DIABETES MELITUS
CREATED
BY:
ROSALINDA
NIM
: 200.14.008
NURSING STUDY PROGRAM DIPLOMA III
COLLEGE OF HEALTH SCIENCES MUHAMMADIYAH PALEMBANG
2014/2015
COLLEGE OF HEALTH SCIENCES MUHAMMADIYAH PALEMBANG
2014/2015
PREFACE
Praise be to God Almighty for his blessing and
guidance, this paper can be completed. This paper is a paper on knowledge for
students Nursing and readers to the field of science and health.
This paper itself is made in order to fulfill one of
the tasks for meteri presentation "the perfect guide to understanding diabetes"
In writing this report, the author gets a lot of help from
others because of the criticism and suggestions from readers is in need for the
progress of the subsequent paper making. Hopefully this paper can be useful for
the readers and health institutions.
May Allah can give rewarded for their guidance and support
that has been given to the author. Finally the author expects this paper may be
useful for all of us. Aamiin
Palembang, Oktober 2015
author
author
CONTENTS
Page
TITLE PAGE..........................................................................
....................................... 1
PREFACE............................................................................... ....................................... 2
CONTENTS.................................................................................................................... 3
PREFACE............................................................................... ....................................... 2
CONTENTS.................................................................................................................... 3
A.
What is diabetes..................................................................................................
5
B.
What are the types and symptoms of
diabetes................................................... 5
C.
How does it transmit ........................................................................................ 7
D.
How do we test
diabetes.................................................................................... 9
E.
How do we prevent or control diabetes............................................................
15
CONCLUSION.............................................................................................................
20
BIBLIOGRAPHY..........................................................................................................
21
CHAPTER I
INTRODUCE
A.
BACKGROUND
A worldwide epidemic of diabetes mellitus is
looming. The Centers for Disease Control and Prevention (CDC) predicts the
national incidence of diabetes will rise by 37.5% by the year 2025 and by 170%
in developing countries over the next 30 years. Of particular concern is the
alarming increase in the prevalence of type 2 diabetes in both adults and
children. In 2002, an estimated 18.2 million people, or 6.3% of the United
States population, had diabetes. Of these, 5.2 million or about one-third were
undiagnosed. But there is good news. Clinical studies have affirmed that type 2
diabetes can be delayed or prevented in high-risk populations and that good
glycemic control and other interventions can slow the devastating complications
of diabetes. Nevertheless, broad implementation of guidelines and goals
established by the American Diabetes Association and others has been slow.
From the above background
writer interested in discussing about the “Perfect guide to Understanding Diabetis”.
B.
FORMULATION OF PROBLEMS
1. What
is diabetes?
2. What
are the types and symptoms of diabetes?
3. How
does it transmit ?
4. How
do we test diabetes?
5. How
do we prevent or control diabetes?
C. PURPOSE
1. To
know definition of diabetes.
2. To
know diffrent types and symptoms of diabetes.
3. To
know how to transmit diabetes.
4. To
know how the tested diabetes.
5. To
know how to prevent and control diabetes.
CHAPTER
II
DISCUSSION
A. What is diabetes?
The term "diabetes mellitus"
describes a metabolic disorder of multiple aetiology characterized by chronic
hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism
resulting from defects in insulin secretion, insulin action, or both. The
effects of diabetes mellitus include long–term damage, dysfunction and failure
of various organs (WHO 1999).
Diabetes is a chronic disease that
occurs when the pancreas does not produce enough insulin, or when the body
cannot effectively use the insulin it produces. Hyperglycaemia, or raised blood
sugar, is a common effect of uncontrolled diabetes and over time leads to
serious damage to many of the body's systems, especially the nerves and blood
vessels.
B.
There are two main types of diabetes
Type 1 diabetes (T1D)
Description
·
formerly known as Insulin-Dependent
Diabetes Mellitus (IDDM).
·
characterized by hyperglycemia due to an
absolute deficiency of the insulin hormone produced by the pancreas.
·
patients require lifelong insulin
injections for survival.
·
usually develops in children and
adolescents (although can occur later in life).
·
may present with severe symptoms such as
coma or ketoacidosis.
·
patients are usually not obese with this
type of diabetes, but obesity is not incompatible with the diagnosis.
·
patients are at increased risk of
developing microvascular and macrovascular complications.
