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Teemad. Haiguse kirjeldusKas tegemist on t
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1. 2 tpi diabeetMiks inimesed haigestuvad? Verner Fogel
2010
2. Teemad Haiguse kirjeldus
Kas tegemist on tsise probleemiga?
Kes on ohustatud? Kaebused ja diagnoosimine
Mis on erinevat tervel ja haigel patsiendil organismis
Mis on veresuhkru omastamise hire?
Mis on metaboolne sndroom?
Kokkuvte
Ksimused patsientidele
3. Haiguse kirjeldus
4. Diabeedi definitsioon Haigus, mille korral veresuhkur on normist krgem:
Insuliini toime lihastes ja maksas on halvenenud
Hiritud on insuliini tootmine khunrmes
Aastaid krge psinud veresuhkur phjustab erinevate organite kahjustusi
5. Diabeedi definitsioon Krooniliselt krge veresuhkur phjustab erinevate organite kahjustusi:
Silmaphjad
Neerud
Nrvid
Sda ja veresooned kogu kehas
6. Diabeet on eluaegne haigus, mis vib phjustada raskeid tsistusi Diabetes and increased blood glucose levels are associated with severe and life-threatening complications.14 These may either be macrovascular (e.g. stroke, myocardial infarction or peripheral arterial disease) or microvascular (e.g. diabetic retinopathy, kidney function deterioration or neuropathy).
Heart disease and stroke account for about 65% of deaths in people with diabetes; adults with diabetes are 24 times more likely to die from heart disease and 2.8 times more likely to die from stroke than unaffected adults.5 Diabetic retinopathy causes 1224,000 new cases of blindness each year; diabetes is the leading cause of new cases of blindness in adults aged 2074 years. In people with type 1 diabetes, maintaining blood glucose levels as close to normal as possible reduces eye damage by 76%.5 Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2002; in people with type 1 diabetes, maintaining blood glucose levels as close to normal as possible reduces kidney damage by 3556%.5 Approximately 6070% of people with diabetes have some form of nervous system damage; severe forms are a major contributing factor in lower-extremity amputations. Indeed, > 60% of non-traumatic lower-limb amputations occur in people with diabetes and the rate of amputation is 10 times higher than for people without diabetes.5 Therefore, the importance of blood glucose control in preventing or reducing diabetic complications cannot be underestimated.
1. UK prospective diabetes study 16. Overview of 6 years' therapy of type II diabetes: a progressive disease. UK Prospective Diabetes Study Group. Diabetes 1995;44:124958.
2. Khaw KT, et al. Association of hemoglobin A1c with cardiovascular disease and mortality in adults: the European prospective investigation into cancer in Norfolk. Ann Intern Med 2004;141:41320.
3. Stratton IM, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:40512.
4. Saydah SH, et al. Subclinical states of glucose intolerance and risk of death in the US. Diabetes Care 2001;24:44753.
5. Complications of Diabetes in the United States. Available at: http://www.diabetes.org/diabetes-statistics/complications.jsp. Last accessed 25 January 2007.Diabetes and increased blood glucose levels are associated with severe and life-threatening complications.14 These may either be macrovascular (e.g. stroke, myocardial infarction or peripheral arterial disease) or microvascular (e.g. diabetic retinopathy, kidney function deterioration or neuropathy).
Heart disease and stroke account for about 65% of deaths in people with diabetes; adults with diabetes are 24 times more likely to die from heart disease and 2.8 times more likely to die from stroke than unaffected adults.5 Diabetic retinopathy causes 1224,000 new cases of blindness each year; diabetes is the leading cause of new cases of blindness in adults aged 2074 years. In people with type 1 diabetes, maintaining blood glucose levels as close to normal as possible reduces eye damage by 76%.5 Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2002; in people with type 1 diabetes, maintaining blood glucose levels as close to normal as possible reduces kidney damage by 3556%.5 Approximately 6070% of people with diabetes have some form of nervous system damage; severe forms are a major contributing factor in lower-extremity amputations. Indeed, > 60% of non-traumatic lower-limb amputations occur in people with diabetes and the rate of amputation is 10 times higher than for people without diabetes.5 Therefore, the importance of blood glucose control in preventing or reducing diabetic complications cannot be underestimated.
1. UK prospective diabetes study 16. Overview of 6 years' therapy of type II diabetes: a progressive disease. UK Prospective Diabetes Study Group. Diabetes 1995;44:124958.
2. Khaw KT, et al. Association of hemoglobin A1c with cardiovascular disease and mortality in adults: the European prospective investigation into cancer in Norfolk. Ann Intern Med 2004;141:41320.
3. Stratton IM, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:40512.
4. Saydah SH, et al. Subclinical states of glucose intolerance and risk of death in the US. Diabetes Care 2001;24:44753.
5. Complications of Diabetes in the United States. Available at: http://www.diabetes.org/diabetes-statistics/complications.jsp. Last accessed 25 January 2007.
