Diabetes糖尿病英文學(xué)習(xí)課件

2023/1/312022/12/2612023/1/3

Terminology

222022/12/26Terminology2023/1/3

Terminology

332022/12/26Terminology2023/1/3

Terminology

442022/12/26Terminology01BriefIntroduction02Classification03

Themajorfactors04

Pathogenesis

05

ClinicalManifestations06Complications07

Diagnosis08

Antidiastole09TherapycontentsFigure1：Mainsymptomofdiabetes5

01BriefIntroductioncontents6Diabetesmellitus,orsimply

diabetes,isagroupofmetabolicdiseasesinwhichapersonhashigh

bloodsugar,eitherbecausethepancreas

doesnotproduceenough

insulin,orbecausecellsdonotrespondtotheinsulinthatisproduced.

Thishighbloodsugarproducestheclassicalsymptomsof

polyuria

(frequenturination),

polydipsia

(increasedthirst),and

polyphagia

(increasedhunger).

01BriefIntroduction

6Diabetesmellitus,orsimply

702Classification2.1

Type1diabetes

Thepancreas

undergoesanautoimmuneattackbythebodyitself,andisrenderedincapableofmakinginsulin.Abnormalantibodieshavebeenfoundinthemajorityofpatientswithtype1diabetes.Antibodiesareproteinsinthebloodthatarepartofthebody‘simmunesystem,thepatientwithtype1diabetesmustrelyoninsulinmedicationforsurvival.

702Classification2.1

Type102Classification2.2

Type2diabetes

Itpreviouslyreferredtoasnon-insulindependentdiabetesmellitus,oradultonset

diabetesmellitus.patientscanstillproduceinsulin,butdosorelativelyinadequatelyfortheirbody‘sneeds,particularlyinthefaceofinsulinresistanceasdiscussedabove.Inmanycasesthisactuallymeansthepancreasproduceslargerthannormalquantities

ofinsulin.Amajorfeatureoftype2diabetesisalackofsensitivitytoinsulinbythecellsofthebody.8

02Classification2.2

Type2d02Classification2.3

Othertypeofdiabetesgestationaldiabetes,occurswhenpregnantwomenwithoutapreviousdiagnosisofdiabetesdevelopahighbloodglucoselevel.Itmayprecededevelopmentoftype2DM.Otherformsofdiabetesmellitusincludecongenitaldiabetes,whichisdueto

genetic

defectsofinsulinsecretion,

cysticfibrosis-relateddiabetes,steroiddiabetesinducedbyhighdosesof

glucocorticoids,andseveralformsof

monogenicdiabetes.9

02Classification2.3

Othert2023/1/3meta-變化的metabolismn.新陳代謝metaboliten.代謝物metabolizev.使新陳代謝metabolicadj.變化的，新陳代謝的

poly-多的，多個(gè)的，聚合的

polydipsia多飲polyuria多尿polyphagia多食

WordAnalysis102022/12/26meta-變化的WordAnaly2023/1/3uri-尿的，與尿有關(guān)的urinen.尿polyuria多尿uricadj.尿的urinaln.尿壺urinatev.小便urinationn.排尿glucosuria糖尿WordAnalysis112022/12/26uri-尿的，與尿有關(guān)的Word2023/1/3Birthweight:FatIrregularmenses(menstruation)InflammationObesity

andasedentary

lifestyleSmokingMetabolicsyndrome

03

Themajorfactors122022/12/26Birthweight:03

The03

Themajorfactors

3.1

BirthweightThereisarelationshipbetweenbirthweightanddevelopingdiabetes.Thehigherthebirthweightthehighertheriskoftype2diabetes.Attheotherendofthespectrum,averyhighbirthweight(over8.8poundsor4kg)alsoisassociatedwithanincreasedrisk.Additionally,mothersofinfantswhohadahigherbirthweight(over9pounds)areatincreasedriskfordevelopingdiabetes.13

03

Themajorfactors3.1Birth03

Themajorfactors

3.2

FatThedistributionoffatisimportant.Theclassic"pear"shapeperson(smallerwaistthanhips)hasalowerriskofdevelopingdiabetesthanthe"apple"shapeperson(largeraroundthewaist).Theexactreasonforthisdifferenceisunknown,butitisthoughttohavesomethingtodowiththemetabolicactivityofthefattissueindifferentareasofthebody.14

