DM Tipe 2

EVA DECROLI
klasifikasi

1. DM Tipe 1 : Auto Imun

2. DM Tipe 2 : RI (resistensi
Insulin) dan Betasel Disfunction,
Faktor Lingkungan
3. DM Tipe Lain :Virus,Gizi,Kalsifikasi
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 Circulation FFA Lipoatrophy

Obexisity adipokines

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

Physical
inactivity Genetica
Aging
 Etiology of -Cell Dysfunction

Genetics Lipotoxicity Glucose

toxicity

-Cell Failure
Inadequate compentation for insulin
resistance and selective
non-responsivoness to glucose

Loss of Amyloid
-cell ? Cytokines ? accumulation
 The Role of Genes and the Environment

Normal

GENES Insulin Environment

resistance

Diabetes genes
insulin resistance genes Decreased Insulin Diet Activity
-cel function genes secretion Toxins
Obesity genes

Type DM
Risk Factors for Type 2 Diabetes
Gastational
Genetic factors Diabetes polycystic
-Ethnicity Ovarian syndrome,
-Family history and party

Type 2
Diabetes Diet

Increasing Physical
age inactivity
Central
obesity
Hepatic glucose Peripheral Glucose
Production (HGP Uptake

Blood Glucose
o Poliuria
o Polidipsi KLASIK

o Poliphagia
o Penurunan Berat Badan
o Gejala Tidak Klinis
o Gatal-Gatal
oKesemutan
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%
 KAD

AKUT

KOMA Hipoglikemi

Mikro Vaskular

KRONIS

Macro Vaskular
 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