糖尿病2009预防.ppt

  糖尿病（Diabetes Mellitus, DM） 西安交通大学第一医院内分泌科 张进安  [概念] 多因素（遗传、自身免疫和环境）→临床综合征 共同标志——高血糖（伴蛋白质、脂肪代谢异常） 发病环节 1、胰岛素分泌不足 和/或 2、胰岛素作用缺陷（靶组织敏感性降低） 危害（后果） 1、慢性多系统损害（眼、肾、神经、心血管） 2、急性代谢紊乱（酮症、高渗昏迷） [流行病学] 1980年 14省市 30万人 0.67% 1986年 大庆 11万人 1.3% 1994年 19省市 21万人 2.51% 1996年 11省市 4万人 3.21% 1997年 全世界 1.35亿 2025年 全世界 3亿 继心血管病、肿瘤之后第三大非传染病，世界性公共卫生问题，社会问题。 Prevalence of Diabetes among Men and Women in China Wenying Yang,  RESULTS The age-standardized prevalences of total diabetes (which included both previously diagnosed diabetes and previously undiagnosed diabetes) and prediabetes were 9.7% (10.6% among men and 8.8% among women) and 15.5% (16.1% among men and 14.9% among women), respectively, accounting for 92.4 million adults with diabetes (50.2 million men and 42.2 million women) and 148.2 million adults with prediabetes (76.1 million men and 72.1 million women). The prevalence of diabetes increased with increasing age (3.2%, 11.5%, and 20.4% among persons who were 20 to 39, 40 to 59, and ≥60 years of age, respectively) and with increasing weight (4.5%, 7.6%, 12.8%, and 18.5% among persons with a body-mass index [the weight in kilograms divided by the square of the height in meters] of 18.5, 18.5 to 24.9, 25.0 to 29.9, and ≥30.0, respectively). The prevalence of diabetes was higher among urban residents than among rural residents (11.4% vs. 8.2%). The prevalence of isolated impaired glucose tolerance was higher than that of isolated impaired fasting glucose (11.0% vs. 3.2% among men and 10.9% vs. 2.2% among women). [糖尿病分类] 1980年 WHO标准 1997年 ADA标准 一、1型DM （B细胞破坏，胰岛素绝对不足） 1.免疫介导（急发型、缓发型） 2.特发性 二、2型DM （胰岛素分泌不足伴胰岛素抵抗） 三、其他特殊类型DM 四、GDM(Gestational Diabetes Mellitus) 三、其他特殊类型DM 1、共八种亚型 ： ⑴内分泌疾病、 ⑵胰腺外分泌病 ⑶明确病因的类型:Mit基因突变