03

Themajorfactors3.2Fat103

Themajorfactors

3.3

Irregularmenses(menstruation)

Thereisanassociationbetweenthelengtheningofthemenstrualcycleandtheriskfordevelopingdiabetes,particularlyinobesewomen.thosewhohadacyclelengthofgreaterthan40daysweretwiceaslikelytodevelopdiabetesthanthosewhocycledevery26to31days.Theassociationisthoughttobelinkedwithpolycystic

ovariansyndrome(PCOS)whichisalsoknowntobeassociatedwithinsulinresistance.Insulinresistancemaybeaprecursorfortype2diabetes.15

03

Themajorfactors3.3Irre03

Themajorfactors

3.4

inflammationInrecentyearswehavebeguntounderstandtheimportanceofinflammationandheartdisease.Wenowknowthatinflammationmayplayanimportantroleinthedevelopmentofdiabetesaswell.AninflammationmarkerknownasC-reactiveproteinhasbeenshowntobeincreasedinwomenatriskfordevelopingthemetabolicsyndrome,andinbothmenandwomenatriskfordevelopingtype2diabetes.16

03

Themajorfactors3.4infl03

Themajorfactors

3.5

ObesityandasedentarylifestyleObesityandasedentarylifestylearethebiggestriskfactorsthatarecontrollable.Thisisinpartduetothefactthatobesityincreasesthebody'sresistancetoinsulin.Studieshaveshownthatreversalofobesitythroughweightreductionimprovesinsulinsensitivityandregulationofbloodsugar.17

03

Themajorfactors3.5Obes03

Themajorfactors

3.6

smoking

Smokingisharmfulinmanywaysincludingincreasingtheriskofcancerandheartdisease.Italsoincreasestheriskofdevelopingtype2diabetes.18

03

Themajorfactors3.6smoki2023/1/3men/o與月經(jīng)有關(guān)的menstruationn.月經(jīng)menstrualadj.月經(jīng)的dysmenorrhean.menstrualpainamenorrhea/Menopausen.nomenstruationmetr/o子宮

metrorrhagian.uterinebleedingmetrostaxisn.SmalluterinebleedingWordAnalysis192022/12/26men/o與月經(jīng)有關(guān)的Word2023/1/3metabolic代謝的metabolicsyndrome代謝綜合征lipidmetabolism脂代謝glucosemetabolism糖代謝metabolicacidosis代謝性酸中毒basalmetabolicrate基礎(chǔ)代謝率precursor:prodromalsymptomsofdiseaseC-reactiveprotein：Itisasharplyrisedprotein，whentissuesinjuryandinfect.WordAnalysis202022/12/26metabolic代謝的Word04

Pathogenesis4.1

ThePathogenesis

ofType1

Isrelatedtogeneticfactors,environmentalfactorsandautoimmunity1）geneticpredisposition2）startautoimmuneresponse3）immumologicalabnormalities4）progressivelossofisletBcellfunction5)clinicaldiabetes6）isletBcellsdestroyed,diabetesclinicalmanifestations21

04

Pathogenesis4.1ThePathog04

Pathogenesis4.2

ThePathogenesisofType2Itsoccurrenceanddevelopmentcanbedividedintofourstages1）Geneticsusceptibility2）

Hyperinsulinism,and/orinsulinresistance3）Glucotoxicity(糖尿病毒性),lipotoxicity(脂毒性)4）Clinicaldiabetes22

04

Pathogenesis4.2ThePathog2023/1/3immune免疫autoimmunity自身免疫immumological免疫學(xué)的hyper-高Hyperinsulinism高胰島素癥Hyperglycemia高血糖toxic毒的，中毒的，有毒的Glucotoxicity

