糖尿病英文ppt课件

2020 2 24 2020 2 24 Terminology 2 2020 2 24 Terminology 3 2020 2 24 Terminology 4 01BriefIntroduction02Classification03Themajorfactors04Pathogenesis05ClinicalManifestations06Complications07Diagnosis08Antidiastole09Therapy contents Figure1 Mainsymptomofdiabetes 6 Diabetesmellitus orsimplydiabetes isagroupofmetabolicdiseasesinwhichapersonhashighbloodsugar eitherbecausethepancreasdoesnotproduceenoughinsulin orbecausecellsdonotrespondtotheinsulinthatisproduced Thishighbloodsugarproducestheclassicalsymptomsofpolyuria frequenturination polydipsia increasedthirst andpolyphagia increasedhunger 01BriefIntroduction 02Classification 2 3Othertypeofdiabetesgestationaldiabetes occurswhenpregnantwomenwithoutapreviousdiagnosisofdiabetesdevelopahighbloodglucoselevel Itmayprecededevelopmentoftype2DM Otherformsofdiabetesmellitusincludecongenitaldiabetes whichisduetogeneticdefectsofinsulinsecretion cysticfibrosis relateddiabetes steroiddiabetesinducedbyhighdosesofglucocorticoids andseveralformsofmonogenicdiabetes 2020 2 24 meta 变化的metabolismn 新陈代谢metaboliten 代谢物metabolizev 使新陈代谢metabolicadj 变化的 新陈代谢的poly 多的 多个的 聚合的polydipsia多饮polyuria多尿polyphagia多食 WordAnalysis 2020 2 24 uri 尿的 与尿有关的urinen 尿polyuria多尿uricadj 尿的urinaln 尿壶urinatev 小便urinationn 排尿glucosuria糖尿 WordAnalysis 2020 2 24 Birthweight FatIrregularmenses menstruation InflammationObesityandasedentarylifestyleSmokingMetabolicsyndrome 03Themajorfactors 03Themajorfactors 3 1BirthweightThereisarelationshipbetweenbirthweightanddevelopingdiabetes Thehigherthebirthweightthehighertheriskoftype2diabetes Attheotherendofthespectrum averyhighbirthweight over8 8poundsor4kg alsoisassociatedwithanincreasedrisk Additionally mothersofinfantswhohadahigherbirthweight over9pounds areatincreasedriskfordevelopingdiabetes 03Themajorfactors 3 2FatThedistributionoffatisimportant Theclassic pear shapeperson smallerwaistthanhips hasalowerriskofdevelopingdiabetesthanthe apple shapeperson largeraroundthewaist Theexactreasonforthisdifferenceisunknown butitisthoughttohavesomethingtodowiththemetabolicactivityofthefattissueindifferentareasofthebody 03Themajorfactors 3 3Irregularmenses menstruation Thereisanassociationbetweenthelengtheningofthemenstrualcycleandtheriskfordevelopingdiabetes particularlyinobesewomen thosewhohadacyclelengthofgreaterthan40daysweretwiceaslikelytodevelopdiabetesthanthosewhocycledevery26to31days Theassociationisthoughttobelinkedwithpolycysticovariansyndrome PCOS whichisalsoknowntobeassociatedwithinsulinresistance Insulinresistancemaybeaprecursorfortype2diabetes 03Themajorfactors 3 4inflammationInrecentyearswehavebeguntounderstandtheimportanceofinflammationandheartdisease Wenowknowthatinflammationmayplayanimportantroleinthedevelopmentofdiabetesaswell AninflammationmarkerknownasC reactiveproteinhasbeenshowntobeincreasedinwomenatriskfordevelopingthemetabolicsyndrome andinbothmenandwomenatriskfordevelopingtype2diabetes 03Themajorfactors 3 5ObesityandasedentarylifestyleObesityandasedentarylifestylearethebiggestriskfactorsthatarecontrollable