromegaly pecific-defined gene mutations S Diabetes secondary to immune suppression Maturity-onset diabetes of youth(MODY Diabetes associated with genetic syndromes; e.g, MODY 1 hepatic nuclear factor 4a gene mutations Prader-Willi syndrome ModY 2 glucokinase gene mutations MODY 3 hepatic nuclear factor Ia gene mutations Diabetes associated with drug therapy(see Table 61-5) MODY 4 pancreatic determining factor x gene mutations MODY X unidentified gene mutation(s) Maternally inherited diabetes and deafness(MIDD) Mitochondrial leucine tRNA gene mutations Insulin gene mutations Insulin receptor gene mutations
Different forms of diabetes mellitus
Natural History of Type 2 Diabetes Obesity IGT Diabetes Uncontrolled Hyperglycemia Plasma Post-meal Glucose Glucose Fasting Glucose 120(mg/dL) Relative B-Cell Function Insulin Resistance 100(% prediabetic metabolic Insulin Level syndrome “Beta- cell failure 20100 102030 Years of Diabetes IGT=impaired glucose tolerance Adapted from International Diabetes Center(IDC), Minneapolis, Minnesota
“Beta-cell failure” prediabetic metabolic syndrome
Headache Extreme thirst Blurred vision bathroom a lot Dry skin Feeling sick Feeling drowsy your stomach
Complications of diabetes mellitus Acute complications Diabetic ketoacidosis(酮症畋中睾) Hyperosmotic nonketotic coma(高渗性非酮症性昏速) Chronic complications Cardiovascular diseases Renal damage Retinal damage Nerve degeneration Infection Myopathy etc
Complications of diabetes mellitus • Acute complications – Diabetic ketoacidosis (酮症酸中毒) – Hyperosmotic nonketotic coma(高渗性非酮症性昏迷） • Chronic complications – Cardiovascular diseases – Renal damage – Retinal damage – Nerve degeneration – Infection – Myopathy – etc
Diabetes Complications of Chronic Hyperglycemia Retinopathy Stroke Macular edema Heart Capillary nonperfusion Angiogenesis disease Hemorrhage e Glaucoma Atherosclerosis Endothelial dysfunction Hypertension Nephropathy Dyslipidemia Procoagulant state Antinibrinolitie state Damaged glomeruli Vaseular inflammation Hyperfiltration Renat damage Autonomic Peripheral neuropathy neuropath Nerve damage Nerve damage Gestrolntestinat dyfunction Ulceration Genitourinary dysfuncton Necrosis Armenean Diabetes Association Positian Statements Diabetes Care 2004 27