糖尿病毒性lipotoxicity

脂毒性WordAnalysis232022/12/26immune免疫WordAnal05

ClinicalManifestations

5.1Type1DiabetesMellitusPolyuriaPolydipsiaPolyphagiaWeightloss24

05

ClinicalManifestations5.05

ClinicalManifestations

5.2Type2DiabetesMellitusNon-specificsymptomsFatigueRecurrentinfectionsProlongedwoundhealingVisual

changes25

05

ClinicalManifestations5.2023/1/3proteolysis蛋白質(zhì)水解lipolysis脂類(lèi)分解arthrolysis關(guān)節(jié)松解術(shù)-lysis松解術(shù)，分解，溶解prote-蛋白質(zhì)lipo-脂肪的arthro-關(guān)節(jié)WordAnalysis262022/12/26proteolysis蛋白質(zhì)水解06

Complications6.1

DiabeticKetoacidosis(DKA)

Itisthemostcommonacutecomplicationofdiabetesmellitus.TheearlymanifestationsofDKAisthatthesymptomsbeingmoreserve,suchaspolydipsia、polyuria、polyphagiaandsoon.TheDKAischaracterizedbydifferentdegreesofdisturbanceconsciousnessintheadvancedstage.27

06

Complications6.1Diabetic06

Complications6.2

Hyperglycemichyperosmolarstatus(HHS)Mainclinicalfeatures:hyperglycemiacrisis(高血糖危象),higherplasmaosmotic

pressure(高血漿滲透壓),dehydration(脫水).

Minorclinicalmanifestation:varyingdegreesofdisturbanceconsciousnessorcoma,unconspicuousDKA.28

06

Complications6.2Hyperglyc06

Complications6.3

Infectiouscomplications

Pyogenicinflammation:

furuncle,carbuncle,pustule,etc.Fungalinfection:

tineapedis,tineacorporis,etc.

PulmonarytuberculosisFigure2：

Infectiouscomplications

29

06

Complications6.3Infectiou06

Complications6.4

Macroangiopathy:

Themainhistopathological

changeisatherosclerosis

(AS).Itismostliketoaccompanywithaorta,coronaryartery,cerebralartery,renalartery

,peripheralartery,etc.TheASleadstoischemic

changesofheart,brain,kidneysandlimbs.

30

06

Complications6.4Macroangi06

Complications6.5

Microangiopathy

ItisthespecificcomplicationsofDM.It’stypicalhistopathologicalchangesaremicrocirculationdisturbancesandthethicknessofbasalmembrane

ofvessel.Themicroangiopathymostliketoaffectsretina,nerves，nephridium,andmyocardium

31

06

Complications6.5Microangi06

Complications6.6

Neurologicalcomplications:

1)centralnervoussystemcomplication(CNSC):

alteredmentalstatus,ischemicstroke,seniledementia.2)peripheralneuropathy:paresthesia,decreasedofmuscle,areflexia3)autonomicneuropathy:gastroparesis,diarrhea,astriction,abnormalsweating.32

06

Complications6.6Neurologi06

Complications6.7

Diabeticfoot

?Relatedtodistallowerneurologicaldisorderanddifferentlevelsperipheralvasculardisease.?Symptomsoflight:footabnormal,skincold,high-riskfoot?Severesymptoms:footulcer,necrosis?Diabeticfootisthemainreasonofdisabilityandamputation33

06

Complications6.7Diabetic06

Complications6.8

Otherdiseaseseyecomplications：suchasretinalmacular

disease,cataracts,glaucoma

,Iridocyclitisskinlesions:likeSkininfections,skinitch,chapped

skin,rash.Figure4：

skinlesionsFigure3：

eyecomplications34

06

Complications6.8Otherdis2023/1/3Macroangiopathy大血管病變

macro-largemicro-small

angi-arteries動(dòng)脈血管-pathythesuffixof“diseases”Athersclerosis動(dòng)脈粥樣硬化ather/oplaqueoffattysubstance動(dòng)脈粥樣-sclerosishardening硬化WordAnalysis352022/12/26Macroangiopathy大血管病2023/1/3Peripheralangiopathy周?chē)懿?/p>

Peri-surrounding周angi-meansvessel-pathymeansdiseaseNeurological神經(jīng)病學(xué)的

Neur-meansnerve

-ologicaldiscipline學(xué)科的Dementia癡呆

De—脫，去，減，除，離

-mentiaspiritWordAnalysis362022/12/26Peripheralangiopath07

diagnosisFastingbloodglucosegreaterthanorequalto7mmol/L.Twohourspostprandialbloodglucosegreaterthanorequalto11.1mmol/L3)Thesymptomsofdiabetesandanytimeplasmaticglucosegreaterthanorequalto11.1mmol/L37

