Ali Albayati
Consultant
(internal medicine)
Fellowship
of American college of endocrinology
FACE
Supervisor
of endocrinology specialty/iraqi
council for medical specialization
Member
of ADA/ESE/AACE/ENDOCRINE
SOCIETY
Diabetes
=
siphon
Mellitus
=
honey
History
Mentioned first in
1500
bc by
egyption
Indians
called it
madhumeha
(honey urine)
Galen
called
it
diarrhea urinosa
Thomas willis
add the term mellitus to diff. it
from insipidus
(
1675
)
Areteaus of cappadocia
first used term
diabetes(greek)1
st
century ce
1989
st. vincent declaration
???
definition
Clinical
syndrome
characterized By either absolute ins.
Defic.
Or
relative defic. And ins resistance
Global pandemic
leg
+
blindness
=
of
Most common cause
amputation
+
ESRD
Type 2
is more than
90%
of cases
classificaton
Type 1
A-immune mediated 90%
B-idiopathic 10%
Type 2
A-obese
B- non obese
Other specific types
Gestational
diabetes
physiology
Pancreas
=
endo
+
exo
Endo=
Alpha
cell
=
glucagon
Beta
cell
=
insulin
Delta
cell
=
somatostatin
P.p
cell
=
…
Porinsulin
=
ins
+
C- peptide
Ins
=
anabolic hormone
Aetiology and pathogenesis
Type 1
Genetics
One third of aetiology
DR3
+
DR4
Concordance rate
=40
%
mediated disease
cell
-
Slow autoimmune T
70-90%
destruction needed to appear clinically
Its paternal disease
Environmental
Hygiene theory
et
…
mumps,coxsakie,rubella,EBV,cytomegalovirus
=
Virus
c
BSA,nitrosamines,coffee
=
Diet
stress
Type 2
=
Genetics
More imp. And common than type 1
Concordanece rate
=100%
Multifactorial
Polygenic
Mody=
maturiy onset diabetes of young
=
less
than5%
+
aut.dominant
+
Less than 25+ respond to oral
drugs
+
normal weight
+
year
LADA=
latent auto immune diabetes in adult
=
Environmental
Overeating
+
obesity
+
underactivity
+
ageing
+
pregnancy
Metabolic
=
reavans
=
insulin resistance
=
syndromeX
Minority of obese develops diabetes
50%
destruction is needed to appear
Stress hyperglycemia
…..?
Thank you