胡仁明－糖尿病.pptVIP

Classification of diabetes(ADA-1997) Type 1 (beta-cell destruction, usually leading to absolute insulin deficiency) Autoimmune Idiopathic Type 2 (may range from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with or without insulin resistance) Other specific types Gestational diabetes** Other specific types Genetic defects of beta-cell function Genetic defects in insulin action Diseases of the exocrine pancreas Endocrinopathies Drug- or chemical-induced Infections Uncommon forms of immune-mediated diabetes Other genetic syndromes sometimes associated with diabetes Pathology Type 1 DM：inflammation of pancreas Type 2 DM：amyloidosis of pancreas Large vessel ：atherosclerosis Kidney ：diffuse or nodular glomerular sclerosis Retina：arteriolar sclerosis、microaneurysm、exudates、new vessel formation Nerve：axon degeneration 、myelinolysis Pathophysiology Abnormalities in metabolism Carbohydrate ：anabolism? ，catabolism?、 utilization Lipid ： anabolism? ，catabolism? ，ketoplasia protein： anabolism? ，catabolism? ，glyconeogenesis Clinical Presentation WHO plasma glucose guideline Comparison of type 1 and type 2 DM type1 DM type2 DM Usual age of onset 30 years 40years Mode of onset acute chronic weight normal overweight or obesity or weight loss symptoms polyuria,polydipsia, similar but usually weight loss less severe presentation Acute complications often few Chronic complications Large vessel disease less then type 2 DM leading cause of death Renal disease leading