Diabetes糖尿病英文

1、2020/6/24,2020/6/24,Terminology,2,2020/6/24,Terminology,3,2020/6/24,Terminology,4,01 Brief Introduction 02 Classification 03 The major factors 04 Pathogenesis 05 Clinical Manifestations 06 Complications 07 Diagnosis 08 Antidiastole 09 Therapy,contents,Figure1：Main symptom of diabetes,6,Diabetes mell

2、itus, or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent

3、 urination), polydipsia (increased thirst), and polyphagia (increased hunger).,01 Brief Introduction,7,02 Classification,2.1 Type 1 diabetes The pancreas undergoes an autoimmune attack by the body itself,and is rendered incapable of making insulin.Abnormal antibodies have been found in the majority

4、of patients with type1 diabetes.Antibodies are proteins in the blood that are part of the bodys immune system,the patient with type1 diabetes must rely on insulin medication for survival.,02 Classification,2.2 Type 2 diabetes It previously referred to as non-insulin dependent diabetes mellitus,or ad

5、ult onset diabetes mellitus.patients can still produce insulin,but do so relatively inadequately for their bodys needs,particularly in the face of insulin resistance as discussed above.In many cases this actually means the pancreas produces larger than normal quantities of insulin.A major feature of

6、 type2 diabetes is a lack of sensitivity to insulin by the cells of the body.,02 Classification,2.3 Other type of diabetes gestational diabetes,occurs when pregnant women without a previous diagnosis of diabetes develop a high blood glucose level. It may precede development of type 2 DM. Other forms

7、 of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.,2020/6/24,meta-变化的 metabolism n.新陈代谢 metabolite n.代谢物 metabol

8、ize v.使新陈代谢 metabolic adj.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,Word Analysis,2020/6/24,uri- 尿的，与尿有关的 urine n.尿 polyuria 多尿 uric adj. 尿的 urinal n.尿壶 urinate v.小便 urination n.排尿 glucosuria 糖尿,Word Analysis,2020/6/24,Birth weight: Fat Irregular menses (menstruation) Inflam

9、mation Obesity and a sedentary lifestyle Smoking Metabolic syndrome,03 The major factors,03 The major factors,3.1 Birth weight There is a relationship between birth weight and developing diabetes.The higher the birth weight the higher the risk of type 2 diabetes. At the other end of the spectrum , a

10、 very high birth weight (over 8.8 pounds or 4 kg) also is associated with an increased risk. Additionally, mothers of infants who had a higher birth weight (over 9 pounds) are at increased risk for developing diabetes.,03 The major factors,3.2 Fat The distribution of fat is important. The classic pe

11、ar shape person (smaller waist than hips) has a lower risk of developing diabetes than the apple shape person (larger around the waist). The exact reason for this difference is unknown, but it is thought to have something to do with the metabolic activity of the fat tissue in different areas of the

12、body.,03 The major factors,3.3 Irregular menses (menstruation) There is an association between the lengthening of the menstrual cycle and the risk for developing diabetes, particularly in obese women.those who had a cycle length of greater than 40 days were twice as likely to develop diabetes than t

13、hose who cycled every 26 to 31 days. The association is thought to be linked with polycystic ovarian syndrome(PCOS) which is also known to be associated with insulin resistance. Insulin resistance may be a precursor for type 2 diabetes.,03 The major factors,3.4 inflammation In recent years we have b

14、egun to understand the importance of inflammation and heart disease. We now know that inflammation may play an important role in the development of diabetes as well. An inflammation marker known as C-reactive protein has been shown to be increased in women at risk for developing the metabolic syndro

15、me, and in both men and women at risk for developing type 2 diabetes.,03 The major factors,3.5 Obesity and a sedentary lifestyle Obesity and a sedentary lifestyle are the biggest risk factors that are controllable.This is in part due to the fact that obesity increases the bodys resistance to insulin

16、. Studies have shown that reversal of obesity through weight reduction improves insulin sensitivity and regulation of blood sugar.,03 The major factors,3.6 smoking Smoking is harmful in many ways including increasing the risk of cancer and heart disease. It also increases the risk of developing type

17、 2 diabetes.,2020/6/24,men/o 与月经有关的 menstruation n. 月经 menstrual adj.月经的 dysmenorrhea n. menstrual pain amenorrhea/Menopause n. no menstruation metr/o 子宫 metrorrhagia n.uterine bleeding metrostaxis n.Small uterine bleeding,Word Analysis,2020/6/24,metabolic 代谢的 metabolic syndrome 代谢综合征 lipid metaboli

18、sm 脂代谢 glucose metabolism 糖代谢 metabolic acidosis 代谢性酸中毒 basal metabolic rate 基础代谢率 precursor: prodromal symptoms of disease C-reactive protein：It is a sharply rised protein，when tissues injury and infect.,Word Analysis,04 Pathogenesis,4.1 The Pathogenesis of Type 1 Is related to genetic factors, env

19、ironmental factors and autoimmunity 1）genetic predisposition 2）start autoimmune response 3）immumological abnormalities 4）progressive loss of islet B cell function 5) clinical diabetes 6）islet B cells destroyed,diabetes clinical manifestations,04 Pathogenesis,4.2 The Pathogenesis of Type 2 Its occurr

20、ence and development can be divided into four stages 1 ）Genetic susceptibility 2） Hyperinsulinism, and/or insulin resistance 3 ）Glucotoxicity(糖尿病毒性),lipotoxicity(脂毒性) 4 ）Clinical diabetes,2020/6/24,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

