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Diabetes Mellitus (DM) 糖尿病

2016-12-14
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

Symptoms include: 

  1. 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. 

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 meal: 90-130 mg/dL.
  2. Plasma glucose after meal: less than 180 mg/dL.
  3. HbA1c: lower than 7.0%.
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