COMPLICATIONS OF DIABETES MELLITUS：糖尿病并发症.ppt

COMPLICATIONS OF DIABETES MELLITUS ACUTE COMPLICATIONS Hypoglycemia DKA, HSS CHRONIC COMPLICATIONS Microvascular Macrovascular HYPOGLYCEMIA It is a clinical syndrome in which low serum or plasma glucose levels lead to symptoms of sympathoadrenal activation (sweating, anxiety, tremor, nausea, palpitations, tachycardia) from increased secretion of counterregulatory hormones. Neuroglycopenia occurs as the glucose level decreases further (fatigue, dizziness, headache, visual disturbances, drowsiness, difficulty speaking, inability to concentrate, abnormal behavior, confusion and loss of consciousness or seizures. In diabetics a blood glucose 70mg/dL In diabetics - iatrogenic factors In non diabetics – fasting _ postprandial RISK FACTORS – skipped or insufficient meals, unaccustomed physical exertion, misguided therapy, alcohol ingestion and drug overdose. Normal Target Blood Glucose Ranges Normal Blood Glucose Levels in People Who Do Not Have Diabetes Upon waking—fasting : 70 to 99 mg/dL After meals : 70 to 140 mg/dL Target Blood Glucose Levels in People Who Have Diabetes Before meals : 70 to 130 mg/dL 1 to 2 hours after the start of a meal : 180mg/dL Hypoglycemia can also happen during sleep. Some signs of hypoglycemia during sleep include :- crying out or having nightmares finding pajamas or sheets damp from perspiration feeling tired, irritable, or confused after waking up _Hypoglycemia unawareness - develops when frequent episodes of hypoglycemia lead to changes in how the body reacts to low blood glucose levels. The body stops releasing the hormone epinephrine and other stress hormones when blood