Pendukung Jurnal Diabetes

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DIABETES MELLITUS Diabetes Mellitus (DM) salah satu sindrom metabolik atau penyakit gangguan metabolisme kronik yang ditandai oleh hiperglikemia. Klasifikasi DM Tipe 1 Kerusakan sel beta Adanya defisiensi produksi insulin, baik karena proses autoimun maupun idiopatik DM Tipe 2 Resistensi insulin Defisiensi relatif insulin

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Transcript of Pendukung Jurnal Diabetes

Pendukung Jurnal

Diabetes MellitusDiabetes Mellitus (DM) salah satu sindrom metabolik atau penyakit gangguan metabolisme kronik yang ditandai oleh hiperglikemia.

KlasifikasiDM Tipe 1Kerusakan sel betaAdanya defisiensi produksi insulin, baik karena proses autoimun maupun idiopatikDM Tipe 2Resistensi insulinDefisiensi relatif insulin

1PathophysiologyInsulin resistance means that body cells do not respond appropriately when insulin is presentOther important contributing factors:increased hepatic glucose production (e.g., from glycogen degradation), especially at inappropriate times decreased insulin-mediated glucose transport in (primarily) muscles & adipose tissues (receptor and post-receptor defects) impaired beta-cell functionloss of early phase of insulin release in response to hyperglycemic stimuli2

3Underlying causes of type 2 diabetesObesityInsulinresistance-celldefectImpairedglucose toleranceEarlydiabetesLatediabetesHyperinsulinaemiaDecreased insulinsecretion-cell failureAdapted from Saltiel AR. J Clin Invest 2000;106:163164.4

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6NormalThe progressive nature of type 2 diabetesImpaired glucose toleranceType 2 diabetesFasting plasma glucoseInsulin sensitivityInsulin secretionInsulin sensitiveNormal insulin secretionNormoglycaemiaHyperglycaemia-cell exhaustionInsulin resistance

Late type 2 diabetes complicationsAdapted from Bailey CJ et al. Int J Clin Pract 2004;58:867876. Groop LC. Diabetes Obes Metab 1999;1 (Suppl. 1):S1S7. Insulin resistance7

ScreeningWidespread use of the fasting plasma glucose (FPG) as a screening test for T2DM is recommended because:A large number of individuals who meet the current criteria for DM are asymptomatic & unawareEpidemiologic studies suggest that T2DM may be present for up to a decade before diagnosisAs many as 50% of individuals with T2DM have one or more diabetes-specific complications at the time of their diagnosisTreatment may favorably alter the natural history of DM

ADA recommends screening all individuals >45 years every 3 years & screening individuals at an earlier age if they are overweight (BMI > 25km/m2) & have one additional risk factor for diabetes10

11DiagnosisKeluhan Khas Klinis DM (+)Keluhan Khas Klinis DM (-)126200