糖尿病基础知识-英文.ppt

Dr.Rasha Salama PhD Public Health,Suez Canal University,Egypt Diabetes MSc,Cardiff University,United Kingdom Diabetes mellitus(DM)is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production,insulin action,or both.The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate,fat and protein metabolism resulting from defects in insulin secretion,insulin action,or both.The effects of diabetes mellitus include longterm damage,dysfunction and failure of various organs.Diabetes mellitus may present with characteristic symptoms such as thirst,polyuria,blurring of vision,and weight loss.In its most severe forms,ketoacidosis or a nonketotic hyperosmolar state may develop and lead to stupor,coma and,in absence of effective treatment,death.Often symptoms are not severe,or may be absent,and consequently hyperglycaemia sufficient to cause pathological and functional changes may be present for a long time before the diagnosis is made.The longterm effects of diabetes mellitus include progressive development of the specific complications of retinopathy with potential blindness,nephropathy that may lead to renal failure,and/or neuropathy with risk of foot ulcers,amputation,Charcot joints,and features of autonomic dysfunction,including sexual dysfunction.People with diabetes are at increased risk of cardiovascular,peripheral vascular and cerebrovascular disease.The development of diabetes is projected to reach pandemic proportions over the next10-20 years.International Diabetes Federation(IDF)data indicate that by the year 2025,the number of people affected will reach 333 million 90%of these people will have Type 2 diabetes.In most Western societies,the overall prevalence has reached 4-6%,and is as high as 10-12%among 60-70-year-old people.The annual health costs caused by diabetes and its complications account for around 6-12%of all health-care expenditure.Type 1 Diabetes Mellitus Type 2 Diabetes Mellitus Gestational Diabetes Other types:LADA(MODY(maturity-onset diabetes of youth)Secondary Diabetes Mellitus Was previously called insulinWas previously called insulin-dependent diabetes mellitus dependent diabetes mellitus(IDDM)or juvenile(IDDM)or juvenile-onset diabetes.onset diabetes.Type 1 diabetes develops when the bodys immune system Type 1 diabetes develops when the bodys immune system destroys pancreatic beta cells,the only cells in the body destroys pancreatic beta cells,the only cells in the body that make the hormone insulin that regulates blood that make the hormone insulin that regulates blood glucose.glucose.This form of diabetes usually strikes children and young This form of diabetes usually strikes children and young adults,although disease onset can occur at any age.adults,although disease onset can occur at any age.Type 1 diabetes may account for 5%to 10%of all Type 1 diabetes may account for 5%to 10%of all diagnosed cases of diabetes.diagnosed cases of diabetes.Risk factors for type 1 diabetes may include autoimmune,Risk factors for type 1 diabetes may include autoimmune,genetic,and environmental factors.genetic,and environmental factors.Was previously called nonWas previously called non-insulininsulin-dependent diabetes mellitus dependent diabetes mellitus(NIDDM)or adult(NIDDM)or adult-onset diabetes.onset diabetes.Type 2 diabetes may account for about 90%to 95%of all Type 2 diabetes may account for about 90%to 95%of all diagnosed cases of diabetes.diagnosed cases of diabetes.It usually begins as insulin resistance,a disorder in which the It usually begins as insulin resistance,a disorder in which the cells do not use insulin properly.As the need for insulin rises,cells do not use insulin properly.As the need for insulin rises,the pancreas gradually loses its ability to produce insulin.the pancreas gradually loses its ability to produce insulin.Type 2 diabetes is associated with older age,obesity,family Type 2 diabetes is associated with older age,obesity,family history of diabetes,history of gestational diabetes,impaired history of diabetes,history of gestational diabetes,impaired glucose metabolism,physical inactivity,and race/ethnicity.glucose metabolism,physical inactivity,and race/ethnicity.African Americans,Hispanic/Latino Americans,American African Americans,Hispanic/Latino Americans,American Indians,and some Asian Americans and Native Hawaiians or Indians,and some Asian Americans and Native Hawaiians or Other Pacific Islanders are at particularly high risk for type 2 Other Pacific Islanders are at particularly high risk for type 2 diabetes.diabetes.Type 2 diabetes is increasingly being diagnosed in children and Type 2 diabetes is increasingly being diagnosed in children and adolescents.adolescents.A form of glucose intolerance that is diagnosed in some A form of glucose intolerance that is diagnosed in some women during pregnancy.women during pregnancy.Ges