7. Kas 2 tpi diabeet on tsine probleem?
8. Diabeedi epideemia 230 miljonit inimest on juba haigsetunud diabeeti aastaks 2006
350 miljonit haigestub jrgneva 20 aasta jooksul
9. Kes on ohustatud?Millised on kaebused?Kuidas diagnoositakse?
10. Mis soodustab haigusetumist 2 tpi diabeeti? Vanus le 40 eluaasta
Perekonnas varasemalt olnud 2 tpi diabeet
Varasemalt juba teada veresuhkru omastamise hire
Sdame ja veresoonte haigused varasemalt
Naistel rasedusaegne veresuhkru omastamise hire vi rasedusaegne diabeet
11. Mis soodustab haigusetumist 2 tpi diabeeti? Vererhk varasemalt krge
Varasemalt teada normist krgemad kolesteroolid
lekaal ja/vi khupiirkonna rasvumine
12. Kaebused haigestumisel Sage urineerimine
Sage ine urineerimine
Sage joomine
Ngemise halvenemine
Vsimus ja nrkus
Kehakaalu langus ( esineb harvem )
Sagedased pletikud ( sageli mdanikud jalgadel )
13. Kuidas diagoositakse 2 tpi diabeet?
14. NB! Hommikune veresuhkur vib olla normipiirides, kuid see ei vlista haiguse olemasolu.
15. Mis on erinevat tervel ja haigel patsiendil organismis?
17. 2 tpi diabeeti pdev patsient 90-95% diabeetikutest pevad 2 tpi diabeeti
Probleemiks on insuliini tundetus haiguse alguses ja hiljem insuliini puudumine
90% 2 tpi diabeetikutest on lekaalulised
2 tpi diabeetikutel on tekkinud tsistused juba enne haiguse diagnoosimist
18. The World Health Organization reports that around 90% of individuals with type 2 diabetes are overweight or obese.1
Fat distribution in the body may be either abdominal (android or central obesity often referred to as apple-shaped) or affect the lower body (mainly thighs and buttocks; gynoid obesity often referred to as pear-shaped).2
Central obesity (indicated by, for example, high waist:hip ratio; that is waist:hip ratio > 0.90 for men, > 0.85 for women) is a strong risk factor for insulin resistance.3
1 World Health Organization, 2005. http://www.who.int/dietphysicalactivity/publications/facts/obesity
2Basdevant A, et al. Presse Med 1987; 16:167170.
3Ascaso JF, et al. Eur J Intern Med 2003; 14:101106. The World Health Organization reports that around 90% of individuals with type 2 diabetes are overweight or obese.1
Fat distribution in the body may be either abdominal (android or central obesity often referred to as apple-shaped) or affect the lower body (mainly thighs and buttocks; gynoid obesity often referred to as pear-shaped).2
Central obesity (indicated by, for example, high waist:hip ratio; that is waist:hip ratio > 0.90 for men, > 0.85 for women) is a strong risk factor for insulin resistance.3
1 World Health Organization, 2005. http://www.who.int/dietphysicalactivity/publications/facts/obesity
2Basdevant A, et al. Presse Med 1987; 16:167170.
3Ascaso JF, et al. Eur J Intern Med 2003; 14:101106.
19. Veresuhkru taseme reguleerimine suhkruhaigust pdeval inimesel
20. Veresuhkru taseme reguleerimine suhkruhaigust pdeval inimesel
21. Insuliini tootvate rakkude hulk 2 tpi diabeetikul -Cell mass in Type 2 diabetes
This slide shows the outcomes of a retrospective autopsy study that assessed human pancreatic -cell mass in lean and obese subjects (n=124). Cases were categorized based on recent fasting plasma glucose (FPG) measurements as non-diabetic (ND), impaired fasting glucose (IFG), or Type 2 diabetes.
For inclusion, cases were required to have had at least one FPG in the year prior to death. Cases were categorized as obese (body mass index [BMI] >27 kg/m2) or lean (BMI <25 kg/m2) and further classified as: ND (FPG <6.1 mmol/l [<110 mg/dl]); IFG (FPG=6.1-6.9 mmol/l [110-125 mg/dl]); or Type 2 diabetes (FPG >7.0 mmol/l [>126 mg/dl]). Relative -cell volume percentage was used to estimate -cell mass.
Obese subjects with IFG or Type 2 diabetes had relative -cell volumes of 40% (P<0.05) and 63% (P<0.01), respectively?representing a lower relative -cell volume compared with ND-obese cases. Lean subjects with Type 2 diabetes cases had 41% less relative -cell volume compared with ND cases (P<0.05). The ND-obese subgroup had approximately 50% greater -cell volume compared with ND-lean (P=0.05), which may have been a result of the younger age at death for obese-ND (66.9 yr) compared with lean-ND (78.1 yr) cases.
These results illustrate the link between -cell mass, IFG, and Type 2 diabetes.
