Glukosa (mg/dl)
Genetic
Environment
Hyperglycaemia
Obesity
TNF- Adiponectin
INSULIN RESISTANCE
Pancreas Liver
Muscle
M E T A B O L I C
S Y N D R O M E
Hyperinsulinaemia
FFA TG HDL
Hypertension - cell compensation
FPG
IFG
ED CVD
Hyperinsulinemia
Decompensation I
Hyperinsulinemia
SRI HARTINI KS KARIADI,2007
Decompensation II
Modified from WHO consultation Report: Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications (1999)
GEJALA DIABETES
KLASIK Poliuria Polidipsi Polifagi BB Tenaga
KUALITAS HIDUP
GEJALA KOMPLIKASI
Faktor genetik
Komplikasi akut
Diabetes yang tidak dikelola baik mudah terkena infeksi Infeksi menjadi berat dan sukar sembuh apabila tidak diatasi Turunnya kesadaran Koma
KOMPLIKASI MENAHUN
Penebalan dinding pembuluh darah Penyempitan pembuluh darah
Retina Kebutaan
Ginjal
Cuci darah
Otak Stroke
Tungkai Borok
4
0
<71 7175.9 7681 81.186 86.191 91.196.3 >96.3
HBA1c
* Average Blood Glucose Concentration = 33,3 X HBA1c (%) 86 mg/dl Nathan & Singer Equation.-
Mechanism of Oxidative Stress in Diabetes Mellitus.1. Autoxidative Glycosylation Superoxide, H2O2 2. Lipid Peroxidation F2-isoprostane, GPx, SOD 3. Reduced Anti-oxidant Defence TAOS (TRAP)
Blood Glucose
(Home (self) -Monitoring) Blood Glucose Fasting + 2 hr pp HBA1c or Fructosamine Lipid Profile Ureum, Kreatinin Microalbuminuria Fibrinogen PAI-1 TAOS or OX-LDL