Symptoms
·
increased urinary frequency (polyuria),
thirst (polydipsia), hunger (polyphagia), and unexplained weight loss.
·
numbness in extremities, pain in feet
(disesthesias), fatigue, and blurred vision.
·
recurrent or severe infections.
·
loss of consciousness or severe
nausea/vomiting (ketoacidosis) or coma. Ketoacidosis more common in T1D than in
T2D.
Type 2 diabetes （T2D）
Description
·
formerly named non-insulin-dependent
diabetes mellitus (NIDDM).
·
characterized by hyperglycemia due to a
defect in insulin secretion usually with a contribution from insulin
resistance.
·
patients usually do not require lifelong
insulin but can control blood glucose with diet and exercise alone, or in
combination with oral medications, or with the addition of insulin.
·
usually (but not always) develops in
adulthood (and is on the rise in children and adolescents).
·
is related to obesity, decreased
physical activity and unhealthy diets.
·
as in T1D, patients are at a higher risk
of microvascular and macrovascular complications.
Symptoms
·
patients may have no symptoms at all or
minimal symptoms for years before being diagnosed.
·
may have increased urinary frequency
(polyuria), thirst (polydipsia), hunger (polyphagia), and unexplained weight
loss.
·
may also experience numbness in
extremities, pain in feet (disesthesias), and blurred vision.
·
may have recurrent or severe infections.
·
patients may present with loss of
consciousness or coma but this is less common than in T1D.
Gestational diabetes (GDM)
Description
·
characterized by hyperglycemia of
varying severity diagnosed during pregnancy (without previously known diabetes)
and usually (but not always) resolving within 6 weeks of delivery.
·
risks to the pregnancy itself include
congenital malformations, increased birth weight and an elevated risk of
perinatal mortality.
·
increased risk to woman of developing
diabetes (T2D) later in life.
Symptoms
·
increased thirst (polydipsia) and
increased urination (polyuria) are more commonly noted (although other symptoms
can be present).
·
because pregnancy itself causes
increased urination, these symptoms are difficult to recognize as abnormal.
·
a larger than normal baby during
pregnancy (noted on routine prenatal exam) may prompt diabetic screening.
C.
How
does to transmit diabetes ?
a. Type 1, or
juvenile diabetes, appears in very early childhood and is a chronic condition
requiring drug therapy. It results from a failure of the autoimmune system that
limits the ability of the pancreas to produce insulin. It cannot be
"caught" like a virus or bacteria. However, recent studies have
confirmed that certain DNA triggers tend to be present in persons with
diabetes. When mothers with diabetes have obese children, the children often
appear to inherit the same DNA characteristic and develop diabetes. Children
who have two parents with diabetes also appear to inherit the characteristic.
This tendency to inherit has only been established with Type 1 diabetes. Since
a Type 1 diabetic's pancreas will never produce insulin properly, it is
important to diagnose and begin a treatment plan as early in life as possible.
b.
Type 2 diabetes develops after age 40 in persons who
have certain risk factors, including obesity, a carbohydrate-rich diet and
sedentary lifestyle. Adult-onset diabetes limits the ability of insulin to
control blood glucose levels, rather than attacking the pancreas directly. No
genetic triggers have been identified. Gestational diabetes, a temporary
condition that resembles---and may develop into---Type 2 diabetes, primarily
affects pregnant women who are obese or who may gain a great deal of weight
with pregnancy. Both conditions can usually be managed using careful control of
diet, exercise and use of appropriate medication supervised by a medical
professional. Although obesity may be related to hereditary metabolic factors,
these types of diabetes seem to be more related to behavior and environment
than to heredity. Behavioral factors, like diet and exercise seem to be more
important than obesity alone. The type of diet people grow up eating may be a
risk factor over which they have little control. Others, like sweets, junk food
and a sedentary lifestyle can be controlled by using good nutritional practice
and regular exercise. Medications are available to aid insulin in its task of
blood sugar management, but insulin is seldom required if the adult-onset
diabetic is willing to lose weight, modify diet and exercise regularly.
D.