REFERENCE
Butler AE, Janson J, Bonner-Weir S, Ritzel R, Rizza RA, Butler PC. Diabetes. 2003;52:102-110.-Cell mass in Type 2 diabetes
This slide shows the outcomes of a retrospective autopsy study that assessed human pancreatic -cell mass in lean and obese subjects (n=124). Cases were categorized based on recent fasting plasma glucose (FPG) measurements as non-diabetic (ND), impaired fasting glucose (IFG), or Type 2 diabetes.
For inclusion, cases were required to have had at least one FPG in the year prior to death. Cases were categorized as obese (body mass index [BMI] >27 kg/m2) or lean (BMI <25 kg/m2) and further classified as: ND (FPG <6.1 mmol/l [<110 mg/dl]); IFG (FPG=6.1-6.9 mmol/l [110-125 mg/dl]); or Type 2 diabetes (FPG >7.0 mmol/l [>126 mg/dl]). Relative -cell volume percentage was used to estimate -cell mass.
Obese subjects with IFG or Type 2 diabetes had relative -cell volumes of 40% (P<0.05) and 63% (P<0.01), respectively?representing a lower relative -cell volume compared with ND-obese cases. Lean subjects with Type 2 diabetes cases had 41% less relative -cell volume compared with ND cases (P<0.05). The ND-obese subgroup had approximately 50% greater -cell volume compared with ND-lean (P=0.05), which may have been a result of the younger age at death for obese-ND (66.9 yr) compared with lean-ND (78.1 yr) cases.
These results illustrate the link between -cell mass, IFG, and Type 2 diabetes.
REFERENCE
Butler AE, Janson J, Bonner-Weir S, Ritzel R, Rizza RA, Butler PC. Diabetes. 2003;52:102-110.
22. Mis on veresuhkru omastamise hire?
23. Veresuhkru omastamise hire Tegemist on haigusega, mis eelneb 2 tpi diabeedi tekkele
Veresuhkrud on juba le normi, kuid ei saavuta 2 tpi diabeedi vrtusi
Sageli tekib 3-4 aasta jooksul nendel patsientidel 2 tpi diabeet
Haigus oluliselt suurendab haigestumist sdame ja -veresoonkonna haigustesse
Fsilise koormuse, elustiili muutmise ja kaalu langetamisega on vimalik veresuhkruid parandada ja 2 tpi diabeeti haigestumist vhendada
24. Kuidas diagnoositakse veresuhkru omastamise hire?
25. NB! Hommikune veresuhkur vib olla normipiirides, kuid see ei vlista haiguse olemasolu
26. Mis haigus on metaboolne sndroom?
27. Metaboolne sndroom Patsient on lekaaluline
Patsiendil on veresuhkru omastamise hire vi 2 tpi diabeet
Patsiendil on vererhud le normi
Patsiendil on kolesteroolid le normi
28. Metaboolne sndroom 3 korda suurem vimalus pdeda sdame infarkti vi insulti
2 korda suurem vimalus surra sdamehaiguse tttu
29. Metaboolne sndroom Haiguste tekkimist on vimalik vltida:
Kui patsient langetab kehakaalu
Kui patsient muudab elustiili
Kui patsient hakkab tervislikult toituma
Kui vererhud, kolesteroolid ja veresuhkur on hsti ravitud
30. Kokkuvte 2 tpi diabeet, veresuhkru omastamise hire ja metaboolne sndroom on vga sage haigus
2 tpi diabeedil, veresuhkru omastamise hirel ja metaboolsel sndroomil on vga palju tsistusi
2 tpi diabeedi, veresuhkru omastamise hire ja metaboolse sndroomi phjuseks on vhene fsiline koormus ja vale dieet
31. Kokkuvte Fsiline koormus ja tervislik toitumine vhendab haigestumist nendesse haigustesse
Fsiline koormus ja tervislik toitumine vhendab vimalust saada nende haiguste tsistusi ( juhul kui patsient juba peb hte nendest haigustest )
32. Kokkuvte Teie sugulane vi tuttav:
Hommikune veresuhkur le normi
2 tundi peale ski veresuhkur le normi
Kolesteroolid ja/vi vererhk le normi
lekaaluline
Soovitage prduda perearsti juurde. NB! Tuleb teha 2 tunni test magusa veega
33. Ksimused patsiendile
34. Ksimused Mis haigus on 2 tpi diabeet?
Milliseid tsistusi phjustab 2 tpi diabeet?
Kas 2 tpi diabeet on sage haigus?
Kui palju insuliini tootvatest rakkudest on hvinud 2 tpi diabeedi diagnoosimisel?
Mis haigus on veresuhkru omastamise hire?
Milliseid tsistusi phjustab see haigus?
35. Ksimused Mis haigus on metaboolne sndroom?
Mis tsistusi phjustab metaboolne sdroom?
Kas neid haigusi on vimalik vltida vi tekkimist pidurdada?
Kuidas tuleks nende tekkimist vltida?
Mitu protsenti suhkruhaigetest on lekaalulised?
36. Tnan