1、2022-7-1312022-7-13 Terminology 2Combining form prefix and suffixmeaningterminologymeaningaden/ogland腺adenitisadenomaadenopathy腺炎腺瘤腺病crin/osecrete分泌endocrinologyhypercrinecrinogenic内分泌学内分泌机能亢进的促分泌的hormon/ohormone激素hormonalhormonogenesishormonology激素的，激素性激素生成内分泌学adren/oadrenal glands肾上腺adrenitisadren
2、olyticadrenopathy肾上腺炎抗肾上腺素的肾上腺病22022-7-13 Terminology 3Combining form prefix and suffixmeaningterminologymeaningpancreat/opancreas胰腺pancreaticpancreatinpancreatogram胰腺，胰脏的胰酶胰造影摄片gluc/osugar糖glucagonglucogenesisglucolysis胰高血糖素葡萄糖生成糖酵解glyc/osugar糖glycopeniaglycosuriahyperglycemia低糖，糖过少糖尿高血糖症insulin/oi
3、nsulin胰岛素insulinaseinsulomahyperinsulinism胰岛素酶胰岛素瘤高胰岛素血症32022-7-13 Terminology 4Combining form prefix and suffixmeaningterminologymeaningendo-within内endodermendoscopeendoplasm内胚层内镜内质thyroid/othyroid甲状腺thyroiditisthyroidectomyhypothyroidism甲状腺炎甲状腺切除术甲状腺功能减退ovari/oovary卵巢ovariotomyovaritisovariopathy卵
4、巢切开术卵巢炎卵巢病-trophicnutrition,growth,nourishment营养（的）neurotrophicthymotrophicadrenotrophic神经营养性的促胸腺的促肾上腺的401 Brief Introduction02 Classification03 The major factors 04 Pathogenesis 05 Clinical Manifestations06 Complications07 Diagnosis08 Antidiastole09 Therapy contentsFigure1：Main symptom of diabetes5
5、 6Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of pol
6、yuria (frequent urination), polydipsia (increased thirst), and polyphagia (increased hunger). 01 Brief Introduction 702 Classification 2.1 Type 1 diabetes The pancreas undergoes an autoimmune attack by the body itself,and is rendered incapable of making insulin.Abnormal antibodies have been found in
7、 the majority of patients with type1 diabetes.Antibodies are proteins in the blood that are part of the bodys immune system,the patient with type1 diabetes must rely on insulin medication for survival. 02 Classification 2.2 Type 2 diabetes It previously referred to as non-insulin dependent diabetes
8、mellitus,or adult onset diabetes mellitus.patients can still produce insulin,but do so relatively inadequately for their bodys needs,particularly in the face of insulin resistance as discussed above.In many cases this actually means the pancreas produces larger than normal quantities of insulin.A ma
9、jor feature of type2 diabetes is a lack of sensitivity to insulin by the cells of the body.8 02 Classification 2.3 Other type of diabetes gestational diabetes,occurs when pregnant women without a previous diagnosis of diabetes develop a high blood glucose level. It may precede development of type 2
10、DM.Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.9 2022-7-13 meta-变化的变化的 metabolism n.新陈代谢 metabo
11、lite n.代谢物 metabolize v.使新陈代谢 metabolic adj.变化的，新陈代谢的 poly- 多的，多个的，聚合的多的，多个的，聚合的 polydipsia 多饮 polyuria 多尿 polyphagia 多食 Word Analysis102022-7-13 uri- 尿的，与尿有关的尿的，与尿有关的 urine n.尿 polyuria 多尿 uric adj. 尿的 urinal n.尿壶 urinate v.小便 urination n.排尿 glucosuria 糖尿 Word Analysis112022-7-13 Birth weight: Fat
12、Irregular menses (menstruation) Inflammation Obesity and a sedentary lifestyle Smoking Metabolic syndrome 03 The major factors1203 The major factors 3.1 Birth weight There is a relationship between birth weight and developing diabetes.The higher the birth weight the higher the risk of type 2 diabete
13、s. At the other end of the spectrum , a very high birth weight (over 8.8 pounds or 4 kg) also is associated with an increased risk. Additionally, mothers of infants who had a higher birth weight (over 9 pounds) are at increased risk for developing diabetes.13 03 The major factors 3.2 Fat The distrib
14、ution of fat is important. The classic pear shape person (smaller waist than hips) has a lower risk of developing diabetes than the apple shape person (larger around the waist). The exact reason for this difference is unknown, but it is thought to have something to do with the metabolic activity of
15、the fat tissue in different areas of the body.14 03 The major factors 3.3 Irregular menses (menstruation) There is an association between the lengthening of the menstrual cycle and the risk for developing diabetes, particularly in obese women.those who had a cycle length of greater than 40 days were
