糖尿病基础知识-英文VIP免费

Dr.RashaSalamaPhDPublicHealth,SuezCanalUniversity,EgyptDiabetesMSc,CardiffUniversity,UnitedKingdomDiabetesmellitus(DM)isagroupofdiseasescharacterizedbyhighlevelsofbloodglucoseresultingfromdefectsininsulinproduction,insulinaction,orboth.Thetermdiabetesmellitusdescribesametabolicdisorderofmultipleaetiologycharacterizedbychronichyperglycaemiawithdisturbancesofcarbohydrate,fatandproteinmetabolismresultingfromdefectsininsulinsecretion,insulinaction,orboth.Theeffectsofdiabetesmellitusincludelong–termdamage,dysfunctionandfailureofvariousorgans.Diabetesmellitusmaypresentwithcharacteristicsymptomssuchasthirst,polyuria,blurringofvision,andweightloss.Initsmostsevereforms,ketoacidosisoranon–ketotichyperosmolarstatemaydevelopandleadtostupor,comaand,inabsenceofeffectivetreatment,death.Oftensymptomsarenotsevere,ormaybeabsent,andconsequentlyhyperglycaemiasufficienttocausepathologicalandfunctionalchangesmaybepresentforalongtimebeforethediagnosisismade.Thelong–termeffectsofdiabetesmellitusincludeprogressivedevelopmentofthespecificcomplicationsofretinopathywithpotentialblindness,nephropathythatmayleadtorenalfailure,and/orneuropathywithriskoffootulcers,amputation,Charcotjoints,andfeaturesofautonomicdysfunction,includingsexualdysfunction.Peoplewithdiabetesareatincreasedriskofcardiovascular,peripheralvascularandcerebrovasculardisease.Thedevelopmentofdiabetesisprojectedtoreachpandemicproportionsoverthenext10-20years.InternationalDiabetesFederation(IDF)dataindicatethatbytheyear2025,thenumberofpeopleaffectedwillreach333million–90%ofthesepeoplewillhaveType2diabetes.InmostWesternsocieties,theoverallprevalencehasreached4-6%,andisashighas10-12%among60-70-year-oldpeople.Theannualhealthcostscausedbydiabetesanditscomplicationsaccountforaround6-12%ofallhealth-careexpenditure.Type1DiabetesMellitusType2DiabetesMellitusGestationalDiabetesOthertypes:LADA(MODY(maturity-onsetdiabetesofyouth)SecondaryDiabetesMellitusWaspreviouslycalledinsulin-dependentdiabetesmellitus(IDDM)orjuvenile-onsetdiabetes.Type1diabetesdevelopswhenthebody’simmunesystemdestroyspancreaticbetacells,theonlycellsinthebodythatmakethehormoneinsulinthatregulatesbloodglucose.Thisformofdiabetesusuallystrikeschildrenandyoungadults,althoughdiseaseonsetcanoccuratanyage.Type1diabetesmayaccountfor5%to10%ofalldiagnosedcasesofdiabetes.Riskfactorsfortype1diabetesmayincludeautoimmune,genetic,andenvironmentalfactors.Waspreviouslycallednon-insulin-dependentdiabetesmellitus(NIDDM)oradult-onsetdiabetes.Type2diabetesmayaccountforabout90%to95%ofalldiagnosedcasesofdiabetes.Itusuallybeginsasinsulinresistance,adisorderinwhichthecellsdonotuseinsulinproperly.Astheneedforinsulinrises,thepancreasgraduallylosesitsabilitytoproduceinsulin.Type2diabetesisassociatedwitholderage,obesity,familyhistoryofdiabetes,historyofgestationaldiabetes,impairedglucosemetabolism,physicalinactivity,andrace/ethnicity.AfricanAmericans,Hispanic/LatinoAmericans,AmericanIndians,andsomeAsianAmericansandNativeHawaiiansorOtherPacificIslandersareatparticularlyhighriskfortype2diabetes.Type2diabetesisincreasinglybeingdiagnosedinchildrenandadolescents.Aformofglucoseintolerancethatisdiagnosedinsomewomenduringpregnancy.GestationaldiabetesoccursmorefrequentlyamongAfricanAmericans,Hispanic/LatinoAmericans,andAmericanIndians.Itisalsomor...