1、Diabetes Mellitus,Dr.Rasha SalamaPhD Public Health,Suez Canal University,Egypt Diabetes MSc,Cardiff University,United Kingdom,第一页，共四十六页。,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.The t
2、erm diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate,fat and protein metabolism resulting from defects in insulin secretion,insulin action,or both.The effects of diabetes mellitus include longterm damage,
3、dysfunction and failure of various organs.,What is diabetes?,第二页，共四十六页。,Diabetes mellitus may present with characteristic symptoms such as thirst,polyuria,blurring of vision,and weight loss.In its most severe forms,ketoacidosis or a nonketotic hyperosmolar state may develop and lead to stupor,coma a
4、nd,in absence of effective treatment,death.Often symptoms are not severe,or may be absent,and consequently hyperglycaemia sufficient to cause pathological and functional changes may be present for a long time before the diagnosis is made.,Diabetes,第三页，共四十六页。,The longterm effects of diabetes mellitus
5、 include progressive development of the specific complications of retinopathy with potential blindness,nephropathy that may lead to renal failure,and/or neuropathy with risk of foot ulcers,amputation,Charcot joints,and features of autonomic dysfunction,including sexual dysfunction.People with diabet
6、es are at increased risk of cardiovascular,peripheral vascular and cerebrovascular disease.,Diabetes Long-term Effects,第四页，共四十六页。,The development of diabetes is projected to reach pandemic proportions over the next10-20 years.International Diabetes Federation(IDF)data indicate that by the year 2025,
7、the number of people affected will reach 333 million 90%of these people will have Type 2 diabetes.In most Western societies,the overall prevalence has reached 4-6%,and is as high as 10-12%among 60-70-year-old people.The annual health costs caused by diabetes and its complications account for around
8、6-12%of all health-care expenditure.,Burden of Diabetes,第五页，共四十六页。,Type 1 Diabetes Mellitus Type 2 Diabetes MellitusGestational DiabetesOther types:LADA(MODY(maturity-onset diabetes of youth)Secondary Diabetes Mellitus,Types of Diabetes,第六页，共四十六页。,Was previously called insulin-dependent diabetes mel
9、litus(IDDM)or juvenile-onset diabetes.Type 1 diabetes develops when the bodys immune system destroys pancreatic beta cells,the only cells in the body that make the hormone insulin that regulates blood glucose.This form of diabetes usually strikes children and young adults,although disease onset can
10、occur at any age.Type 1 diabetes may account for 5%to 10%of all diagnosed cases of diabetes.Risk factors for type 1 diabetes may include autoimmune,genetic,and environmental factors.,Type 1 diabetes,第七页，共四十六页。,Was previously called non-insulin-dependent diabetes mellitus(NIDDM)or adult-onset diabete
11、s.Type 2 diabetes may account for about 90%to 95%of all diagnosed cases of diabetes.It usually begins as insulin resistance,a disorder in which the cells do not use insulin properly.As the need for insulin rises,the pancreas gradually loses its ability to produce insulin.Type 2 diabetes is associate
12、d with older age,obesity,family history of diabetes,history of gestational diabetes,impaired glucose metabolism,physical inactivity,and race/ethnicity.African Americans,Hispanic/Latino Americans,American Indians,and some Asian Americans and Native Hawaiians or Other Pacific Islanders are at particul
13、arly high risk for type 2 diabetes.Type 2 diabetes is increasingly being diagnosed in children and adolescents.,Type 2 diabetes,第八页，共四十六页。,第九页，共四十六页。,第十页，共四十六页。,A form of glucose intolerance that is diagnosed in some women during pregnancy.Gestational diabetes occurs more frequently among African Am
14、ericans,Hispanic/Latino Americans,and American Indians.It is also more common among obese women and women with a family history of diabetes.During pregnancy,gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant.After pregnancy,5%to 10
15、%of women with gestational diabetes are found to have type 2 diabetes.Women who have had gestational diabetes have a 20%to 50%chance of developing diabetes in the next 5-10 years.,Gestational diabetes,第十一页，共四十六页。,Other specific types of diabetes result from specific genetic conditions(such as maturi
16、ty-onset diabetes of youth),surgery,drugs,malnutrition,infections,and other illnesses.Such types of diabetes may account for 1%to 5%of all diagnosed cases of diabetes.,Other types of DM,第十二页，共四十六页。,Latent Autoimmune Diabetes in Adults(LADA)is a form of autoimmune(type1 diabetes)which is diagnosed in individuals who are older than the usual age of onset of type 1 diabetes.Alternate terms that have been used for LADA include Late-onset Autoimmune Diabetes of Adulthood,Slow Onset Type 1 diabetes,an