Diabetes mellitus, DM (Greece: & amp; # 948; & amp; amp; # 953; & amp; amp; # 945; & amp; amp; # 946; & amp; amp; # 945; & amp; amp; # 943; & amp; amp; # 957; & amp; amp; # 949; & amp; amp; # 953; & amp; amp; # 957;, diaba nein, translucent or shower) (Latin: mellitus, sweetness), also known in Indonesia as the disease of the urinary sugar is a disorder caused by metabolis many factors, with the symptom of chronic hiperglisemia and disorders of the metabolism of carbohydrates, fats and proteins, as a result of:
- deficiency of the hormone insulin secretion, insulin activity, or both.[2]
- the glucose transporter deficiency.
Various disease, syndrome and symptom can be triggered by diabetes mellitus, among others: ataxia-telangiectasia, Alzheimer 's, Down syndrome, Huntington's disease, mitochondrial disorders, muscular dystrophy, Parkinson's disease, miotonis syndrome, Prader-Willi syndrome, Werner's syndrome, Wolfram [3] leukoaraiosis, dementia, [4] hypothyroidism, hyperthyroidism, hipogonadisme, [5] and others.
Classification
The World Health Organization (WHO) classifies forms of diabetes mellitus and treatments based on symptom: [2]
Type 1 Diabetes, which include symptom in diabetic to destruction of pancreatic beta cells inside caused or causes autoimmunity, and idiopathic. Diabetes mellitus with pathogenesis is clear, such as cystic fibrosis or mitochondrial deficiency, not included in this classification.
Type 2 Diabetes, which is caused by a deficiency of insulin secretion, often accompanied by insulin resistance syndrome.
Type 3 Gestasional, which include Diabetes, gestational impaired glucose tolerance, diabetes mellitus and gestational GIGT, GDM.
and according to clinical stage of pathogenesis, without any consideration being made:
1 Insulin-requiring diabetes for survival, as in the case of C-peptide deficiency.
2 Requiring Insulin for control of diabetes. At this stage, the insulin secretion is insufficient to reach the endogenus symptom normoglicemia, if not accompanied by additional hormones from outside the body.
3 Not insulin-requiring diabetes.
Fourth grade at the clinical stage classification similar to IDDM (United Kingdom: insulin-dependent diabetes mellitus), were fifth and sixth stages are members of NIDDM classification (United Kingdom: non insulin-dependent diabetes mellitus). IDDM and NIDDM is a classification that is listed in the International Nomenclature of Diseases in 1991 and the tenth revision of the International Classification of Diseases in 1992.
Malnutrion classification-related diabetes mellitus, MRDM, is no longer used because, although the malnutrition can affect the expression of several types of diabetes, until now, has not found evidence that malnutrition or protein deficiency can cause diabetes. MRDM Subtypes; Protein-deficient pancreatic diabetes mellitus, PDPDM, PDPD, PDDM, still considered a form of malnutrition induced by diabetes mellitus and requires further research. While the other subtypes, pancreatic diabetes, Fibrocalculous, classified as a disease of the FCPD pancreatic exocrine fibrocalculous path pancreatopathy that induces diabetes mellitus.
Classification of Impaired Glucose Tolerance, IGT, is now defined as the stage of the defective regulation of glucose, as can be observed in all types of hiperglisemis disorders. But are no longer considered diabetes.
Classification of Impaired Fasting Glycaemia, IFG, introduced as a medical condition where the ratio of fasting blood sugar is higher than the upper limit range is normally, but still below the ratio defined as the basis for a diagnosis of diabetes.
Type 1 Diabetes Mellitus
Type 1 Diabetes mellitus, diabetic children (United Kingdom: childhood-onset diabetes, juvenile diabetes, insulin-dependent diabetes mellitus, IDDM) is a diabetes that occurs due to a decreased ratio of insulin in the blood circulation due to the loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas. IDDM can be suffered by children as well as adults.
Up to this point can not be prevented and IDDM cannot be cured, even with diet and exercise. Most people with type 1 diabetes have weight and health good when the disease started he suffered. In addition, the sensitivity and the body's response to insulin generally normal on this type of diabetics, especially at an early stage.
The cause of most of the beta cell loss in diabetes type 1 is a mistake that destroyed the cell reaction Autoimmunity beta pancreas. The reaction can be triggered by Autoimmunity is the presence of infection in the body.
Currently, the only type 1 diabetes can be treated with the use of insulin, with careful monitoring of blood glucose levels through blood testing monitors. The basic treatment of type 1 diabetes, even for the earliest stage though, is the replacement of insulin. Without insulin to ketosis and ketoacidosis, diabetic coma can cause even could lead to death. Emphasis is also given on lifestyle adjustments (diet and exercise). Apart from administering injections in General, it is also possible the granting of insulin through a pump, which allows for the grant of the inputs of insulin 24 hours a day at the rate prescribed dose, dosing is also possible (a bolus) of insulin which is required at the time of eating. As well as possible also for administering insulin through the entries ' and inhaled powder '.
Type 1 diabetes treatment should be continued. The treatment will not affect normal activities if sufficient awareness, proper care, and discipline in the examination and treatment is executed. The average Glucose level for patients with type 1 diabetes should be as close as possible to a normal number (80-120 mg/dl, 4–6 mmol/l).[citation needed?] Some doctors recommend up to 140-150 mg/dl (7-7.5 mmol/l) for those who are troubled with lower numbers, such as ' frequent hypoglycemic events '.[citation needed?] Numbers above 200 mg/dl (11 mmol/l) is often accompanied by a sense of discomfort and pee too often causing dehydration.[citation needed] Numbers above 300 mg/dl (16 mmol/l) usually require treatment as soon as possible and can lead to Ketoacidosis.[citation needed?] Low blood glucose levels, called hipoglisemia, can cause loss of consciousness.
