《胡仁明－糖尿病》PPT课件

《《胡仁明－糖尿病》PPT课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、DiabetesMellitusRenmingHuM.D,PhDDepartmentofEndocrinologyHuashanHospitalInstituteofEndocrinologyandDiabetesatFudanUniversityClassificationofdiabetes(ADA-1997)Type1(beta-celldestruction,usuallyleadingtoabsoluteinsulindeficiency)AutoimmuneIdiopathicType2(mayran

2、gefrompredominantlyinsulinresistancewithrelativeinsulindeficiencytoapredominantlysecretorydefectwithorwithoutinsulinresistance)OtherspecifictypesGestationaldiabetes**OtherspecifictypesGeneticdefectsofbeta-cellfunctionGeneticdefectsininsulinactionDiseasesofthe

3、exocrinepancreasEndocrinopathiesDrug-orchemical-inducedInfectionsUncommonformsofimmune-mediateddiabetesOthergeneticsyndromessometimesassociatedwithdiabetesPathogenesisPathologyType1DM：inflammationofpancreasType2DM：amyloidosisofpancreasLargevessel：atherosclero

4、sisKidney：diffuseornodularglomerularsclerosisRetina：arteriolarsclerosis、microaneurysm、exudates、newvesselformationNerve：axondegeneration、myelinolysisPathophysiologyAbnormalitiesinmetabolismCarbohydrate：anabolism，catabolism、utilizationLipid：anabolism，catabol

5、ism，ketoplasiaprotein：anabolism，catabolism，glyconeogenesisInsulinsecretioncurve:normalanddiabeticsClinicalPresentationNaturalhistoryoftype2DMAfterthediagnosisoftype2diabetes:IRconstantlyexistsInsulinsecretionabilitygraduallydeclines:WhenFPGreachsthediagnos

6、ticcriteria，insulinsecretionabilityhasalreadydeclinedby50%WhenFPG≥7.0mmol/L，-cellinsulinsecretionabilityWhenFPG≥1011.0mmol/L，-CinsulinsecretionabilityhasalreadynearedabsolutedeficiencyModelsoftheonsetoftwophrasesoftype2DMNGTIGR(IFG、IGT)DMcellexhaustionIns

7、ulinresistanceInsulinresistanceWHOplasmaglucoseguidelineIGTIFGNGTDM75gOGTT2hPG(mmol/L)FPG(mmol/L)7.06.1FPG7.811.1IGTComparisonoftype1andtype2DMtype1DMtype2DMUsualageofonset<30years>40yearsModeofonsetacutechronicweightnormaloverweightorobesityorweightlosssympt

8、omspolyuria,polydipsia,similarbutusuallyweightlosslessseverepresentationAcutecomplicationsoftenfewChroniccomplicationsLargevesseldiseaselessthentype2DMleadingcauseofdeathRenaldiseaseleadi