DIABETES MELITUS

Definitions
Melitus diabetes (DM) is a metabolic disease marked by high
measure plasma glucose (hiperglikemia) caused by interference sekresi
insulin, insulin action or both.
Have type 2 DM on the basis of the start of the disease, namely:
1. Type-1, Insulin dependent Diabetes Melitus (IDDM) or type of youth
On this there is a type of destruction beta cells pancreas, so it does not
insulin producing cells and consequently can not absorb glucose from the blood.
Blood glucose level increased so that the excess glucose was issued through
urine. Type this happens a lot at the age of 30 years and most often starts in
age 10 - 13 years.
2. Type-2, Non-Insulin dependent Diabetes Melitus (NIDDM) or type of adult
This does not depend on the type of insulin, usually occurs at the age of above 40
years with a greater incidence in the fat and old age.
Causes
The lack of hormone insulin, which functions as a source of glucose utilizing
sintesa energy and fat.
Type-1 it can not clearly caused by a virus infection
cause auto-immune reaction to cope with excess virus, more than that
descendants of factors holding role.
Type-2 is caused by declining function of beta cells and the cumulation amiloid
the beta cells.
Insufisiensi insulin function caused by the disruption of production or defisiensi
insulin by beta cells langerhans pancreas gland, or due to less
responsifnya cells of the body's insulin.

Clinical picture
a. People often complain that weak, sometimes feels a sense pins or
Baal and itching that chronicles.
b. People in general have poliuria , polidipsia
(lots of drinking) and polifagia (many meals).
c. A decrease in body weight that can not be explained.
d. Besides, people will feel very thirsty, loss of energy, feeling faint
and quickly tired.
e. In the case may go decrease the sharpness of vision
Diagnosis
Based on the symptoms of diabetes with the 3P (polifagia, poliuria, polidipsia). Diagnosis
can be ascertained with the determination of blood sugar.
a. When the blood glucose level at 200 mg / dl
b. Fasting blood glucose 126 mg / dl
c. Tolerance Test in Oral glucose (TTGO) obtained results of the examination content
blood sugar 2 hours 200 mg / dl after 75 grams of glucose.
Penatalaksanaan
a. Actions undertaken for diabetics, among others; diet with
calorie restriction, exercise occurs when insulin resistance exercise
regularly can minimize it, stop smoking because nicotine can
affect the absorption of glucose by cells.
b. if public action is not effective in lowering blood glucose of
Type 2 diabetes-the oral antidiabetik can be given:
- Klorpropamid start with 0.1 gr / day in the once, the maximum
0.5 mg / day
- Glibenklamid start with 5 mg / day in the once, the maximum
10 mg / day
- Metformin started with 0.5 gr / day in 2 - 3 times a provision, the maximum
2 g / day.
This medicine must begin with the smallest dose. After 2 weeks treatment,
dose can be increased.
c. In the diabetics Type-1 was given insulin for life, not
recommended drinking antidiabetik oral.