Type 2 Diabetes Mellitus
Diabetes mellitus type 2 (adult-onset of United Kingdom: diabetes, obesity-related diabetes, non-insulin-dependent diabetes mellitus, NIDDM) is a type of diabetes mellitus that occurs is not caused by a ratio of insulin in the blood circulation, but rather is a metabolic disorder caused by mutations in many genes, [6] including those expressing cell dysfunction & amp; # 946 hormone secretion disorders;, insulin, resistance of the cells to insulin [9] caused by dysfunction GLUT10 [8] with the hormone resistin cofactors that causes cell network, especially in the liver become less sensitive to insulin [9] as well as RBP4 that suppress absorption of glucose by muscle striated but increases the secretion of blood sugar by heart.[9] Gene Mutations that often occurs on chromosome 7 which is the most populous chromosomes that are found in humans.[10]
On the expression of SGLT1 NIDDM found on high, [11] and the hormone resistin RBP4 ratio is high, [9] increased metabolic rate glikogenolisis and gluconeogenesis in the liver, [9] decrease in the rate of oxidation and increased the rate of esterification in the heart.[12]
NIDDM can also be induced by Dyslipidemia [13], lipodystrophy, [9] and the insulin resistance syndrome.
In the early stages of the disorder that arises is the reduced sensitivity to insulin, which is characterized by increased levels of insulin in the blood.[citation needed] Hiperglisemia can be coped with diabetes drugs that can increase sensitivity to insulin or reduce the production of glucose from hepar, but getting worse disease, insulin secretion is also reduced, and therapy with insulin is sometimes required.[citation needed?] There are several theories that mention the exact cause and mechanism of the onset of resistance, but the Central obesity predisposition factor known as the occurrence of resistance to insulin, in regard to the expenditure of adipokines (its a hormone) that impair glucose tolerance.[citation needed?] Obesity is found in approximately 90% of patients developed world with diagnosis of diabetes type 2.[citation needed?] Other factors include the brood and family history, although in the last decade has been steadily began to affect teenagers and children.[citation needed?].
Type 2 Diabetes can occur without any symptoms before the results of the diagnosis. Type 2 Diabetes is usually treated with initially, how changes in physical activity (sports), diet (general reduction of the intake of carbohydrates), and through weight reduction. It can restore hormone insulin sensitivity back, even when the load is weight loss/humble, for example, around 5 kg (10 to 15 lb), most especially when it is in the abdominal fat deposit. The next step, if necessary, treatment with oral antidiabetic drugs [[. [As/when/Because] production of the hormone insulin treatment is hindered, initially an oral (often used in combination) can be used to increase the production of the hormone insulin (e.g., sulfonylureas) and set the release/release is not appropriate of glucose by the liver (and insulin hormones retaliation thinning to a certain extent (e.g., metformin), and in fact thinned insulin hormones retaliation (e.g., thiazolidinediones). If this fails, the insulin hormone medicine will be needed to maintain normal or near normal glucose levels. A way of life that orderly about blood glucose checks are recommended in most cases, most notably and need when taking most medications.
A bearer of dipeptidyl peptidase 4 substances called sitagliptin, recently allowed for use as a treatment for diabetes mellitus type 2.[14] such as dipeptidyl peptidase 4 substances brominated, sitagliptin will open up opportunities for the development of tumor cells as well as cancer.[15][16]
A phenotype is typically indicated by a human is a deficiency of NIDDM in oxidative metabolism in the mitochondria [19] on the striated muscles.[18][19] in contrast, tri-iodotironina hormone induces mitochondrial biogenesis, and increasing the synthesis of ATP synthase in complex V, improve the activity of cytochrome c oxidase at complex IV, lower reactive oxygen, reduces oxidative stress, [21] is the hormone melatonin will increase the production of ATP inside mitochondria and increases the activity of the respiratory chain, especially in complex I, III and IV.[9] along with insulin, the hormone is formed the third cycle regulating mitochondrial oxidative phosphorylation in skeletal muscle.[22] on the other hand, metalotionein that inhibits the activity of GSK-3beta will reduce the risk of heart muscle deficiency in diabetics.[23][24][25]
The symptom occurs in NIDDM can be reduced with dramatic, followed by a reduction in body weight, after intestinal bypass surgery. This is known as a result of an increase in the secretion of the hormone inkretin, but experts have not been able to determine whether this method can provide healing for NIDDM with changes in glucose homeostasis.[26]
In the traditional therapy, flavonoid compounds containing naringin, hesperidin and is known to cause: [27]
- increase in mRNA expression of GLUT4 glukokinase,
- an increase of the liver tissue and absorbent peroxisome proliferator gamma enhancement
- increased the ratio of plasma hormones insulin and leptin, a protein C [28]
- decrease in the expression of GLUT2 in liver
- decrease in the ratio of plasma fatty acid and triglyceride levels in the liver and plasma ratio
- decrease cholesterol levels in the liver, among others by pressing the 3-hydroxy-3-methylglutaryl-coenzyme reductase, and acyl-Coa acyltransferase, cholesterol reduction
- in fatty acid oxidation in the liver and the activity of carnitine palmitoil, among other things by reducing the synthesis of glucose-6-Phosphatase dehydrogenase and phosphatidic fosfohidrolase Glycolysis rate
- increase and/or decrease the rate of gluconeogenesis pathway
Naringin are themselves, lowering of mRNA transcription fosfoenolpiruvat karboksikinase and glucose-6-Phosphatase in the liver. Hesperidin is an organic compound found in many types of fruit are oranges, many found in the fruit of naringin types of wine.
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