TYPE 2 DIABETES

Tutor : DR. Sahala

Panggabean Sp.PD KGH
By: Dr. Diana Eva Simanjuntak

Definition

A cronic disorder characterized by abnormality in

the metabolisme carbohydrate, protein and fat.

CRITERIA DIABETES

HbA1C >/ 6,5 %

FPG >/126 mg/dl (no caloric in take
8h)
RPG >/ 200mg/dl
OGTT 2h PG >200mg/dl
Hiperglikemia (polydipsi, polyuria,
unintentional weight loss)

Target For Diabetic Patient

Glycemic Control

A1C < 7,0%

Preprandial Plasma Glukose 70-130mg/dl

Post Prandial Plasma Glucose < 180mg/dl

Blood Pressure
< 130mg/dl
Lipids
LDL Cholesterol
<100mg/dl
TG
<150mg/dl
HDL Cholesterol
>40mg/dl

ETIOLOGI

Type I
- Immune Mediated
- Idiopatic
Type II
Insulilin Dependent
Gestational

Other
Genetic Insulin Defec
Genetic B Cell

Function Defect
Genetic Sindrom
Disease Exocrine
Pankreas
Endocrinopathy
Drug Induced
Infection
Immuned Mediated

HIGH RISK

Physical Inactivity
First Degree Relative with Diabetes
High Risk Ethnic ( African American, Latino, Native
American, Asian American, Pasific Islander)
Women with Gestational DM
Hipertension (>/ 140/90 mmHg)
Women with Poly Cystic Ovarii Desease
History CVD
A1C > 5,7%
HDL < 35 mg/dl
TG >/ 250 mg/dl
BMI >/ 25 kg/m2

INSULIN RESISTENCE

Fig 344-4

INSULIN RESISTENCE

DKA - HHS

Simpthom DKA

COMPLICATION

INSULIN REGIMEN

INSULIN REGIMENT

PREPARAT INSULIN

OTHER REGIMENT

OTHER PREPARAT

METABOLIC SINDROM

PATOGENESIS

PATOGENESIS METABOLIC SINDROM

MANAGEMENT

DIET

MEDICATION

OTHER PREPARAT

INSULIN SEKRETAGOGE

MANAGEMENT

MONITORING

CAUSED HIPOGLIKEMIA

INSULIN INDICATION

Nephropahy

Nephrophathy DM

Kimmelstiel Wilson Nodule

Patogenesis Nefropathy Diabeticum

GFR

Calsium Channel Blockers

Amputation Indication

ANTIBIOTIC

CKD STAGING

AMPUTATION

OSTEOMIELITIS

Kriteria Wagner

AB Ratio Index