Tasted
and diagnosis diabetic
Symptoms of
type 1 diabetes often appear suddenly and are often the reason for checking
blood sugar levels. Because symptoms of other types of diabetes and prediabetes
come on more gradually or may not be evident, the American Diabetes Association
(ADA) has recommended screening guidelines. The ADA recommends that the
following people be screened for diabetes:
·
Anyone with a body mass index higher
than 25, regardless of age,
who has additional risk factors, such as high blood pressure, a sedentary
lifestyle, a history of polycystic ovary syndrome, having delivered a baby who
weighed more than 9 pounds, a history of diabetes in pregnancy, high
cholesterol levels, a history of heart disease, and having a close relative
with diabetes.
·
Anyone older than age 45 is advised to receive an initial
blood sugar screening, and then, if the results are normal, to be screened
every three years thereafter.
E. Tests for type 1 and type 2 diabetes
·
Glycated hemoglobin (A1C) test.
This blood test indicates your average blood sugar
level for the past two to three months. It measures the percentage of blood
sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells.
The higher your blood sugar levels, the more hemoglobin you'll have with sugar
attached. An A1C level of 6.5 percent or higher on two separate tests indicates
that you have diabetes. An A1C between 5.7 and 6.4 percent indicates
prediabetes. Below 5.7 is considered normal.
·
Random blood sugar test. A blood sample will be taken at
a random time. Regardless of when you last ate, a random blood sugar level of
200 milligrams per deciliter (mg/dL) — 11.1 millimoles per liter (mmol/L) — or
higher suggests diabetes.
·
Fasting blood sugar test. A blood sample will be taken
after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6
mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to
6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher
on two separate tests, you have diabetes.
·
Oral glucose tolerance test. For this test, you fast
overnight, and the fasting blood sugar level is measured. Then you drink a
sugary liquid, and blood sugar levels are tested periodically for the next two
hours. A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading
of more than 200 mg/dL (11.1 mmol/L) after two hours indicates diabetes. A
reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates
prediabetes.
Tests for gestational diabetes
Your doctor
will likely evaluate your risk factors for gestational diabetes early in your
pregnancy:
·
If you're at high risk of gestational
diabetes — for
example, if you were obese at the start of your pregnancy, you had gestational
diabetes during a previous pregnancy, or you have a mother, father, sibling or
child with diabetes — your doctor may test for diabetes at your first prenatal
visit.
- If you're at average risk of gestational diabetes, you'll likely have a screening test for gestational diabetes sometime during your second trimester — typically between 24 and 28 weeks of pregnancy.
Your doctor may use the following screening tests:
·
Initial glucose challenge test.
You'll
begin the glucose challenge test by drinking a syrupy glucose solution. One
hour later, you'll have a blood test to measure your blood sugar level. A blood
sugar level below 140 mg/dL (7.2 to 7.8 mmol/L) is usually considered normal on
a glucose challenge test, although this may vary at specific clinics or labs.
If your blood sugar level is higher than normal, it only means you have a higher
risk of gestational diabetes. Your doctor will order a follow-up test to
determine if you have gestational diabetes.
·
Follow-up glucose tolerance testing.
For the
follow-up test, you'll be asked to fast overnight and then have your fasting
blood sugar level measured. Then you'll drink another sweet solution — this one
containing a higher concentration of glucose — and your blood sugar level will
be checked every hour for a period of three hours. If at least two of the blood
sugar readings are higher than the normal values established for each of the
three hours of the test, you'll be diagnosed with gestational diabetes.
F. Simple Steps to Lower Your Risk
Making a few lifestyle changes can dramatically lower the chances of
developing type 2 diabetes. The same changes can also lower the chances of
developing heart disease and some cancers.
Control Your Weight
Excess weight is the single most important cause of type 2 diabetes.
Being overweight increases the chances of developing type 2 diabetes seven
fold. Being obese makes you 20 to 40 times more likely to develop diabetes than
someone with a healthy weight.
Losing weight can help if your weight is above the healthy-weight range.
Losing 7 to 10 percent of your current weight can cut your chances of
developing type 2 diabetes in half.
Get Moving—and Turn Off the Television
Inactivity promotes type 2 diabetes.Working your muscles more often and
making them work harder improves their ability to use insulin and absorb
glucose. This puts less stress on your insulin-making cells.
Long bouts of hot, sweaty exercise aren’t necessary to reap this benefit.
Findings from the Nurses’ Health Study and Health Professionals Follow-up Study
suggest that walking briskly for a half hour every day reduces the risk of
developing type 2 diabetes by 30 percent.More recently, The Black Women’s
Health Study reported similar diabetes-prevention benefits for brisk walking of
more than 5 hours per week. This amount of exercise has a variety of other
benefits as well. And even greater cardiovascular and other advantages can be
attained by more, and more intense, exercise.
