糖尿病英文PPT课件.ppt
《糖尿病英文PPT课件.ppt》由会员分享,可在线阅读,更多相关《糖尿病英文PPT课件.ppt(102页珍藏版)》请在三一办公上搜索。
1、2023/10/17,Beijing Xuanwu Hospital,1,Diabetes Mellitus,2023/10/17,Beijing Xuanwu Hospital,2,Diabetes Mellitus,definitiontypessymptoms diagnosisLaboratory findingstreatmentcomplications,2023/10/17,Beijing Xuanwu Hospital,3,Definition-WHO(4/2000),The term diabetes mellitus describes a metabolic disord
2、er 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,2023/10/17,Beijing Xuanwu Hospital,4,Definition,A metabolic condition characterised by high plasma glucose
3、levels and chronic vascular complicationsA vascular disease affecting small and large arteries with coexistent metabolic disturbance particularly high plasma glucose levels,2023/10/17,Beijing Xuanwu Hospital,5,Diabetes Mellitus,definitiontypessymptoms diagnosisLaboratory findingstreatmentcomplicatio
4、ns,2023/10/17,Beijing Xuanwu Hospital,6,Aetiological Classification of Disorders of Glycaemia,Type 1(betacell destruction,usually leading to absolute insulin deficiency):Autoimmune:IdiopathicType 2(may range from predominantly insulin resistance with relative insulin deficiency to a predominantly se
5、cretory defect with or without insulin resistance),Other specific types Genetic defects of betacell function Genetic defects in insulin actionDiseases of the exocrine pancreas Endocrinopathies Drug or chemicalinduced Infections Uncommon forms of immunemediated diabetesOther genetic syndromes sometim
6、es associated with diabetesGestational diabetes,2023/10/17,Beijing Xuanwu Hospital,7,Type 1 diabetes,Previously known as IDDM(Insulin dependent diabetes)Ketosis prone:Usually diagnosed in younger age group(30 years)(Peak incidence 11-13 yr)Prevalence highly variable but approximately 0.20%with an in
7、cidence of 15-20 per 100000 population aged less than 21Seasonal variation-with lowest rate in spring and summer,2023/10/17,Beijing Xuanwu Hospital,8,Type 1 diabetes mellitus,Immune-mediated type 1 diabetes acute LADA latent autoimmune diabetes in adults Idiopathic type 1 diabetes mellitus,2023/10/1
8、7,Beijing Xuanwu Hospital,9,Type 1 diabetes mellitus,GeneticsEnvironmental factor Viruses Chemical agentsAutoimmune Auto-antibodies:islet cell cytoplasm antibody(ICCA)islet cell surface antibody(ICSA)glutamic acid decarboxylase antibody GADA(64KD)Insulin antibody(IAA),2023/10/17,Beijing Xuanwu Hospi
9、tal,10,Type 1 diabetes,This presentation is the end point of recent and continuing beta cell function resulting in near total loss of Insulin productionHyperglycaemia itself begets further beta cell destruction as treatment with insulin often results in a“honeymoon”period when the patient can often
10、manage without insulin,2023/10/17,Beijing Xuanwu Hospital,11,Type 1 diabetes mellitususually autoimmune destruction of insulin-producing pancreatic islet cellsover monthsabsolute insulin deficiencyrapid presentation withthirst,polyuria,weight loss,blurred visionthrush,lethargy,dizziness.nausea,vomit
11、ing,abdominal cramps,and superficial infectionusually thin and ketotic at presentation Auto-antibodies identified:anti islet cell(ICCA.ICSA),anti GAD(64KD),anti Insulin(IAA),2023/10/17,Beijing Xuanwu Hospital,12,A progressive metabolic disordercharacterised by:,Insulin resistance,Type 2diabetes,-cel
12、l dysfunction,2023/10/17,Beijing Xuanwu Hospital,13,Type 2 diabetes,Previously known as NIDDMNon ketosis prone:,diagnosis 30 years1 in 1000 population as new cases each year Insidious presentation with symptoms of polyuria,polydipsia,lethargy,weight loss,nausea,vomiting,abdominal cramps,blurred visi
13、on and superficial infection.Often discovered at routine medicalThis presentation is the end point of the gradual loss of beta cell function in the setting of Insulin resistanceStrong(90-100%)concordance in TwinsReavans syndrome or Syndrome X Insulin resistance,2023/10/17,Beijing Xuanwu Hospital,14,