07

diagnosisFastingbloodglu07

diagnosis7.1Type1diabetesmellitus1.Theageofonsetisyoung,theage<30yearsold.2.Thesymptomscomeonabruptly3.ThesymptomsofPolydipsia,PolyphagiaandPolyuriaareobvious.4.Thebloodglucoselevelishigh,andmanypatientswithketosisacidtoxicasthefirstsymptom.Lowserum

levelofinsulinandThelowlevelofCpeptide38

07

diagnosis7.1Type1diabet07

diagnosis7.2

Type2diabetesmellitusThecommonintheelderly,highincidenceofobesity,oftenaccompaniedbyhypertension,dyslipidemia

,atherosclerosisandotherdiseases.Insidiousonset,hasnoearlysymptoms,oronlymildfatigue,thirst,hyperglycemiaisnotobvious.GlucosetolerancetesttoconfirmthediagnosisSeruminsulinlevelinearlynormalorincreased,Theadvancedislow39

07

diagnosis7.2Type2diabet2023/1/3Plasmatic血漿的plasm-血漿-atic性質(zhì)的Dyslipidemia血脂異常dys-不良的，困難lip-脂肪的-emia血癥Gluc(o)葡萄糖

glucagon胰高血糖素glucokinase葡萄糖激酶glucocorticoids糖皮質(zhì)激素enteroglucagon腸高血糖素WordAnalysis402022/12/26Plasmatic血漿的Word08

Antidiastole8.1

Liverdiseases:Livercirrhosis

patientsoftenhaveabnormalglucosemetabolism,thefastingbloodglucoseofthetypicalpatientisnormalorlow,postprandialbloodglucoseriserapidly.Thedurationoftheelderly,thefastingplasmaglucosecanalsobeelevated.41

08

Antidiastole8.1Liverdise2023/1/3DiabetshealtheducationMedicalnutritiontherapyConditionmonitoringDrugstherapy09Therapy422022/12/2609Therapy4209Therapy9.1MedicalnutritiontherapyCalculatethetotalquantityofheat;Nutrientcontent;Reasonabledistribution;Follow-up43

09Therapy9.1Medicalnutriti09Therapy9.2conditionmonitoringRegularchecksbloodsugartoadjustthetreatmentplanProperexerciseregularlyEveryyearortwocomprehensivereview,complications,earlydetectionandtreatment44

09Therapy9.2conditionmonito09Therapy9.3

DiabetshealtheducationMedicaistaffadheretofollowup,accordingtotheneedtoadjustthetreatmentplan;Lifeshouldberegular,quitsmokinganddring;Topreventinfection.45

09Therapy9.3Diabetshealth09Therapy9.4Drugstherapy:Alphaglucosidaseinhibitor（AGI）AGIdefersabsorptionofcarbohydrationbymeansofinhibitingα-glucosidase’sactivity,therebydebasingpostprandialhyperglycemia .Indication:AGIisusefulinpatientshavingcarbohydrationdietdailyandthosewhosebloodsugararenormalorslightlyhigheronemptystomachbutrisingsignificantlyaftermeal.Contraindication

:pregnantandlactantwomen,childrenandpatientswithgastrointestinaldysfunction.Representativedrugs:acarbose,voglibose,miglitol

46

09Therapy9.4Drugstherapy:A09Therapy9.4

Drugstherapy：Insulintherapy

Insulinisanimportantandeffectivemedicineofcontrolling

hyperglycemia.Insulinpromotestheoxidation

,compositionandstorageofglucosetoreducethebloodsugar,andhelpsfatandproteinsynthetising

andinhibitstheirdecomposingaswell.Indication:(1)

T1DM;

(2)Applytotheacuteandchroniccomplicationofdiabetes(3)

surgery,pregnantandaccouchment;

(4)somespecialtypeofdiabetesetc.

