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1、DiabetesMellitusTeachingobjectivesgraspthedefinitionandtypesofdiabetesmellitusrealizeetiologyandpathogenesisrealizediagnosisandclassificationgrasptheclinicalmanifestationforthepatientwithdiabetesmellitusbeawareofthemainlabexaminationrealizethetreatmentforthepatient
2、withdiabetesmellitusIntroductionTherearemoreandmorepeoplesufferfromdiabeteswiththedevelopmentofsociety,populationagingandchangesoflifestyle.Diabetesmellitusisagroupofmetabolicdisorderscharacterizedbychronichyperglycemiawhichresultsfromthedefectsofinsulinsecretionor
3、function,orboth.Long-standingdiabetesmayleadtomultisystemdamagesuchaseye,kidney,nerve,heart,bloodvesselsandsoon.EtiologyEtiologyandpathologyarecomplex,andstillunknown.Butitisasyndromeresultsfromcompoundetiologicalfactorandhasrelationtoinheritance,autoimmuneandenvir
4、onment.Factorsassociatedwithdiabetesincludeobesity,aging,andethnicgroup.ClassificationType1diabetesStage1:geneticsemotivityStage2:startautoimmuneStage3:immunologyabnormalityStage4:progressivedysfunctionofbetacellsStage5:clinicaldiabetesStage6:betacellsoftheclientsw
5、hohavelongtimediabetesaredamagedthoroughly,bloodinsulinlevelisverylowType2diabetesgeneticsemotivityhyperinsulinismand(or)insulinresistanceimpairedglucosetolerance(IGT)clinicaldiabetesOthertypesincludebetacellgeneticdefects,endocrinopathies,anddrugorchemical-induced
6、diabetesgestationaldiabetesmellitusClinicalmanifestationMetabolicdisorderssyndrome:polyuria,polydipsia,polyphagiaandweightlossAcutecomplicationsofdiabetes:DKA,hyperosmolarnonketoticdiabeticcoma,infectionDKAevocationfactorssurgery,stress,infection,deficiencyofinsuli
7、ndosage,pregnancy,delivery,anesthesia,orillnessmaytriggerDKAClinicalfeaturesClassicsymptomsofhyperglycemia(polyuria,polyphagia,polydipsia)precedeDKA.Othersymptoms:nausea,vomiting,abdominalpain,headache,weakness,fatigue,hyperpneaLabtestLaboratoryvalueswillrevealbloo
8、dglucosefrom300to600mg/dl(16.7-33.3mmol/l),andmetabolicacidosis.Urinewillbepositiveforglucoseandketones.hyperosmolarnonketoticdiabeticcomaevocati