Television-watching appears to be an especially-detrimental form of
inactivity: Every two hours you spend watching TV instead of pursuing something
more active increases the chances of developing diabetes by 20 percent; it also
increases the risk of heart disease (15 percent) and early death (13
percent). The more television people
watch, the more likely they are to be overweight or obese, and this seems to
explain part of the TV viewing-diabetes link. The unhealthy diet patterns
associated with TV watching may also explain some of this relationship.
Tune Up Your Diet
Four dietary changes can have a big impact on the risk of type 2
diabetes.
1.
Choose whole grains and whole grain products over highly processed
carbohydrates .
There is convincing evidence that diets rich in whole grains protect
against diabetes, whereas diets rich in refined carbohydrates lead to increased
risk.In the Nurses’ Health Studies I and II, for example, researchers looked at
the whole grain consumption of more than 160,000 women whose health and dietary
habits were followed for up to 18 years. Women who averaged two to three
servings of whole grains a day were 30 percent less likely to have developed
type 2 diabetes than those who rarely ate whole grains. When the researchers
combined these results with those of several other large studies, they found
that eating an extra 2 servings of whole grains a day decreased the risk of
type 2 diabetes by 21 percent.
Whole grains don’t contain a magical nutrient that fights diabetes and
improves health. It’s the entire package—elements intact and working
together—that’s important. The bran and fiber in whole grains make it more
difficult for digestive enzymes to break down the starches into glucose. This
leads to lower, slower increases in blood sugar and insulin, and a lower
glycemic index. As a result, they stress the body’s insulin-making machinery
less, and so may help prevent type 2 diabetes. Whole grains are also rich in
essential vitamins, minerals, and phytochemicals that may help reduce the risk
of diabetes.
In contrast, white bread, white rice, mashed potatoes, donuts, bagels,
and many breakfast cereals have what’s called a high glycemic index and glycemic
load. That means they cause sustained spikes in blood sugar and insulin levels,
which in turn may lead to increased diabetes risk. In China, for example, where
white rice is a staple, the Shanghai Women’s Health Study found that women
whose diets had the highest glycemic index had a 21 percent higher risk of
developing type 2 diabetes, compared to women whose diets had the lowest
glycemic index. Similar findings were reported in the Black Women’s Health
Study.
2.
Skip the sugary drinks, and choose water, coffee, or tea instead.
Like refined grains, sugary beverages have a high glycemic load, and
drinking more of this sugary stuff is associated with increased risk of
diabetes. In the Nurses’ Health Study II, women who drank one or more
sugar-sweetened beverages per day had an 83 percent higher risk of type 2
diabetes, compared to women who drank less than one sugar-sweetened beverage
per month.
Combining the Nurses’ Health Study results with those from seven other
studies found a similar link between sugary beverage consumption and type 2
diabetes: For every additional 12-ounce serving of sugary beverage that people
drank each day, their risk of type 2 diabetes rose 25 percent.Studies also
suggest that fruit drinks— Kool Aid, fortified fruit drinks, or juices—are not
the healthy choice that food advertisements often portray them to be: Women in
the Black Women’s Health study who drank two or more servings of fruit drinks a
day had a 31 percent higher risk of type 2 diabetes, compared to women who drank
less than one serving a month.
How do sugary drinks lead to this increased risk? Weight gain may explain
the link: In both the Nurses’ Health Study II and the Black Women’s Health
Study, women who increased their consumption of sugary drinks gained more weight
than women who cut back on sugary drinks. Several studies show that children
and adults who drink soda or other sugar-sweetened beverages are more likely to
gain weight than those who don’t,and that switching from these to water or
unsweetened beverages can reduce weight. Even so, however, weight gain caused
by sugary drinks may not completely explain the increased diabetes risk.
There is mounting evidence that sugary drinks contribute to chronic
inflammation, high triglycerides, decreased “good” (HDL) cholesterol, and
increased insulin resistance, all of which are risk factors for diabetes.
What to drink in place of the sugary stuff? Water is an excellent choice.
Coffee and tea are also good calorie-free substitutes for sugared beverages (as
long as you don’t load them up with sugar and cream). And there’s convincing
evidence that coffee may help protect against diabetes; emerging research
suggests that tea may hold diabetes-prevention benefits as well, but more
research is needed.