47

09Therapy9.4Drugstherapy：In2023/1/3Gluco-glucosidase葡萄糖苷酶Post-postprandial 餐后的Carbo-carbohydration碳水化合物Contra-contraindication禁忌癥indication適應(yīng)癥Gastro-gastrointestinal胃腸道的Dys-dysfunction功能紊亂De-decompose分解WordAnalysis482022/12/26Gluco-glucosidase2023/1/3492022/12/2612023/1/3

Terminology

50502022/12/26Terminology2023/1/3

Terminology

51512022/12/26Terminology2023/1/3

Terminology

52522022/12/26Terminology01BriefIntroduction02Classification03

Themajorfactors04

Pathogenesis

05

ClinicalManifestations06Complications07

Diagnosis08

Antidiastole09TherapycontentsFigure1：Mainsymptomofdiabetes53

01BriefIntroductioncontents54Diabetesmellitus,orsimply

diabetes,isagroupofmetabolicdiseasesinwhichapersonhashigh

bloodsugar,eitherbecausethepancreas

doesnotproduceenough

insulin,orbecausecellsdonotrespondtotheinsulinthatisproduced.

Thishighbloodsugarproducestheclassicalsymptomsof

polyuria

(frequenturination),

polydipsia

(increasedthirst),and

polyphagia

(increasedhunger).

01BriefIntroduction

6Diabetesmellitus,orsimply

5502Classification2.1

Type1diabetes

Thepancreas

undergoesanautoimmuneattackbythebodyitself,andisrenderedincapableofmakinginsulin.Abnormalantibodieshavebeenfoundinthemajorityofpatientswithtype1diabetes.Antibodiesareproteinsinthebloodthatarepartofthebody‘simmunesystem,thepatientwithtype1diabetesmustrelyoninsulinmedicationforsurvival.

702Classification2.1

Type102Classification2.2

Type2diabetes

Itpreviouslyreferredtoasnon-insulindependentdiabetesmellitus,oradultonset

diabetesmellitus.patientscanstillproduceinsulin,butdosorelativelyinadequatelyfortheirbody‘sneeds,particularlyinthefaceofinsulinresistanceasdiscussedabove.Inmanycasesthisactuallymeansthepancreasproduceslargerthannormalquantities

ofinsulin.Amajorfeatureoftype2diabetesisalackofsensitivitytoinsulinbythecellsofthebody.56

02Classification2.2

Type2d02Classification2.3

Othertypeofdiabetesgestationaldiabetes,occurswhenpregnantwomenwithoutapreviousdiagnosisofdiabetesdevelopahighbloodglucoselevel.Itmayprecededevelopmentoftype2DM.Otherformsofdiabetesmellitusincludecongenitaldiabetes,whichisdueto

genetic

defectsofinsulinsecretion,

cysticfibrosis-relateddiabetes,steroiddiabetesinducedbyhighdosesof

glucocorticoids,andseveralformsof

monogenicdiabetes.57

02Classification2.3

Othert2023/1/3meta-變化的metabolismn.新陳代謝metaboliten.代謝物metabolizev.使新陳代謝metabolicadj.變化的，新陳代謝的

poly-多的，多個(gè)的，聚合的

polydipsia多飲polyuria多尿polyphagia多食

WordAnalysis582022/12/26meta-變化的WordAnaly2023/1/3uri-尿的，與尿有關(guān)的urinen.尿polyuria多尿uricadj.尿的urinaln.尿壺urinatev.小便urinationn.排尿glucosuria糖尿WordAnalysis592022/12/26uri-尿的，與尿有關(guān)的Word2023/1/3Birthweight:FatIrregularmenses(menstruation)InflammationObesity

andasedentary

lifestyleSmokingMetabolicsyndrome

03

Themajorfactors602022/12/26Birthweight:03

The03

Themajorfactors

3.1

BirthweightThereisarelationshipbetweenbirthweightanddevelopingdiabetes.Thehigherthebirthweightthehighertheriskoftype2diabetes.Attheotherendofthespectrum,averyhighbirthweight(over8.8poundsor4kg)alsoisassociatedwithanincreasedrisk.Additionally,mothersofinfantswhohadahigherbirthweight(over9pounds)areatincreasedriskfordevelopingdiabetes.61

