DM Tipe 2

EVA DECROLI

klasifikasi
1. DM Tipe 1 : Auto Imun
1. DM Tipe 1 : Auto Imun
2. DM Tipe 2 : RI (resistensi
2. DM Tipe 2 : RI (resistensi
Insulin) dan Betasel Disfunction,
Insulin) dan Betasel Disfunction,
Faktor Lingkungan
Faktor Lingkungan
3. DM Tipe Lain :Virus,Gizi,Kalsifikasi
3. DM Tipe Lain :Virus,Gizi,Kalsifikasi
4. DM Gestasional: Kehamil an
4. DM Gestasional: Kehamil an

Problems
Increased of prevalence
Cronic complications

ex. Diabetic Foot Problems

Prevention, primer, secunder tertier

Etiology of Insulin Resistence

Weight gain
Obexisity

Circulation FFA

Lipoatrophy
adipokines

Insulin Resistance
The subnormal biologic response to
a given concentration of insulin

Physical
inactivity

Aging

Genetica

Etiology of -Cell Dysfunction

Genetics

Lipotoxicity

Glucose
toxicity

-Cell Failure

Inadequate compentation for insulin

resistance and selective
non-responsivoness to glucose

Loss of

-cell ?

Cytokines ?

Amyloid
accumulation

The Role of Genes and the Environment

Normal

GENES

Insulin
resistance

Diabetes genes
insulin resistance genes Decreased Insulin
secretion
-cel function genes
Obesity genes

Type DM

Environment

Diet Activity
Toxins

Risk Factors for Type 2 Diabetes

Gastational
Diabetes polycystic
Ovarian syndrome,
and party

Genetic factors
-Ethnicity
-Family history

Type 2
Diabetes

Increasing
age

Central
obesity

Diet

Physical
inactivity

Pathophysiology of DM

Peripheral Glucose
Uptake

Hepatic glucose
Production (HGP

Blood Glucose

Gambaran Klinis

o Poliuria
o Polidipsi

KLASIK

o Poliphagia
o Penurunan Berat Badan
o Gejala Tidak Klinis
o Gatal-Gatal
o Kesemutan

Kriteria diagnosis
1. Gejala Klasik+ GDp > 126 mg/dl
2. Gejala Klasik + GD Random > 200 mg/dl
3. Gejala Klasik + GD 2Jam PP > 200 mg/dl
4. Tanpa Gejala Klasik + 2 Pemeriksaan GDp 126 mg/dl
5. Tanpa Gejala Klasik + 2 Pemeriksaan GDr 200 mg/dl
6. Tanpa Gejala Klasik + 2 Pemeriksaan GD2jam PP 200 mg/dl
7. GD2j TTGO > 200mg%
8. HbA1c > 6.5%

komplikasi
KAD
AKUT
KOMA Hipoglikemi

Mikro Vaskular
KRONIS
Macro Vaskular

Macrovascular Complication of
Type 2 Diabetes (Contoh)
80% of people with type 2 diabetes thr from CVD

~ Coronary heart disease (CHD)

- eg, angina, heart attack, heart failure
- 2-to 4-fold increased risk
~ Cerebrovascular disease
- eg, stroke, transient ischemic attacks
- 2-to 4-foid increased risk
~ Peripheral vascular disease
- eg. Intermittent claudication, gangrene, amputations

TERIMA KASIH