Professional Documents
Culture Documents
Oleh :
Prilian Akbaril
Farah Nishfi Ramadhani
Adinda Amaliadani
Melyana Habibie
SUPERVISOR:
dr. Laksmi Sasiarini Sp.PD
Outline
Definisi
Epidemiolo
gi
Klasifikasi
Kriteria
Diagnosis
Manifestasi
Klinis
Patofisiologi
Tata
Laksana
Prognosis
Definisi
Diabetes mellitus merupakan suatu kelompok
penyakit metabolik dengan karakteristik
hiperglikemia yang terjadi karena kelainan sekresi
insulin, kerja insulin, atau kedua-duanya
(Purnamasari D, 2009).
Diabetes mellitus merupakan suatu kelainan yang
bersifat kronis yang ditandai dengan terganggunya
metabolisme glukosa dan sumber energi lainnya
yang akan berakibat pada komplikasi vaskuler dan
neuropati (Inzucchi E.s and sherwin r.s, 2007).
Epidemiologi
21 juta penduduk amerika (7% dari seluruh penduduk
Amerika) terdiagnosis diabetes mellitus, 21% dari penduduk
tersebut adalah yang berusia lebih dari 60 tahun, dan 30%
dari mereka tidak mengetahui bahwa terkena diabetes
mellitus (Purnamasari D, 2009).
Patofisiologi
Clinical Manifestations
Classically, symptoms appear abruptly (i.e., during days or
Kriteria diagnosis
Gejala klasik DM + GDS 200
mg/dL
Gejala klasik DM + GDP 126
mg/dL
Glukosa 2 jam PP pada TTGO
200 mg/dL
Tata laksana
Life style
Diet
Exercise
Insulin
Farmakolog Oral glucose-lowering
i
drugs
EXERCISE PRESCRIPTION
A combination of aerobic exercise and resistance training is preferred. Avoid heavy lifting,
straining, and Valsalva maneuvers, which can raise blood pressure and may aggravate proliferative
diabetic retinopathy.
Intensity: Increase heart rate moderately to at least 55% of maximal heart rate (220 minus
age in years), with adjustments based on the patient's cardiovascular fitness. Patients with
improved cardiovascular fitness can proceed to harder activities, achieving heart rates exceeding
70% of maximum.
Duration: 30 minutes, preceded and followed by stretching and flexibility exercises for a
minimum of 5 to 10 minutes.
Frequency: at least 3 days per week. Results are best if exercise occurs nearly every day.
Avoid strenuous exercise if fasting glucose levels are 250 mg/dL or higher. Avoid all forms of
exercise if glucose levels are 300 mg/dL or higher or ketosis is present.
Monitor blood glucose level before, during, and after exercise to learn responses to different
exercise conditions and to identify when changes in insulin or food intake are necessary.
Parameters
Normal
Preprandial plasma glucose
<100
(mg/dL)
2-hour postprandial glucose
<140
(mg/dL)
Bedtime plasma glucose (mg/dL)
<120
Hemoglobin A1c (%)[]
<6
LDL cholesterol (mg/dL)
<130
HDL cholesterol (mg/dL)
>40 (m), >50 (w)
Fasting triglycerides (mg/dL)
<150
Blood pressure (mm Hg)
<140/90
Target[*]
90130
<160180
110150
<7
<100
>45 (m), >55 (w)
<150
<130/85
Several intensive insulin regimens commonly used in the treatment of diabetes. Each is designed to
provide a continuous supply of insulin around-the-clock and to make extra insulin available at the
time of meals, thereby simulating more closely the normal physiologic pattern of insulin secretion
Prognosis
Epidemiology
Predisposition Factor
Age greater than 45 years
Overweight
Family history of type 2 diabetes in a first-degree relative (eg, parent or
sibling)
Hispanic, Native American, African American, Asian American, or Pacific
Islander descent
History of previous impaired glucose tolerance (IGT) or impaired fasting
glucose (IFG)
Hypertension (>140/90 mm Hg) or dyslipidemia (HDL cholesterol level < 40
mg/dL or triglyceride level >150 mg/dL)
History of gestational diabetes mellitus or of delivering a baby with a birth
weight of over 9 lb
Polycystic ovarian syndrome (which results in insulin resistance)
Pathophysiology
DIABETES TYPE 2
Type 2 diabetes- Results from insulin resistance (a
condition in which the body fails to properly use insulin),
combined with relative insulin deficiency. Approximately
90-95% (16 million) have type 2 diabetes.
Clinical manifestation
Asymptomatic
Classic symptoms : polyuria, polydipsia, polyphagia and
weight loss
Other symptoms: blurred vision, lower extremity
paresthesias and yeast infection
Diagnosis
TheAmerican Diabetes Association(ADA) criteria for the diagnosis
Prognosis
Individualized-varies
Hipoglikemia
Definisi
kadar
glukosa
darah
Dibawah
< 55
level
mg/dl
normal
Penurunan
Tanda
kesadaran
dan
Stimulasi saraf
gejala
simpatis
Epidemiologi
Klasifikasi
Ringan
Secara Klinis
Sedang
Berat
Penyebab
Insulin
Penyebab
fasting hypoglycaemia
Ex
Exogenous drugs
Penyebab
Post-Prandial Hypoglycaemia
Gastric surgery
Neuroglikopenik Malaise
Bingung
Mual
(confussion)
Sakit kepala
Mengantuk
Sulit berbicara
Inkoordinasi
Perilaku yang
berbeda
Gangguan Visual
Parestesi
Glukosa
Terapi
Glukagon 1 mg pada
dewasa
Thankyou