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Diabetes Mellitus
PREPARED BY:
NURNILAM SAFITRI
ARDIANTI
SYAFARUDDIN
INTRODUCTION
We say thanks to God forhis blessings so that we can completed a paper with
titleDiabetes mellitus.We also say thanks to the faculty who have provide guidance to us
so that we can finish the preparation of this paper .
The purpose of this paper is fullfilled the task from lecturer and to increase our
knowledge about diabetes mellitus.In this paper we realize that a lot of shortcomings. The
critics and suggestions that are built from a very helpful reader is necessary for the perfection
of the next paper. We also expect that this paper may be useful for all of us, especially us as a
writer and is expected to God will reward all our good. Amin yaa Robal Alamin .
author
TABLE OF CONTENTS
PREFACE...................................................................................................... i
TABLE OF CONTENTS.................................................................... ii
CHAPTER I INTRODUCTION................................................................. 1
1.1 Background.............................................................................................. 1
1.2 Formulation of Masala.............................................................................2
1.3 Objective.................................................................................................. 2
CHAPTER II DISCUSSION
2.1 Definition of Diabetes Mellitus ........................................................................3
2.2 Patofisiologi.......................................................................................................3
2.3 Classification of Diabetes Mellitus ...................................................................4
2.4 Signs and symptoms of diabetes .......................................................................5
2.5 Diagnosis of Diabetes Mellitus ....................................................................... 6
2.6 factors Pencetus..................................................................................................7
2.7 Treatment of Diabetes Mellitus .........................................................................8
According to WHO figures popular with diseases as diabetes is quite fantastic , which
ranks fourth in the world. According to WHO data , the world is now inhabited by 171
million people diabtes mellitus ( 2000) and will be doubled to 366 million in 2030 . Than
50 % were aware of the virus, only 30% of the routine treatment. The increasing
prevalence will bring change increasingly prominent position of diabetes mellitus , which
is characterized by a change or increase in substantial improvement grouped 10 (leading
diseases) . Besides diabetes mellitus members increasingly greater contribution to
mortality ( ten diseases leading cause of death ) . ( Bustan , 2007)
Problem Formulation
1. How to understand the pathophysiology of Diabetes Mellitus?
2. What is the classification of Diabetes Mellitus ?
3. How to diagnose the disease diabetes mellitus ?
4. How to treatment of diabetes mellitus ?
Objectives
1. To determine the pathophysiology of Diabetes Mellitus
2. To determine the classification of Diabetes Mellitus
3. To find out how to diagnose the disease of Diabetes Mellitus
4. To find out how to cure diabetes mellitus
CHAPTER II
DISCUSSION
Definition of Diabetes Mellitus
Diabetes mellitus , DM (Greek : , diabanein , translucent or shower
water ) (Latin : mellitus , sweet taste ) , also known in Indonesia by the term sugar urine
disease is a metabolic disorder that is caused by many factors , with simtoma form of
chronic hyperglycemia and impaired metabolism of carbohydrates , fats and proteins .
According to the American Diabetes Asosiation ( ADA ) of 2003, diabetes was a
group of metabolic diseases with hyperglikemia characteristics that occur due to
abnormalities in insulin secretion , insulin action or both . Meanwhile, according to the
1980 WHO mellistus diabetes is something that can not be poured in a clear and concise
answer but in general it can be said as a collection of anatomical and chemical problems
that are the result of a number of factors which come by absolute or relative insulin
deficiency and impaired insulin function .
Diabetes mellitus is a group of disorders characterized by elevated levels of blood
glucose ( hyperglikemia ) there may be a decrease in the body's ability to respond to
insulin and or a decrease or absence of the formation by the pancreas ( Burnner and
suddarrth , 2003)
Pathophysiology
In humans the energy comes from food that we eat everyday , which consists of
carbohydrates ( sugars and starches ) , protein ( amino acids ) and fats ( fatty acids ) . The
food processing starts from the mouth to the stomach and then further into the intestines .
In the digestive tract , which consists of carbohydrate foods are broken down into glucose
, proteins are broken down into amino acids and fats into fatty acids . These three
nutrients was circulated throughout the body to be used by the organs in the body as
energy . In order to function as an energy food substances that must be processed , where
the glucose is burned through a chemical process that produces energy is called
metabolism . In the process of insulin metabolism plays an important role that incorporate
glucose into the cells that are used as fuel ( Faculty of Medicine , Department of Health ,
WHO , 2004)
Insulin is released by the beta cells can be described as a child was the key that can
unlock the door entry of glucose into the cells , and then in the cells was in metabolism of
glucose into energy . If there is no insulin , the glucose can enter the cells with glucose
result will still be inside the blood vessels , which means the levels in the blood rises . In
these circumstances the body becomes weak because there is no source of energy in the
cell . This is what happens in diabetes mellitus type 1 .
Pathophysiologyof diabetes mellitustype 1
No insulin production in type 1 of diabetes mellitus , this is caused by this type arise
due to an autoimmune reaction that caused inflammation in insulitis beta cells . This led
to the emergence of antibodies against beta cells called ICA ( Islet Cell Antibody ) .
Antigen ( beta cells ) caused by antibodies cause destruction of beta cells .
2. Medications
Oral antidiabetic drugs were divided into 2 groups, namely:
class of sulfonylureas
Sulfonylurea class of works by stimulating the beta cells of the pancreas to
secrete insulin
1 . Blocking the binding of insulin
2 . Enhance tissue sensitivity to insulin
3 . Suppresses glucagon
4 . Sulfonylureas group I
chlorpropamide ( Diabenese )
Indications : NIDDM
Contra - indications : juveil diabetes , NIDDM heavy or unstable .
