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Diabetes Mellitus 認識糖尿病

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Diabetes Mellitus 認識糖尿病

2024/4/15

Definition of DM

DM is a group of diseases characterized by hyperglycemia (elevated blood glucose) resulting from defects in insulin secretion, insulin action, or both.

Diagnostic criteria for DM

  1. Symptoms include: Thirst, increased daily urine amount, weight loss, and causal plasma glucose greater than 200 mg/ dL
  2. With empty stomach more than 8 hours, the plasma glucose level exceeds 126 mg/dL
  3. 2 hours after taking the 75-g oral glucose test, the plasma glucose level exceeds 200 mg/ dL.

Note: when any aforementioned symptom is fulfilled, it is deemed diabetes mellitus.

  1. Glycated A1c (HbA1c) ≥ 6.5%.

In the absence of unequivocal hyperglycemia, diagnosis requires two abnormal test results obtained at the same time or at two different time points.

DM Classification

  1. Type 1 DM : pancreatic β cell destruction and insulin deficiency.
  2. Type 2 DM : insulin resistance.
  3. Other specific types: resulting from pancreatitis, endocrine disorders, or drug
  4. Gestational DM : hyperglycemia with first recognition during pregnancy.

Acute complications of DM

  1. Hypoglycemia: Low level glucose is induced by medication overdose, insufficient food intake, or excessive work-out.
  2. Ketpacidosis: excessive ketone accumulation in the body results distinct gastrointestinal symptoms and acute short breath.
  3. Hyperglycemic hyperosmolar syndrome: extremely high hyperglycemia with combination of dehydration and consciousness disturbance.

Chronic complications of DM

  1. Retinopathy : vision blurring or loss of vision.
  2. Neuropathy : numbed and painful limbs, postural dizziness, constipation or diarrhea, and impotence.
  3. Nephropathy : protein in urine, edema, hypertension, and renal failure.
  4. Cardiovascular disease : atherosclerosis incurs stoke, myocardial infarction, lower limb circulation disturbance.
  5. Foot ailment : ulceration, necrosis, gangrene, infection, and amputation.

DM Treatment

  1. Diet : adequate calories and balanced nutrients.
  2. Exercise : 30-minute to an hour daily exercise with moderate intensity.
  3. Drugs : oral medication or insulin injection.
  4. Comprehensive health education.
  5. Regular and normal life style.

Goals for DM control

  1. Plasma glucose before mea l : 70 - 130 mg/dL.
  2. Plasma glucose after meal : less than 180 mg/dL.
  3. HbA1c : lower than 7.0 %.
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