21、毒的，中毒的，有毒的 Glucotoxicity 糖尿病毒性 lipotoxicity 脂毒性,Word Analysis,05 Clinical Manifestations,5.1 Type 1 Diabetes Mellitus Polyuria Polydipsia Polyphagia Weight loss,05 Clinical Manifestations,5.2 Type 2 Diabetes Mellitus Non-specific symptoms Fatigue Recurrent infections Prolonged wound healing Visual c

22、hanges,2020/6/24,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,Word Analysis,06 Complications,6.1 Diabetic Ketoacidosis(DKA) It is the most common acute complication of diabetes mellitus. The early manifestations of DKA is that the symptoms being more s

23、erve ,such as polydipsia、polyuria、polyphagia and so on.The DKA is characterized by different degrees of disturbance consciousness in the advanced stage.,06 Complications,6.2 Hyperglycemic hyperosmolar status (HHS) Main clinical features: hyperglycemia crisis(高血糖危象),higher plasma osmotic pressure(高血浆

24、渗透压),dehydration(脱水). Minor clinical manifestation: varying degrees of disturbance consciousness or coma ,unconspicuous DKA.,06 Complications,6.3 Infectious complications Pyogenic inflammation : furuncle,carbuncle,pustule,etc. Fungal infection: tinea pedis ,tinea corporis,etc. Pulmonary tuberculosis

25、,Figure2： Infectious complications,06 Complications,6.4 Macroangiopathy : The main histopathological change is atherosclerosis (AS).It is most like to accompany with aorta,coronary artery,cerebral artery,renal artery , peripheral artery ,etc.The AS leads to ischemic changes of heart ,brain,kidneys a

26、nd limbs.,06 Complications,6.5 Microangiopathy It is the specific complications of DM.Its typical histopathological changes are microcirculation disturbances and the thickness of basal membrane of vessel. The microangiopathy most like to affects retina, nerves，nephridium, and myocardium,06 Complicat

27、ions,6.6 Neurological complications: 1)central nervous system complication(CNSC): altered mental status,ischemic stroke,senile dementia. 2)peripheral neuropathy: paresthesia , decreased of muscle,areflexia 3)autonomic neuropathy: gastroparesis, diarrhea,astriction,abnormal sweating.,06 Complications

28、,6.7 Diabetic foot Related to distal lower neurological disorder and different levels peripheral vascular disease. Symptoms of light: foot abnormal,skin cold,high-risk foot Severe symptoms:foot ulcer,necrosis Diabetic foot is the main reason of disability and amputation,06 Complications,6.8 Other di

29、seases eye complications： such as retinal macular disease , cataracts ,glaucoma , Iridocyclitis skin lesions : like Skin infections,skin itch,chapped skin, rash.,Figure4： skin lesions,Figure3： eye complications,2020/6/24,Macroangiopathy 大血管病变 macro- large micro- small angi- arteries 动脉血管 -pathy the

30、suffix of“diseases” Athersclerosis 动脉粥样硬化 ather/o plaque of fatty substance 动脉粥样 -sclerosis hardening硬化,Word Analysis,2020/6/24,Peripheral angiopathy 周围血管病 Peri- surrounding 周 angi- means vessel -pathy means disease Neurological 神经病学的 Neur- means nerve -ological discipline 学科的 Dementia 痴呆 De 脱，去，减，除

31、，离 -mentia spirit,Word Analysis,07 diagnosis,Fasting blood glucose greater than or equal to 7 mmol / L . Two hours postprandial blood glucose greater than or equal to 11.1 mmol / L 3) The symptoms of diabetes and any time plasmatic glucose greater than or equal to 11.1 mmol / L,07 diagnosis,7.1 Type

32、 1 diabetes mellitus 1.The age of onset is young, the age 30 years old. 2.The symptoms come on abruptly 3.The symptoms of Polydipsia, Polyphagia and Polyuria are obvious. 4.The blood glucose level is high, and many patients with ketosis acid toxic as the first symptom. Low serum level of insulin and

33、 The low level of C peptide,07 diagnosis,7.2 Type 2 diabetes mellitus The common in the elderly, high incidence of obesity,often accompanied by hypertension, dyslipidemia , atherosclerosis and other diseases. Insidious onset,has no early symptoms, or only mild fatigue, thirst, hyperglycemia is not o

34、bvious. Glucose tolerance test to confirm the diagnosis Serum insulin level in early normal or increased, The advanced is low,2020/6/24,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

35、素,Word Analysis,08 Antidiastole,8.1 Liver diseases: Liver cirrhosis patients often have abnormal glucose metabolism, the fasting blood glucose of the typical patient is normal or low, postprandial blood glucose rise rapidly. The duration of the elderly , the fasting plasma glucosecan also be elevate

36、d.,2020/6/24,Diabets health education Medical nutrition therapy Condition monitoring Drugs therapy,09 Therapy,09 Therapy,9.1 Medical nutrition therapy Calculate the total quantity of heat; Nutrient content; Reasonable distribution; Follow-up,09 Therapy,9.2 condition monitoring Regular checks blood s

37、ugar to adjust the treatment plan Proper exercise regularly Every year or two comprehensive review, complications,early detection and treatment,09 Therapy,9.3 Diabets health education Medicai staff adhere to follow up,according to the need to adjust the treatment plan; Life should be regular,quit smoking and d