Overview Therapy: early treatment, long term therapy, combined therapy and therapeutic measure individualization Purpose: blood glucose -normal, to correct metabolic disorder increase in life span, decrease death a Principle: persevere(cannot cure
Overview ◼ Therapy: early treatment, long term therapy, combined therapy and therapeutic measure individualization ◼ Purpose：blood glucose－→normal, to correct metabolic disorder, increase in life span, decrease death ◼ Principle：persevere (cannot cure)
Overview a Drink and food: gross calorific value >kg=height -105 Daily kg=-1051255K (25~30Kcal)(25~40Kca) a Therapy: before meals
Overview ◼ Drink and food：gross calorific value ➢ Kg＝height－105 ➢ Daily Kg＝105～125.5K ➢ （25～30Kcal） (25～40Kcal) ◼ Therapy：before meals
Substance metabolic disorder and Clinical situation of Diabetic glucose utilization disorder-glucose decomposition decrease energy insufficient-starvation condition → polyphagia(多食) hyperglycemia -glucosuria hypertonicity diuresis→ polyuria(多尿) protein degradation dehydration thirst→ polydipsia(多饮) accentuation athrepsy(消瘦) lipolysis excessive hyperosmolar non ketotic diabetic coma ketonuria lipolysis excessive -ketoplasia excessive→ Ketonemia→ acidosis coma
Substance Metabolic Disorder and Clinical Situation of Diabetic ◼ glucose utilization disorder→glucose decomposition decrease→energy insufficient→starvation condition →polyphagia(多食） hyperglycemia →glucosuria →hypertonicity diuresis →polyuria（多尿） ◼ protein degradation↓dehydration thirst→polydipsia（多饮） accentuation┤ athrepsy （消瘦） lipolysis excessive hyperosmolar nonketotic diabetic coma ketonuria lipolysis excessive →ketoplasia excessive→Ketonemia→acidosis coma
Classification of Diabetes Mellitus(WHO 1998) ype l insulin dependent diabetes mellitus, IDDM ype ll non-insulin dependent diabetes mellitus, NIDDM a Others: secondary diabetes
Classification of Diabetes Mellitus (WHO 1998) ◼ TypeⅠ: insulin dependent diabetes mellitus，IDDM ◼ TypeⅡ: non-insulin dependent diabetes mellitus，NIDDM ◼ Others： secondary diabetes
Diabetes Mellitus Type I Diabetes a Type 2 Diabetes cells that produce insulin are blood glucose levels rise due to destroved 1) Lack of insulin results in insulin dependence production commonly detected before 30 2)Insufficient insulin action(resistant cells) commonly detected after 40 effects >90% Pancrea eventually leads to B-cell failure (resulting in insulin dependence) killed to lymph nodes Gestational Diabetes(妊娠糖尿病) 3-5% of pregnant women in the US Lymph node develop gestational diabetes
Diabetes Mellitus ◼ Type 1 Diabetes - cells that produce insulin are destroyed - results in insulin dependence - commonly detected before 30 ◼ Type 2 Diabetes - blood glucose levels rise due to 1) Lack of insulin production 2) Insufficient insulin action (resistant cells) - commonly detected after 40 - effects > 90% - eventually leads to β-cell failure (resulting in insulin dependence) Gestational Diabetes （妊娠糖尿病） 3-5% of pregnant women in the US develop gestational diabetes