03

Themajorfactors3.1Birth03

Themajorfactors

3.2

FatThedistributionoffatisimportant.Theclassic"pear"shapeperson(smallerwaistthanhips)hasalowerriskofdevelopingdiabetesthanthe"apple"shapeperson(largeraroundthewaist).Theexactreasonforthisdifferenceisunknown,butitisthoughttohavesomethingtodowiththemetabolicactivityofthefattissueindifferentareasofthebody.62

03

Themajorfactors3.2Fat103

Themajorfactors

3.3

Irregularmenses(menstruation)

Thereisanassociationbetweenthelengtheningofthemenstrualcycleandtheriskfordevelopingdiabetes,particularlyinobesewomen.thosewhohadacyclelengthofgreaterthan40daysweretwiceaslikelytodevelopdiabetesthanthosewhocycledevery26to31days.Theassociationisthoughttobelinkedwithpolycystic

ovariansyndrome(PCOS)whichisalsoknowntobeassociatedwithinsulinresistance.Insulinresistancemaybeaprecursorfortype2diabetes.63

03

Themajorfactors3.3Irre03

Themajorfactors

3.4

inflammationInrecentyearswehavebeguntounderstandtheimportanceofinflammationandheartdisease.Wenowknowthatinflammationmayplayanimportantroleinthedevelopmentofdiabetesaswell.AninflammationmarkerknownasC-reactiveproteinhasbeenshowntobeincreasedinwomenatriskfordevelopingthemetabolicsyndrome,andinbothmenandwomenatriskfordevelopingtype2diabetes.64

03

Themajorfactors3.4infl03

Themajorfactors

3.5

ObesityandasedentarylifestyleObesityandasedentarylifestylearethebiggestriskfactorsthatarecontrollable.Thisisinpartduetothefactthatobesityincreasesthebody'sresistancetoinsulin.Studieshaveshownthatreversalofobesitythroughweightreductionimprovesinsulinsensitivityandregulationofbloodsugar.65

03

Themajorfactors3.5Obes03

Themajorfactors

3.6

smoking

Smokingisharmfulinmanywaysincludingincreasingtheriskofcancerandheartdisease.Italsoincreasestheriskofdevelopingtype2diabetes.66

03

Themajorfactors3.6smoki2023/1/3men/o與月經(jīng)有關(guān)的menstruationn.月經(jīng)menstrualadj.月經(jīng)的dysmenorrhean.menstrualpainamenorrhea/Menopausen.nomenstruationmetr/o子宮

metrorrhagian.uterinebleedingmetrostaxisn.SmalluterinebleedingWordAnalysis672022/12/26men/o與月經(jīng)有關(guān)的Word2023/1/3metabolic代謝的metabolicsyndrome代謝綜合征lipidmetabolism脂代謝glucosemetabolism糖代謝metabolicacidosis代謝性酸中毒basalmetabolicrate基礎(chǔ)代謝率precursor:prodromalsymptomsofdiseaseC-reactiveprotein：Itisasharplyrisedprotein，whentissuesinjuryandinfect.WordAnalysis682022/12/26metabolic代謝的Word04

Pathogenesis4.1

ThePathogenesis

ofType1

Isrelatedtogeneticfactors,environmentalfactorsandautoimmunity1）geneticpredisposition2）startautoimmuneresponse3）immumologicalabnormalities4）progressivelossofisletBcellfunction5)clinicaldiabetes6）isletBcellsdestroyed,diabetesclinicalmanifestations69

04

Pathogenesis4.1ThePathog04

Pathogenesis4.2

ThePathogenesisofType2Itsoccurrenceanddevelopmentcanbedividedintofourstages1）Geneticsusceptibility2）

Hyperinsulinism,and/orinsulinresistance3）Glucotoxicity(糖尿病毒性),lipotoxicity(脂毒性)4）Clinicaldiabetes70

04

Pathogenesis4.2ThePathog2023/1/3immune免疫autoimmunity自身免疫immumological免疫學(xué)的hyper-高Hyperinsulinism高胰島素癥Hyperglycemia高血糖toxic毒的，中毒的，有毒的Glucotoxicity