16、 twice as likely to develop diabetes than those who cycled every 26 to 31 days. The association is thought to be linked with polycystic ovarian syndrome(PCOS) which is also known to be associated with insulin resistance. Insulin resistance may be a precursor for type 2 diabetes.15 03 The major facto
17、rs 3.4 inflammation In recent years we have begun to understand the importance of inflammation and heart disease. We now know that inflammation may play an important role in the development of diabetes as well. An inflammation marker known as C-reactive protein has been shown to be increased in wome
18、n at risk for developing the metabolic syndrome, and in both men and women at risk for developing type 2 diabetes.16 03 The major factors 3.5 Obesity and a sedentary lifestyle Obesity and a sedentary lifestyle are the biggest risk factors that are controllable.This is in part due to the fact that ob
19、esity increases the bodys resistance to insulin. Studies have shown that reversal of obesity through weight reduction improves insulin sensitivity and regulation of blood sugar.17 03 The major factors 3.6 smoking Smoking is harmful in many ways including increasing the risk of cancer and heart disea
20、se. It also increases the risk of developing type 2 diabetes.18 2022-7-13 men/o 与月经有关的与月经有关的 menstruation n. 月经 menstrual adj.月经的 dysmenorrhea n. menstrual pain amenorrhea/Menopause n. no menstruation metr/o 子宫子宫 metrorrhagia n.uterine bleeding metrostaxis n.Small uterine bleeding Word Analysis19202
21、2-7-13 metabolic 代谢的代谢的 metabolic syndrome 代谢综合征 lipid metabolism 脂代谢 glucose metabolism 糖代谢 metabolic acidosis 代谢性酸中毒 basal metabolic rate 基础代谢率 precursor: prodromal symptoms of disease C-reactive protein：It is a sharply rised protein，when tissues injury and infect. Word Analysis2004 Pathogenesis4.
22、1 The Pathogenesis of Type 1 Is related to genetic factors, environmental factors and autoimmunity 1）genetic predisposition 2）start autoimmune response 3）immumological abnormalities 4）progressive loss of islet B cell function 5) clinical diabetes 6）islet B cells destroyed,diabetes clinical manifesta
23、tions21 04 Pathogenesis4.2 The Pathogenesis of Type 2 Its occurrence and development can be divided into four stages1 ）Genetic susceptibility2） Hyperinsulinism, and/or insulin resistance3 ）Glucotoxicity(糖尿病毒性),lipotoxicity(脂毒性)4 ）Clinical diabetes22 2022-7-13 immune 免疫免疫 autoimmunity 自身免疫 immumologi
24、cal 免疫学的 hyper- 高高 Hyperinsulinism 高胰岛素症 Hyperglycemia 高血糖 toxic 毒的，中毒的，有毒的毒的，中毒的，有毒的 Glucotoxicity 糖尿病毒性 lipotoxicity 脂毒性 Word Analysis2305 Clinical Manifestations 5.1 Type 1 Diabetes Mellitus Polyuria Polydipsia Polyphagia Weight loss24 05 Clinical Manifestations 5.2 Type 2 Diabetes Mellitus Non-s
25、pecific symptoms Fatigue Recurrent infections Prolonged wound healing Visual changes25 2022-7-13 proteolysis蛋白质水解蛋白质水解 lipolysis脂类分解脂类分解 arthrolysis关节松解术关节松解术 -lysis松解术，分解，溶解 prote-蛋白质 lipo-脂肪的 arthro-关节 Word Analysis2606 Complications6.1 Diabetic Ketoacidosis(DKA) It is the most common acute compli
26、cation of diabetes mellitus. The early manifestations of DKA is that the symptoms being more serve ,such as polydipsia、polyuria、polyphagia and so on.The DKA is characterized by different degrees of disturbance consciousness in the advanced stage.27 06 Complications6.2 Hyperglycemic hyperosmolar stat
27、us (HHS) Main clinical features:hyperglycemia crisis(高血糖危象),higher plasma osmotic pressure(高血浆渗透压),dehydration(脱水). Minor clinical manifestation:varying degrees of disturbance consciousness or coma ,unconspicuous DKA.28 06 Complications6.3 Infectious complications Pyogenic inflammation : furuncle,ca
28、rbuncle,pustule,etc.Fungal infection: tinea pedis ,tinea corporis,etc. Pulmonary tuberculosisFigure2： Infectious complications 29 06 Complications6.4 Macroangiopathy : The main histopathological change is atherosclerosis (AS).It is most like to accompany with aorta,coronary artery,cerebral artery,re
29、nal artery , peripheral artery ,etc.The AS leads to ischemic changes of heart ,brain,kidneys and limbs. 30 06 Complications6.5 Microangiopathy It is the specific complications of DM.Its typical histopathological changes are microcirculation disturbances and the thickness of basal membrane of vessel.
