Diabetes Mellitus

definisi
Diabetes mellitus (DM) is a group of
diseases characterized by high levels
of blood glucose resulting from
defects in insulin production, insulin
action, or both.
 Etiology

1. Etiology of Type 1 Diabetes

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2. Etiology of Type 2 Diabetes

4
a

5
 Type 2 Diabetes
Type 1 Diabetes
- blood glucose levels rise
- cells that due to
produce insulin 1) Lack of insulin production
2) Insufficient insulin
are destroyed action (resistant cells)
- results in insulin - commonly detected after
40
dependence
- effects > 90%
- commonly
detected before - eventually leads to -cell
failure
30 (resulting in insulin dependence)
patogenesa
 Pathophysiology

Type 1 DM
There are four stages in the development
of Type 1 DM:

1. Preclinical period with positive -cell antibodies

2. Hyperglycemia when 80-90% of the

- cells are destroyed.

3. Transient remission (honeymoon phase).

4. Establishment of the disease

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 Pathophysiology

Type 2 DM
Type 2 DM is characterized by the presence
of both insulin resistance (tissue
insensitivity) and some degree of insulin
deficiency or - cell dysfunction

Type 2 DM occurs when a diabetogenic

lifestyle (excessive calories, inadequate
caloric expenditure and obesity) is
superimposed upon a susceptible genotype

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Symptoms of Diabetes
People with diabetes often have typical complaints (symptoms):
Thirst and frequent drinking
More frequent urination, particularly at night
Unexplained weight loss
Fatigue
Blurred vision
Frequent infections : skin, genital
 Gejala klinis

Type 1 DM Type 2 DM
- Polyuria - Patients can be asymptomatic
- - Polyuria
Polydipsia
- Polydipsia
- Polyphagia
- Polyphagia
- Weight loss - Fatigue
- Weakness - Weight loss
- Dry skin - Most patients are discovered
- Ketoacidosis while performing urine glucose
screening
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 Diagnostic Criteria

Any one test should be confirmed with a

second test, most often fasting plasma
glucose (FPG).

This criteria for diagnosis should be

confirmed by repeating the test on a
different day. 13
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Management of DM
The major components of the
treatment of diabetes are:
A
 Treatment
Nonpharmacological therapy

Diet
- For type 1 the goal is to regulate insulin
administration with a balanced diet

- In most cases, high carbohydrate, low

fat, and low cholesterol diet is
appropriate

- Type 2 DM patients need caloric

restriction 16
 Treatment
Nonpharmacological therapy
Diet (Contd)

- Artificial sweeteners:
- e.g. Aspartame, saccharin, sucralose,
and acesulfame
- Safe for use by all people with diabetes
- Nutritive sweeteners:
- e.g. fructose and sorbitol
- Their use is increasing except for
acute diarrhea in
some patients 17
 Treatment
Nonpharmacological
therapy
Activity

- Exercise improves insulin resistance and

achieving glycemic control.

- Exercise should start slowly for patients with

limited activity.

- Patients with CV diseases should be

evaluated before starting any exercise
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 Diabetes
Management
Algorithm
Can Diabetes be Prevented?

To be able to prevent a disease we need

to be able to indentify people at
particular risk of developing it
Risk factors for type 2 diabetes
Certain people are more at risk of
diabetes:
Those who are overweight/obese
People with a family history of diabetes
Women who had diabetes during pregnancy or have had a
baby weighing more than 9lbs
Physically inactive people
Certain ethnic groups (african, american indian, asian)
People who have high blood pressure or high cholesterol
Age more than 45 years
 Can Diabetes be Prevented?
Risk of Type 2 Diabetes can be reduced:
Losing weight
Taking regular exercise : walking for 30 mins per day
Eating healthier food:
Less fat (burgers, fries, crisps, sweet foods)
More fibre (fruit and vegetables, wholegrain
alternatives for rice, bread)
Cutting down on alcohol consumption