糖尿病毒性lipotoxicity

脂毒性WordAnalysis712022/12/26immune免疫WordAnal05

ClinicalManifestations

5.1Type1DiabetesMellitusPolyuriaPolydipsiaPolyphagiaWeightloss72

05

ClinicalManifestations5.05

ClinicalManifestations

5.2Type2DiabetesMellitusNon-specificsymptomsFatigueRecurrentinfectionsProlongedwoundhealingVisual

changes73

05

ClinicalManifestations5.2023/1/3proteolysis蛋白質(zhì)水解lipolysis脂類(lèi)分解arthrolysis關(guān)節(jié)松解術(shù)-lysis松解術(shù)，分解，溶解prote-蛋白質(zhì)lipo-脂肪的arthro-關(guān)節(jié)WordAnalysis742022/12/26proteolysis蛋白質(zhì)水解06

Complications6.1

DiabeticKetoacidosis(DKA)

Itisthemostcommonacutecomplicationofdiabetesmellitus.TheearlymanifestationsofDKAisthatthesymptomsbeingmoreserve,suchaspolydipsia、polyuria、polyphagiaandsoon.TheDKAischaracterizedbydifferentdegreesofdisturbanceconsciousnessintheadvancedstage.75

06

Complications6.1Diabetic06

Complications6.2

Hyperglycemichyperosmolarstatus(HHS)Mainclinicalfeatures:hyperglycemiacrisis(高血糖危象),higherplasmaosmotic

pressure(高血漿滲透壓),dehydration(脫水).

Minorclinicalmanifestation:varyingdegreesofdisturbanceconsciousnessorcoma,unconspicuousDKA.76

06

Complications6.2Hyperglyc06

Complications6.3

Infectiouscomplications

Pyogenicinflammation:

furuncle,carbuncle,pustule,etc.Fungalinfection:

tineapedis,tineacorporis,etc.

PulmonarytuberculosisFigure2：

Infectiouscomplications

77

06

Complications6.3Infectiou06

Complications6.4

Macroangiopathy:

Themainhistopathological

changeisatherosclerosis

(AS).Itismostliketoaccompanywithaorta,coronaryartery,cerebralartery,renalartery

,peripheralartery,etc.TheASleadstoischemic

changesofheart,brain,kidneysandlimbs.

78

06

Complications6.4Macroangi06

Complications6.5

Microangiopathy

ItisthespecificcomplicationsofDM.It’stypicalhistopathologicalchangesaremicrocirculationdisturbancesandthethicknessofbasalmembrane

ofvessel.Themicroangiopathymostliketoaffectsretina,nerves，nephridium,andmyocardium

79

06

Complications6.5Microangi06

Complications6.6

Neurologicalcomplications:

1)centralnervoussystemcomplication(CNSC):

alteredmentalstatus,ischemicstroke,seniledementia.2)peripheralneuropathy:paresthesia,decreasedofmuscle,areflexia3)autonomicneuropathy:gastroparesis,diarrhea,astriction,abnormalsweating.80

06

Complications6.6Neurologi06

Complications6.7

Diabeticfoot

?Relatedtodistallowerneurologicaldisorderanddifferentlevelsperipheralvasculardisease.?Symptomsoflight:footabnormal,skincold,high-riskfoot?Severesymptoms:footulcer,necrosis?Diabeticfootisthemainreasonofdisabilityandamputation81

06

Complications6.7Diabetic06

Complications6.8

Otherdiseaseseyecomplications：suchasretinalmacular

disease,cataracts,glaucoma

,Iridocyclitisskinlesions:likeSkininfections,skinitch,chapped

skin,rash.Figure4：

skinlesionsFigure3：

eyecomplications82

06

Complications6.8Otherdis2023/1/3Macroangiopathy大血管病變

macro-largemicro-small

angi-arteries動(dòng)脈血管-pathythesuffixof“diseases”Athersclerosis動(dòng)脈粥樣硬化ather/oplaqueoffattysubstance動(dòng)脈粥樣-sclerosishardening硬化WordAnalysis832022/12/26Macroangiopathy大血管病2023/1/3Peripheralangiopathy周?chē)懿?/p>