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1 Acute complication final .pdf



Original filename: 1 Acute complication final.pdf
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ACUTE & LONG TERM COMPLICATIONS OF
DIABETES MELLITUS

DR. A.K.M. MUSA
FCPS(M); DTCD; MCPS(M)
PROFESSOR & Head OF MEDICINE
BIRDEM & IMC

Diabetes mellitus is a common metabolic disorder
characterized by Hyperglycemia, resulting from
defects in Insulin secretion, Insulin action or both.

• The worldwide prevalence of DM has risen
dramatically over the past 2 decades,likewise
prevalence rates of IFG & IGT are also
increasing.. The prevalence in 2000 of 2.8% is
estimated to be 4.4% in 2030.

World wide and Bangladesh
prevalence of DM (Millions)
Millions
366

400
300

171

World

200
3.2

100

11.1

0
2000

2030

Bangladesh

Increase in prevalence is due to
1. Sedentary Lifestyle
2. Increasement in obesity
3. Change in food habit
4. Rapid Urbanization
5. Increased longevity
Emerging Epidemic: estimated that one third of the
population will suffer from Diabetes within two decades

Types of diabetes
Type 1 diabetes –
Autoimmune destruction of beta cells (90% cases )
Absolute Insulin deficiency

Type 2 diabetes – Insulin Resistance
– Progressive

Beta cell failure

Type 1 diabetes







Pathology Type 1 diabetes is a T cell-mediated autoimmune disease
involving destruction of the insulin-secreting β cells in the pancreatic
islets which takes place over many years.
Hyperglycaemia accompanied by the classical symptoms of diabetes
occurs only when 70-90% of β cells have been destroyed. The
pathology in the pre-diabetic pancreas in type 1 diabetes is
characterised by:
'insulitis' infiltration of the islets with mononuclear cells containing
activated macrophages, helper cytotoxic and suppressor T
lymphocytes, natural killer cells and B lymphocytes
β-cell specificity of the destructive process, with the glucagon and
other hormone-secreting cells in the islet remaining intact.


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