Diabetes Mellitus Population Suffering developed and developing countries
Diabetes mellitus a lot happening in the world both in developed countries or recently also occurred in many developing countries. If not uncommon to continually develop this disease can lead to kidney failure resulting in dialysis patients should do and it can spend no small amount of money spent in addition to time wasted to do the dialysis. at least we need to know about this disease because it can so we can experience or suffer from this disease. actual diabetes mellitus is a chronic state of hyperglycemia is accompanied by various metabolic disorders caused by hormonal disorders that cause a variety of chronic complications in the eyes, kidneys, nerves and blood vessels accompanied by the existence of lesions in the basal membrane in the electron microscope examination.
Actually diabetes mellitus were divided into 2 (two), namely because Insulin dependent diabetes mellitus diabetes mellitus (IDDM) because of the islets β cell destruction caused by autoimmune processes, and Non-Insulin Dependent Diabetes Mellitus (NIDDM) because of the relative failure of β cells and insulin resistance. Insulin resistance is a decline in the ability of insulin to stimulate the intake of glucose by peripheral tissue and to inhibit the production of glucose by the liver. Tues β can not compensate for this insulin resistance, which means that will occur relative insulin deficiency. This inability can be seen from reduced secretion of insulin in the stimulation of glucose and on glucose stimulation of insulin secretion together with other stimulant ingredients. Mean pancreatic β cells experiencing desensitization of glucose.
Very easy if we want to know the signs and symptoms of diabetes mellitus because of the situation is very typical of each patient. These diseases are characterized by symptoms such as polifagia, polyuria, polydipsia, lethargy and weight loss. Other symptoms are tingling, itching, eyes blurred and impotence in men and pruritus vulva in women.
Examination filter need to be done in groups with high risk for diabetes mellitus is an old adult age group (above 40 years), high blood pressure, obesity, family history of diabetes mellitus, history of pregnancy with birth weight more than 4000 grams, history of diabetes mellitus in pregnancy and dyslipidemia. Inspection can be done by filter blood glucose checks when, fasting blood glucose level, can then be followed by the standard Oral Glucose Tolerance Test. For high-risk group assessment is negative filters, filters need to repeat the examination every year. For patients aged over 45 years without risk factors, disease inspection can be conducted every three years.
Complaints and symptoms plus the typical blood glucose check results when 200 milligrams per deciliter or fasting plasma glucose greater than or equal to 126 milligrams per deciliter is enough to make a diagnosis of diabetes mellitus. Etiologic classification of diabetes mellitus from the American Diabetes Association (1997) are:
1. Diabetes type 1 (β cell destruction, usually leading to absolute insulin deficiency):
2. Diabetes type 2 (range or particularly dominant insulin resistance with relative insulin deficiency to defac accompanied by insulin resistance and insulin secretion.
In the short term, the management of diabetes mellitus complaint aims to eliminate or symptoms. While long-term goal is to prevent complications. The objectives are carried out by normalizing levels of glucose, lipids, and insulin. To facilitate the achievement of these objectives, the project is implemented in the form of a holistic patient management and teaching activities independently. For patients aged 60 years and above the target blood glucose is higher than the (fasting of less than 150 milligrams per deciliter and after eating less than 200 milligrams per deciliter). Oral hypoglycemic drugs also we need to know. There sulfonylurea, biguanid, α glucosidase inhibitor and insulin-sensitizing agent. Sulfonylurea drugs work by stimulating the insulin release are saved, lowered the threshold of the insulin secretion and increase the insulin secretion as a result of glucose stimulation. Biguanid while lowering blood glucose levels but not below normal. Preparations for existing and secure is metformin. While the β glucosidase inhibitors are drugs that competitively inhibit α glucosidase enzymes work within the gastrointestinal tract and thus reducing the absorption of glucose and reduce hyperglycemia pascaprandial. Insulin sensitizing agent is a new class of drugs that have pharmacological effects of improving insulin sensitivity so that it can overcome the problem of insulin resistance and the various problems caused by insulin resistance without causing hypoglycemia.
Approximately 60 percent of patients with diabetes mellitus who received insulin to survive like normal people but the rest can suffer blindness, kidney failure, chronic and likely to die sooner.