dm pd usia lanjut

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Diabetes melitus padausia lanjut

Alfi Syahar Yakub

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Diabetes melitus

Prevalensi semakin meningkat

Dampakusia lanjut +DM tipe 2

Indonesia

ledakan DM tipe 2, nomor 4

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28/01/2014 3

Endocrine glands release hormones (chemical messengers) into the bloodstream to

be transported to various organs and tissues throughout the body. For instance, the

pancreas secretes insulin, which allows the body to regulate levels of sugar in the

blood. The thyroid gets instructions from the pituitary to secrete hormones which

determine the pace of chemical activity in the body (the more hormone in thebloodstream, the faster the chemical activity; the less hormone, the slower the activity

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The pancreas is located behind the liver and is where the

hormone insulin is produced. Insulin is used by the bodyto store and utilize glucose .

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Islets of Langerhans containbeta cells and are locatedwithin the pancreas. Betacells produce insulin whichis needed to metabolize

glucose within the body.

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Insulin is a hormone secreted bythe pancreas in response to

increased glucose levels in theblood.

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Insulin is a hormoneproduced by the pancreasthat is necessary for cells tobe able to use blood sugar.

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In response to high levels of glucose in the blood, theinsulin-producing cells in the pancreas secrete thehormone insulin. Type I diabetes occurs when these cells

are destroyed by the bodys own immune system.

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Blindness

Renal failure

DisabilityAmputations

Epidemiology of Diabetes Worldwide

151 million patients with diabetes

2.1% of worldwide population

97% are NIDDM patients

221 million estimated by 2010

Complications of diabetes include :

Coronary artery disease

Peripheral vascular disease

Diabetic nephropathyStroke

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Patogenesis

Proses ketuaan Faktor risiko independentintoleransi glukosa

Patogenesis = DM tipe 2

Faktor keturunan & Faktor genetikDisfungsi sel beta, resistensi insulin, inkretin,

lipolisis, neurotransmitter dysfunction,

glukagonDM\Diabetes, Type 1, Type 2, Glucose, Insulin.mp4

DM\Type 2 Diabetes Overview .wmv

What is Type 1 Diabetes_.mp4

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Increased lipolysisDecreased glucose uptake intomuscle and adipose tissue and

increased hepatic glucose

output

Hyperglycemia

Insulin resistance

-cell dysfunction

Elevated

circulating FFA

Insulin resistance and -celldysfunction are linked

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Faktor risiko DM usia lanjut

Umur tua

Obesitas

Aktifitas fisik kurang Obat-obatan

Genetik

Penyakit lain

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Gejala/kelainan DM usia lanjut

Katarak, glaukoma, retinopati diabetik

Pruritus / gatal pada kulit t/u vulva

Kontraktur dupuytren

Infeksi bakteri kulit,sal kemih Infeksi jamur

Neuropati perifer/visceral

Amiotropi Ulkusneurotropik

PAP

PJK

Hipertensi

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Managing Diabetes

Dont be

Glucosecentric

We must treat the entire metabolicsystem

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Pengobatan DM usia lanjut

Diet dan olahraga

Obat oral : Sulfonilurea, non sulfonilurea

Biguanid (metformin)

Akarbose

Tiazolidindion

Insulin

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Interaksi obat dengansulfonilurea

Meningkatkan hipoglikemia Aspirin, fibrat, trimetoprim menggantikan

sulfonilurea dr ikatan albumin

Alkohol, penyekat H2, antikoagulanmenghambat met.