DM Dewasa

EVA DECROLI

Problems
Increased

of prevalence
Cronic complications
ex. Diabetic Foot Problems
Prevention, primer, secunder
tertier

Etiology of Insulin Resistence

Weight gain
Obexisity

Circulation FFA

Lipoatrophy
adipokines

Insulin Resistance

The subnormal biologic response to

a given concentration of insulin

Physical
inactivity

Aging

Genetica

Genetics

Lipotoxicity

Glucose
toxicity

-Cell Failure

Inadequate compentation for insulin

resistance and selective
non-responsivoness to glucose

Loss of

-cell ?

Cytokines ?

Amyloid
accumulation

Etiology of -Cell Dysfunction

The Role of Genes and the Environment

Normal

GENES

Insulin
resistance

Diabetes genes
insulin resistance genes Decreased Insulin
secretion
-cel function genes
Obesity genes

Type DM

Environment

Diet Activity
Toxins

Risk Factors for Type 2 Diabetes

Gastational
Diabetes polycystic
Ovarian syndrome,
and party

Genetic factors
-Ethnicity
-Family history

Type 2
Diabetes

Increasing
age

Central
obesity

Diet

Physical
inactivity

Pathophysiology of DM

Peripheral Glucose
Uptake

Hepatic glucose
Production (HGP

Blood Glucose

 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

Macrovascular Complication of
Type 2 Diabetes