DIABETES MELITUS

Dr. Ferdinandus S Kakiay, SpPD-FINASIM

IDF Diabetes Atlas | 9th edition
Top 10 countries or territories for number of adults (20–79 years) with
diabetes in 2019, 2030 and 2045

IDF Diabetes Atlas | 9th edition

 Type 2 diabetes significantly increases risk of
complications

1. International Diabetes Federation. Time to Act. 2001. http://www.idf.org/webdata/docs/Diabetes%20and%20CVD.pdf. Accessed February 28, 2012.
2. Seaquist ER. Diabetes. 2010;59:4-5.
 DEFINISI
• Diabetes melitus (DM) merupakan suatu kelompok
penyakit metabolik dengan karakteristik hiperglikemia
yang terjadi karena kelainan sekresi insulin, kerja
insulin atau keduanya.
 Classification of diabetes
• Type1diabetes (duetoautoimmuneb-celldestruction,usually leading to
absolute insulin deficiency)
• Type 2 diabetes (due to a progressive loss of adequate b-cell insulin
secretion frequently on the background of insulin resistance)
• Gestational diabetes mellitus (diabetes diagnosed in the second or third
trimester of pregnancy that was not clearly overt diabetes prior to
gestation)
• Specifictypesofdiabetesduetoothercauses,e.g.,monogenicdiabetessyndro
mes (such as neonatal diabetes and maturity-onset diabetes of the
young), diseases of the exocrine pancreas (such as cystic fibrosis and
pancreatitis), and drug- or chemical-induced diabetes (such as with
glucocorticoid use, in the treatment of HIV/AIDS, or after organ
transplantation)
Clinical features distinguishing type 1 diabetes, type 2 diabetes
and monogenic diabetes
PATOGENESA diabetes tipe 2
 Beta Cell Function Deterioration
vs Insulin Resistance
100 Insulin resistance

(% of normal by HOMA) 75
DIAGNOSIS

undiagnosed
Beta-cell function

50
Pancreatic function
= 50% of normal

25 IGT Postprandial
Hyperglycemia

0
–10 -2 0 2 6 10 14
HOMA, homeostasis model assessment Years from Diagnosis
Adapted from Holman1
1. Holman RR. Diabetes Res Clin Pract 1998;40(Suppl 1):S21–5
2. UKPDS Group. Diabetologia 1991; 34:877–90
Lebovitz H. Diabetes Review 1999;7:139-53 (modified)
Potential members of the multidisciplinary diabetes care team

Diabetes Australia/RACGP Diabetes Management in General Practice.2016/2018

Pengelolaan pasien diabetes
Criteria defining prediabetes
Criteria for testing for diabetes or prediabetes in
asymptomatic adults
Penatalaksanaan DM dimulai dengan menerapkan pola hidup sehat
(terapi nutrisi medis dan aktivitas fisik) bersamaan dengan
intervensi farmakologis dengan obat anti hiperglikemia secara oral
dan/atau suntikan. Obat anti hiperglikemia oral dapat diberikan
sebagai terapi tunggal atau kombinasi. Pada keadaan emergensi
dengan dekompensasi metabolik berat, misalnya ketoasidosis, stres
berat, berat badan yang menurun dengan cepat, atau adanya
ketonuria, harus segera dirujuk ke pelayanan kesehatan sekunder
atau tersier.