30、 The microangiopathy most like to affects retina, nerves，nephridium, and myocardium 31 06 Complications6.6 Neurological complications: 1)central nervous system complication(CNSC): altered mental status,ischemic stroke,senile dementia. 2)peripheral neuropathy: paresthesia , decreased of muscle,arefle
31、xia 3)autonomic neuropathy: gastroparesis, diarrhea,astriction,abnormal sweating.32 06 Complications6.7 Diabetic foot Related to distal lower neurological disorder and different levels peripheral vascular disease. Symptoms of light: foot abnormal,skin cold,high-risk foot Severe symptoms:foot ulcer,n
32、ecrosis Diabetic foot is the main reason of disability and amputation33 06 Complications6.8 Other diseases eye complications：such as retinal macular disease , cataracts ,glaucoma , Iridocyclitis skin lesions : like Skin infections,skin itch,chapped skin, rash.Figure4： skin lesions Figure3： eye compl
33、ications34 2022-7-13 Macroangiopathy 大血管病变大血管病变 macro- large micro- small angi- arteries 动脉血管 -pathy the suffix of“diseases” Athersclerosis 动脉粥样硬化动脉粥样硬化 ather/o plaque of fatty substance 动脉粥样 -sclerosis hardening硬化 Word Analysis352022-7-13 Peripheral angiopathy 周围血管病周围血管病 Peri- surrounding 周 angi- m
34、eans vessel -pathy means disease Neurological 神经病学的神经病学的 Neur- means nerve -ological discipline 学科的 Dementia 痴呆痴呆 De 脱，去，减，除，离 -mentia spirit Word Analysis3607 diagnosis1) Fasting blood glucose greater than or equal to 7 mmol / L .2) Two hours postprandial blood glucose greater than or equal to 11.1
35、 mmol / L3) The symptoms of diabetes and any time plasmatic glucose greater than or equal to 11.1 mmol / L37 07 diagnosis7.1 Type 1 diabetes mellitus1.The age of onset is young, the age 30 years old.2.The symptoms come on abruptly3.The symptoms of Polydipsia, Polyphagia and Polyuria are obvious.4.Th
36、e blood glucose level is high, and many patients with ketosis acid toxic as the first symptom. Low serum level of insulin and The low level of C peptide38 07 diagnosis7.2 Type 2 diabetes mellitus 1. The common in the elderly, high incidence of obesity,often accompanied by hypertension, dyslipidemia
37、, atherosclerosis and other diseases.2. Insidious onset,has no early symptoms, or only mild fatigue, thirst, hyperglycemia is not obvious. 3. Glucose tolerance test to confirm the diagnosis4. Serum insulin level in early normal or increased, The advanced is low39 2022-7-13 Plasmatic 血浆的血浆的 plasm-血浆
38、-atic 性质的 Dyslipidemia 血脂异常血脂异常 dys-不良的，困难 lip-脂肪的 -emia血症 Gluc(o) 葡萄糖葡萄糖 glucagon 胰高血糖素 glucokinase 葡萄糖激酶 glucocorticoids 糖皮质激素 enteroglucagon 肠高血糖素 Word Analysis4008 Antidiastole8.1 Liver diseases:Liver cirrhosis patients often have abnormal glucose metabolism, the fasting blood glucose of the typ
39、ical patient is normal or low, postprandial blood glucose rise rapidly. The duration of the elderly , the fasting plasma glucosecan also be elevated.41 2022-7-13 Diabets health education Medical nutrition therapy Condition monitoring Drugs therapy09 Therapy4209 Therapy9.1 Medical nutrition therapy C
40、alculate the total quantity of heat; Nutrient content; Reasonable distribution; Follow-up43 09 Therapy9.2 condition monitoring Regular checks blood sugar to adjust the treatment plan Proper exercise regularly Every year or two comprehensive review, complications,early detection and treatment44 09 Th
41、erapy9.3 Diabets health education Medicai staff adhere to follow up,according to the need to adjust the treatment plan; Life should be regular,quit smoking and dring;To prevent infection.45 09 Therapy9.4 Drugs therapy: Alpha glucosidase inhibitor（AGI） AGI defers absorption of carbohydration by means
42、 of inhibiting - glucosidases activity, thereby debasing postprandial hyperglycemia.Indication: AGI is useful in patients having carbohydration diet daily and those whose blood sugar are normal or slightly higher on empty stomach but rising significantly after meal.Contraindication : pregnant and la
43、ctant women, children and patients with gastrointestinal dysfunction.Representative drugs: acarbose, voglibose, miglitol 46 09 Therapy9.4 Drugs therapy：Insulin therapyl Insulin is an important and effective medicine of controlling hyperglycemia.l Insulin promotes the oxidation , composition and stor
44、age of glucose to reduce the blood sugar, and helps fat and protein synthetising and inhibits their decomposing as well .Indication: (1) T1DM ; (2) Apply to the acute and chronic complication of diabetes (3) surgery, pregnant and accouchment; (4) some special type of diabetes etc. 47 2022-7-13 Gluco- glucosidase 葡萄糖苷酶 Post- postprandial 餐后的 Carbo- carbohydration 碳水化合物 Contra- contraindication 禁忌症 indication 适应症 Gastro- gastrointestinal 胃肠道的 Dys- dysfunction 功能紊乱 De- decompose 分解 Word Analysis48