Ketoacidosis , surgery , severe infection , trauma , liver disorders , kidney or
thyroid . Pregnant .
Dosage forms and dosage : 100 mg tablets ; 250 mg tablets and middle-aged
patients 250 mg / day , the older age of 100-125 mg / day . Rules used 3 times
daily with meals .
Side effects : cholestatic jaundice , such as disulfiram reaction , nausea ,
vomiting , diarrhea , anorexia .
Special risks : in patients with impaired renal function and lactating women .
Sulfonylurea class II
Glipizide ( Aldiab )
Indications : NIDDM
Contra - indications : diabetes ketoacidosis with or without coma , juvenile
diabetes , kidney disorders , liver weight .
Dosage forms and dosage : 5 mg tabs and an initial dose of 15-30 mg 1x / day
before breakfast , plus a dose of 2.5-5 mg depending on blood sugar levels .
Side effects : GI disorders , hypoglycemic , allergic skin reactions erythema ,
maculopapular eruptions , urticaria , pruritus , eczema , porphyria ,
photosensitivity . Reactions such as disulfiram . Hematologic reactions :
agranulositois , leukopenia , thrombocytopenia , anemia plastesik , hemolytic
anemia , pansetopenia , dizziness , drowsiness , headache . Increased AST ,
LDH , alkaline phosphatese , BUN and creatinine .
Special risks : patients with liver , kidney and pregnant women .
Glimepiride ( Amadiab )
Indications : diabetes mellitus type II ( NIDDM )
Contra - indications : type 1 diabetes , diabetic ketoacidosis , diabetic coma
prekoma or , hypersensitivity to glimepiride , pregnancy , lactation .
Dosage forms and dosage : KAPL 1 mg ; 2 mg ; 3 mg ; 4 mg . Dose of 1 mg 1
x / day dose was increased for 1-2 weeks .
Side effects : hypoglycaemic , while visual disorders , GI disorders , liver
damage . Thrombopenia , leukopenia .
Special risks : hypersensitivity and liver function disorders .
Glibenclamide ( Prodiabet )
Indications : NIDDM
Contra - indications : IDDM , ketoacidosis , severe infections , stress , trauma ,
kidney disorders , liver or thyroid weight , acute porifia .
Dosage forms and dosage : 5 mg tablets . Initial dose of 2.5 mg / day , 2.5 mg
improved .
Side effects : cholestatic jaundice , allergic dermatologic and hematologic
reactions , GI disorders , headache , dizziness , paresthesias .
Special risks : old age and hypoglycemia .
An indication of this group are :
1. Ideal when weight around
2. Insulin requirements if less than 40 U / day
3. When no severe acute stress such as infection or surgery
The side effects of sulfonylureas class :
1. Nausea , vomiting, headache , vertigo and fever
2 . Sense skin dermatitis , pruritis
3 . Abnormalities , hermatologik : lekopeni , trombosittopeni and enemia
3 . Extension
Extension to the management plan is essential for maximum clearance can
result . Diabetes education is the education and training in the knowledge and
skills to diabetic patients which aims to support behavior change to improve
patient understanding of his illness , which is necessary to achieve optimum good
health , good health and optimal adjustment , and psychological state of
adjustment and a better quality of life . Education is an integral part of the nursing
care of patients with diabetes .
CHAPTER III
CLOSING
Conclusion
1. Pathophysiology of Diabetes Mellitus are :
a) Patofisologi type 1 diabetes mellitus
No insulin production in type 1 of diabetes mellitus , this is caused by this
type arise due to an autoimmune reaction that caused inflammation in
insulitis beta cells .
b) Pathophysiology of diabetes mellitus type 2
In type 2 diabetes mellitus may in fact be a normal amount of insulin but
the more the number of insulin receptors on the cell surface are less . The
insulin receptor is like a keyhole entrance into the cell .
2. Classification of Diabetes Mellitus are :
a) Type 1 of diabetes mellitus : insulin-dependent diabetes mellitus ( Insulin
Dependent Diabetes Mellitus / IDDM )
b) Type 2 of diabetes mellitus : insulin-dependent diabetes mellitus ( Non -
Insulin Dependent Diabetes Mellitus / NIDDM
3. Diagnosis of Diabetes Mellitus are :
According Utami P , ( 2003) Diabetes mellitus can be diagnosed through
laboratory tests with a blood test . Diabetes mellitus diagnosis criteria are
taken from the World Health Organization 's decision ( WHO) is based on
blood sugar or glucose .
4 . Treatment of Diabetes Mellitus are :
a. physical exercise
b . drug
c . counseling
Advice
In keeping with the times then it will lead to diseases such as those
caused by behavior and lifestyle salah.Salah one example is it necessary
Melitus.Diabetes prevention early in avoiding the disease Diabetes Mellitus
with maintaining and improving the public health of the family starting with
how to do a diet and a healthy lifestyle
REFERENCES
Febriyatri , Diena.2009
Improvement in Diabetes Mellitus Cases Installation Outpatient Disease in Hospital Doctor
Mohammad Hoesin Palembang . Bina Husada sticks . Palembang
http://bkp2011.blogspot.com/2011/04/makalah-diabetes-melitus.html
http://merinirmalasari.wordpress.com/2012/04/04/dmcontoh-makalah-diabetes-melitus/
http://yosefw.wordpress.com/2007/12/27/penggunaan-antidiabetik-oral-gol-sulfonilurea-
pada-diabetes-mellitus/
Holy Raplia , Serni . 2011
Relationship Determinants of Diabetes Mellitus Patients with Genesis Outpatient Hospital
Palembang in Bari in 2011 . Sticks Bina Husada . Palembang