Pendukung Jurnal
Diabetes MellitusDiabetes Mellitus (DM) salah satu sindrom
metabolik atau penyakit gangguan metabolisme kronik yang ditandai
oleh hiperglikemia.
KlasifikasiDM Tipe 1Kerusakan sel betaAdanya defisiensi produksi
insulin, baik karena proses autoimun maupun idiopatikDM Tipe
2Resistensi insulinDefisiensi relatif insulin
1PathophysiologyInsulin resistance means that body cells do not
respond appropriately when insulin is presentOther important
contributing factors:increased hepatic glucose production (e.g.,
from glycogen degradation), especially at inappropriate times
decreased insulin-mediated glucose transport in (primarily) muscles
& adipose tissues (receptor and post-receptor defects) impaired
beta-cell functionloss of early phase of insulin release in
response to hyperglycemic stimuli2
3Underlying causes of type 2
diabetesObesityInsulinresistance-celldefectImpairedglucose
toleranceEarlydiabetesLatediabetesHyperinsulinaemiaDecreased
insulinsecretion-cell failureAdapted from Saltiel AR. J Clin Invest
2000;106:163164.4
5
6NormalThe progressive nature of type 2 diabetesImpaired glucose
toleranceType 2 diabetesFasting plasma glucoseInsulin
sensitivityInsulin secretionInsulin sensitiveNormal insulin
secretionNormoglycaemiaHyperglycaemia-cell exhaustionInsulin
resistance
Late type 2 diabetes complicationsAdapted from Bailey CJ et al.
Int J Clin Pract 2004;58:867876. Groop LC. Diabetes Obes Metab
1999;1 (Suppl. 1):S1S7. Insulin resistance7
ScreeningWidespread use of the fasting plasma glucose (FPG) as a
screening test for T2DM is recommended because:A large number of
individuals who meet the current criteria for DM are asymptomatic
& unawareEpidemiologic studies suggest that T2DM may be present
for up to a decade before diagnosisAs many as 50% of individuals
with T2DM have one or more diabetes-specific complications at the
time of their diagnosisTreatment may favorably alter the natural
history of DM
ADA recommends screening all individuals >45 years every 3
years & screening individuals at an earlier age if they are
overweight (BMI > 25km/m2) & have one additional risk factor
for diabetes10
11DiagnosisKeluhan Khas Klinis DM (+)Keluhan Khas Klinis DM
(-)126200