Thisisinpartduetothefactthatobesityincreasesthebody sresistancetoinsulin Studieshaveshownthatreversalofobesitythroughweightreductionimprovesinsulinsensitivityandregulationofbloodsugar 03Themajorfactors 3 6smokingSmokingisharmfulinmanywaysincludingincreasingtheriskofcancerandheartdisease Italsoincreasestheriskofdevelopingtype2diabetes 2020 2 24 men o与月经有关的menstruationn 月经menstrualadj 月经的dysmenorrhean menstrualpainamenorrhea Menopausen nomenstruationmetr o子宫metrorrhagian uterinebleedingmetrostaxisn Smalluterinebleeding WordAnalysis 2020 2 24 metabolic代谢的metabolicsyndrome代谢综合征lipidmetabolism脂代谢glucosemetabolism糖代谢metabolicacidosis代谢性酸中毒basalmetabolicrate基础代谢率precursor prodromalsymptomsofdiseaseC reactiveprotein Itisasharplyrisedprotein whentissuesinjuryandinfect WordAnalysis 04Pathogenesis 4 1ThePathogenesisofType1Isrelatedtogeneticfactors environmentalfactorsandautoimmunity1 geneticpredisposition2 startautoimmuneresponse3 immumologicalabnormalities4 progressivelossofisletBcellfunction5 clinicaldiabetes6 isletBcellsdestroyed diabetesclinicalmanifestations 04Pathogenesis 4 2ThePathogenesisofType2Itsoccurrenceanddevelopmentcanbedividedintofourstages1 Geneticsusceptibility2 Hyperinsulinism and orinsulinresistance3 Glucotoxicity 糖尿病毒性 lipotoxicity 脂毒性 4 Clinicaldiabetes 2020 2 24 immune免疫autoimmunity自身免疫immumological免疫学的hyper 高Hyperinsulinism高胰岛素症Hyperglycemia高血糖toxic毒的 中毒的 有毒的Glucotoxicity糖尿病毒性lipotoxicity脂毒性 WordAnalysis 05ClinicalManifestations 5 1Type1DiabetesMellitusPolyuriaPolydipsiaPolyphagiaWeightloss 05ClinicalManifestations 5 2Type2DiabetesMellitusNon specificsymptomsFatigueRecurrentinfectionsProlongedwoundhealingVisualchanges 2020 2 24 proteolysis蛋白质水解lipolysis脂类分解arthrolysis关节松解术 lysis松解术 分解 溶解prote 蛋白质lipo 脂肪的arthro 关节 WordAnalysis 06Complications 6 1DiabeticKetoacidosis DKA Itisthemostcommonacutecomplicationofdiabetesmellitus TheearlymanifestationsofDKAisthatthesymptomsbeingmoreserve suchaspolydipsia polyuria polyphagiaandsoon TheDKAischaracterizedbydifferentdegreesofdisturbanceconsciousnessintheadvancedstage 06Complications 6 2Hyperglycemichyperosmolarstatus HHS Mainclinicalfeatures hyperglycemiacrisis 高血糖危象 higherplasmaosmoticpressure 高血浆渗透压 dehydration 脱水 Minorclinicalmanifestation varyingdegreesofdisturbanceconsciousnessorcoma unconspicuousDKA 06Complications 6 3InfectiouscomplicationsPyogenicinflammation furuncle carbuncle pustule etc Fungalinfection tineapedis tineacorporis etc Pulmonarytuberculosis Figure2 Infectiouscomplications 06Complications 6 4Macroangiopathy Themainhistopathologicalchangeisatherosclerosis AS Itismostliketoaccompanywithaorta coronaryartery cerebralartery renalartery peripheralartery etc TheASleadstoischemicchangesofheart brain kidneysandlimbs 06Complications 6 5MicroangiopathyItisthespecificcomplicationsofDM It stypicalhistopathologicalchangesaremicrocirculationdisturbancesandthethicknessofbasalmembraneofvessel Themicroangiopathymostliketoaffectsretina nerves