糖尿病

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一种碳水化合物代谢障碍的疾病,发病机制为胰岛素(insulin)分泌不足或机体对胰岛素的敏感性降低。胰岛素在朗格汉斯氏岛(islets of Langerhans)合成,是代谢葡萄糖(glucose)所必需的。糖尿病的血糖浓度升高(高血糖〔hyperglycemia〕),多余的血糖随尿液排出,而形成糖尿。症状包括了症状包括多尿、尿频、口渴、疼痒、饥饿、消瘦、软弱。分二型︰幼年型(IDDM),一种自体免疫疾病(autoimmune disease),需注射胰岛素治疗。成年型(NIDDM),组织无法对胰岛素发生作用,常与遗传有关,可用限制饮食以控制病情。90%以上的病者都属於NIDDM。本病不经治疗可致酮(ketone)症,血液内脂肪代谢产物--酮体堆积、继之发生酸中毒,致恶心、呕吐。碳水化合物及脂肪代谢障碍,毒性产物堆积,引起糖尿病性昏迷。所有病例均应限制饮食,以达到及保持正常体重。并需限制碳水化合物及脂肪的摄入量,体内胰岛素产生不足的患者应接受正规胰岛素注射,成年型糖尿病患者一度普遍采用口服降血糖药治疗。并发症是造成死亡的重要因素,包括了心脏疾病、糖尿病性视网膜病(diabetic retinopathy,可致盲)、肾脏病、神经系统疾病(特别是腿和脚)。血糖浓度的控制并不一定是和并发症的发展有关,妊娠糖尿病可治癒。

diabetes mellitus

Disorder of insufficient production of or reduced sensitivity to insulin. Insulin, synthesized in the islets of Langerhans, is necessary to metabolize glucose. In diabetes, blood sugar levels increase (hyperglycemia; see glucose tolerance test). Excess sugar is excreted in the urine (glycosuria). Symptoms include increased urine output, thirst, weight loss, and weakness. Type I, or insulin-dependent diabetes mellitus (IDDM), an autoimmune disease in which no insulin is produced, must be treated by insulin injections. Type II, or non-insulin-dependent diabetes mellitus (NIDDM), in which tissues do not respond to insulin, is linked to heredity and obesity and may be controllable by diet; it accounts for 90% of all cases, many of which go undiagnosed for years. Untreated diabetes leads to accumulation of ketones in the blood, followed by acidosis (high blood acid content) with nausea and vomiting and then coma. Careful attention to content and timing of meals, with periodic checking of blood sugar, may manage diabetes. If not, injected or oral insulin is necessary. Complications, including heart disease, diabetic retinopathy (a leading cause of blindness), kidney disease, and nerve disorders, especially in the legs and feet, account for most deaths. Degree of blood-sugar control does not always correlate with progression of complications. Reversible diabetes may occur as a complication of pregnancy.

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