14、Type 2 diabetesUnderlying insulin resistancegenetic and ethnicityObesity BMI WHR inactivity/low physical fitnessintrauterine&childhood factorssmoking&drugsImpaired insulin secretionInsulin secretion worsens with time,2023/10/17,Beijing Xuanwu Hospital,15,Type 2 diabetes,2023/10/17,Beijing Xuanwu Hos
15、pital,16,Pancreatic-cell,Insulin resistance,Liver,HYPERGLYCAEMIA,Islet-cell degranulationReduced insulin content,Adipose tissue,Decreased glucose transport&activity(expression)of GLUT-4,Increased lipolysis,Elevated plasma NEFA,+,-,Low plasmainsulin,Increased glucose output,ElevatedTNF,Insulin resist
16、ance and-cell dysfunctionproduce hyperglycaemia in type 2 diabetes,2023/10/17,Beijing Xuanwu Hospital,17,Tissue Responses to InsulinResistance or Failure,LIVER a.increased glycogen hydrolysis to glucose b.increased gluconeogenesis.c.increased triacylglycerol hydrolysis and conversion of glycerol to
17、glucose d.increased conversion of FA and protein to ketones(AcAc and BHB)e.increased protein and amino acid catabolism f.increased production of urea,2023/10/17,Beijing Xuanwu Hospital,18,MUSCLE,a.serum glucose is poorly taken up by muscle(decrease GLUT activity)b.saturation of hexokinase activity,i
18、nability to retain cellular glu as glu-6-PO4c.increased LPL activity and increased FA productiond.increased b-oxidation,but TCA is overwhelmed because ATP is high alreadyee.increased breakdown of muscle and serum protein into amino acidsf.increased transfer of N onto ALA/GLN and sent back to liver,2
19、023/10/17,Beijing Xuanwu Hospital,19,ADIPOSE,a.increased LPL and HSL send more free FA into bloodstreamb.glucose can not be taken into cell via GLUT4 for glycogen synthesisc.active HSL means TAGs are not being made and stored,2023/10/17,Beijing Xuanwu Hospital,20,Insulin resistance and insulinhypers
20、ecretion precede type 2 diabetes,Insulin Insulin Macrovascularsensitivity secretion disease 30%50%50%50%70100%40%70%150%10%100%100%,Type 2 diabetes,IGT,Impaired glucose metabolism,Normal glucose metabolism,2023/10/17,Beijing Xuanwu Hospital,21,Clinical Reavans Syndrome,Insulin resistanceHypertension
21、Dyslipidaemia(increase LDL,decreased HDL)ObesityOther factors:hyperfibrinogenemia,hyperuricaemia,propensity to microvascular diseases“Metabolic syndrome”in most cases of type 2 diabetes,2023/10/17,Beijing Xuanwu Hospital,22,abdominal obesity,high blood pressure,HDL cholesterol VLDL triglyceride smal
22、l dense LDL,hyperinsulinaemiaglucose intolerancediabetes,hyperuricaemia,PAI-1 fibrinogen factor VII,microalbuminuria,insulin resistance,Syndrome of insulin resistance,AKA Reavens syndrome,syndrome Xmetabolic syndrome,2023/10/17,Beijing Xuanwu Hospital,23,Type 1 diabetestypical onset 30 yearscan star
23、t at any agesudden onsetsevere symptomsrecent weight lossusually thinspontaneous ketosisabsent C-peptidemarkers of autoimmunity,Type 2 diabetestypical onset 20 yearscan start at any agegradual onsetmay be no symptomsoften no weight lossusually obesenot ketoticdetectable C-peptideno autoimmune marker
24、s,2023/10/17,Beijing Xuanwu Hospital,24,Diabetes in pregnancyco-existent or newly diagnosed lifelong diabetestype 1 type 2(especially in South Asian women)other specific types of diabetesgestational diabetes,2023/10/17,Beijing Xuanwu Hospital,25,Other types of Diabetes,Genetic defects of betacell fu
25、nctionChrme 20,HNF4_(MODY1)Chrme 7,glucokinase(MODY2)Chrme 12,HNF1_(MODY3)Chrme 13,IPF1(MODY4)Mitochondrial DNA 3243 mutationGenetic defects in insulin actionType A insulin resistanceLeprechaunismRabsonMendenhall syndromeLipoatrophic diabetes&Others,Diseases of the exocrine-pancreasFibrocalculous pa
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- 糖尿病 英文 PPT 课件
链接地址:https://www.31ppt.com/p-6330703.html