nephridium andmyocardium 06Complications 6 6Neurologicalcomplications 1 centralnervoussystemcomplication CNSC alteredmentalstatus ischemicstroke seniledementia 2 peripheralneuropathy paresthesia decreasedofmuscle areflexia3 autonomicneuropathy gastroparesis diarrhea astriction abnormalsweating 06Complications 6 7Diabeticfoot Relatedtodistallowerneurologicaldisorderanddifferentlevelsperipheralvasculardisease Symptomsoflight footabnormal skincold high riskfoot Severesymptoms footulcer necrosis Diabeticfootisthemainreasonofdisabilityandamputation 06Complications 6 8Otherdiseaseseyecomplications suchasretinalmaculardisease cataracts glaucoma Iridocyclitisskinlesions likeSkininfections skinitch chappedskin rash Figure4 skinlesions Figure3 eyecomplications 2020 2 24 Macroangiopathy大血管病变macro largemicro smallangi arteries动脉血管 pathythesuffixof diseases Athersclerosis动脉粥样硬化ather oplaqueoffattysubstance动脉粥样 sclerosishardening硬化 WordAnalysis 2020 2 24 Peripheralangiopathy周围血管病Peri surrounding周angi meansvessel pathymeansdiseaseNeurological神经病学的Neur meansnerve ologicaldiscipline学科的Dementia痴呆De 脱 去 减 除 离 mentiaspirit WordAnalysis 07diagnosis Fastingbloodglucosegreaterthanorequalto7mmol L Twohourspostprandialbloodglucosegreaterthanorequalto11 1mmol L3 Thesymptomsofdiabetesandanytimeplasmaticglucosegreaterthanorequalto11 1mmol L 07diagnosis 7 1Type1diabetesmellitus1 Theageofonsetisyoung theage 30yearsold 2 Thesymptomscomeonabruptly3 ThesymptomsofPolydipsia PolyphagiaandPolyuriaareobvious 4 Thebloodglucoselevelishigh andmanypatientswithketosisacidtoxicasthefirstsymptom LowserumlevelofinsulinandThelowlevelofCpeptide 07diagnosis 7 2Type2diabetesmellitusThecommonintheelderly highincidenceofobesity oftenaccompaniedbyhypertension dyslipidemia atherosclerosisandotherdiseases Insidiousonset hasnoearlysymptoms oronlymildfatigue thirst hyperglycemiaisnotobvious GlucosetolerancetesttoconfirmthediagnosisSeruminsulinlevelinearlynormalorincreased Theadvancedislow 2020 2 24 Plasmatic血浆的plasm 血浆 atic性质的Dyslipidemia血脂异常dys 不良的 困难lip 脂肪的 emia血症Gluc o 葡萄糖glucagon胰高血糖素glucokinase葡萄糖激酶glucocorticoids糖皮质激素enteroglucagon肠高血糖素 WordAnalysis 08Antidiastole 8 1Liverdiseases Livercirrhosispatientsoftenhaveabnormalglucosemetabolism thefastingbloodglucoseofthetypicalpatientisnormalorlow postprandialbloodglucoseriserapidly Thedurationoftheelderly thefastingplasmaglucosecanalsobeelevated 2020 2 24 DiabetshealtheducationMedicalnutritiontherapyConditionmonitoringDrugstherapy 09Therapy 09Therapy 9 1MedicalnutritiontherapyCalculatethetotalquantityofheat Nutrientcontent Reasonabledistribution Follow up 09Therapy 9 2conditionmonitoringRegularchecksbloodsugartoadjustthetreatmentplanProperexerciseregularlyEveryyearortwocomprehensivereview complications earlydetectionandtreatment 09Therapy 9 3DiabetshealtheducationMedicaistaffadheretofollowup accordingtotheneedtoadjustthetreatmentplan Lifeshouldberegular quitsmokinganddring Topreventinfection 09Therapy 9 4Drugstherapy Alphaglucosidaseinhibito