糖尿病教育权威英文1_1 Diagnosis, classification and prevention.ppt

Diagnosis, classification and prevention of diabetes Definition of diabetes Chronic hyperglycaemia associated with long-term damage to: Eyes Kidneys Nerves Heart and blood vessels The diabetes epidemic 230 million affected in 2006 350 million within 20 years Most rapid in Indian and Asian subcontinents Classification Other specific types MODY Defects in insulin action Diseases of the pancreas Endocrine disorders Drug- or chemical-induced Infections Classification Uncommon forms of immune-mediated diabetes Other genetic syndromes Gestational diabetes  Pathogenesis of type 1 diabetes Idiopathic type 1 diabetes Non-autoimmune type 1 diabetes No autoimmune markers Permanent insulinopenia Ketoacidosis People of African and Asian origin Epidemiology of type 1 diabetes Age of onset peaks preschool puberty Autumn/winter peaks What are the most common risk factors for type 2 diabetes for people in your country? Are any of these risk factors modifiable? Risk factors for type 2 diabetes Hypertension Dyslipidaemia Abdominal obesity Overweight Polycystic ovary disease Acanthosis nigricans Schizophrenia Polydipsia Polyuria Nocturia Visual disturbance Fatigue Weight loss Infections Diagnosing diabetes Impaired glucose toleranceImpaired fasting glucose Intermediate states Increased risk of developing diabetes Prevention strategies to prevent or delay progression Increased risk of cardiovascular disease Uncertain diagnosis:Oral glucose tolerance test 75 g glucose load after 8 hours fasting Readings taken in fasting state and at 1 and 2 hours Possible problems Metabolic syndrome Cluster of risk factors or syndrome Type 2 diabetes Different criteria Three-fold increase in heart disease and stroke Two-fold increase in cardiovascular disease deaths Prevention of type 1 diabetes Prevention of type 1 diabetes Prevention of type 2 diabetes Prevention of type 2 diabetes Summary Type 1 diabetes Results from progressive beta-cell destruction People with type 1