There’s been some controversy over whether artificially sweetened
beverages are beneficial for weight control and, by extension, diabetes
prevention. Some studies have found that people who regularly drink diet
beverages have a higher risk of diabetes than people who rarely drink such
beverages,but there could be another explanation for those findings: People
often start drinking diet beverages because they have a weight problem or have
a family history of diabetes; studies that don’t adequately account for these
other factors may make it wrongly appear as though the diet soda led to the
increased diabetes risk. A recent long-term analysis on data from 40,000 men in
the Health Professionals Follow-Up Study finds that drinking one 12-ounce
serving of diet soda a day does not appear to increase diabetes risk. So in
moderation, diet beverages can be a good sugary-drink alternative.
3.
Choose good fats instead of bad fats.
The types of fats in your diet can also affect the development of
diabetes. Good fats, such as the polyunsaturated fats found in liquid vegetable
oils, nuts, and seeds can help ward off type 2 diabetes. Trans fats do just the
oppositeThese bad fats are found in many margarines, packaged baked goods,
fried foods in most fast-food restaurants, and any product that lists
“partially hydrogenated vegetable oil” on the label. Eating polyunsaturated
fats from fish—also known as “long chain omega 3” or “marine omega 3” fats—does
not protect against diabetes, even though there is much evidence that these
marine omega 3 fats help prevent heart disease. If you already have diabetes,
eating fish can help protect you against a heart attack or dying from heart
disease.
4.
Limit red meat and avoid processed meat; choose nuts, whole grains, poultry, or
fish instead.
The evidence is growing stronger that eating red meat (beef, pork, lamb)
and red meat (bacon, hot dogs, deli
meats) increases the risk of diabetes, even among people who consume only small
amounts. The latest support comes from a “meta analysis,” or statistical
summary, that combined findings from the long-running Nurses’ Health Study I
and II and the Health Professionals Follow-Up Study with those of six other
long-term studies. The researchers looked at data from roughly 440,000 people,
about 28,000 of whom developed diabetes during the course of the study.
They found that eating just one daily 3-ounce serving of red meat—say, a steak
that’s about the size of a deck of cards—increased the risk of type 2 diabetes
by 20 percent. Eating even smaller amounts of processed red meat each day—just
two slices of bacon, one hot dog, or the like—increased diabetes risk by 51
percent.
Why do red meat and processed red meat appear to boost diabetes risk? It
may be that the high iron content of red meat diminishes insulin’s
effectiveness or damages the cells that produce insulin; the high levels of
sodium and nitrites (preservatives) in processed red meats may also be to blame.
Red and processed meats are a hallmark of the unhealthful “Western” dietary
pattern, which seems to trigger diabetes in people who are already at genetic
risk.
If You Smoke, Try to Quit
Add type 2 diabetes to the long list of health problems linked with
smoking. Smokers are roughly 50 percent more likely to develop diabetes than
nonsmokers, and heavy smokers have an even higher risk.
Alcohol Now and Then May Help
A growing body of evidence links moderate alcohol consumption with
reduced risk of heart disease. The same may be true for type 2 diabetes.
Moderate amounts of alcohol—up to a drink a day for women, up to two drinks a
day for men—increases the efficiency of insulin at getting glucose inside
cells. And some studies indicate that moderate alcohol consumption decreases
the risk of type 2 diabetes. If you already drink alcohol, the key is to keep
your consumption in the moderate range, as higher amounts of alcohol could increase
diabetes risk. If you don’t drink alcohol, there’s no need to start—you can get
the same benefits by losing weight, exercising more, and changing your eating
patterns
G.
What parts
of the body does diabetes affect ?
Knowing how diabetes affects your body can help you look after your body
and prevent diabetic complications from developing.
Many of the effects of diabetes stem from the same guilty parties; namely
high
blood pressure, high cholesterol levels and a lack of blood glucose
control.
Signs of diabetes
When undiagnosed or uncontrolled, the effects of diabetes on the body can
be noticed by the classic symptoms of diabetes,
namely:
·
Fatigue
·
Tingling
or pain in the hands, feet and/or legs
Long term effects of diabetes on the body
In addition to the symptoms, diabetes can cause long term damage to our
body. The long term damage is commonly referred to as diabetic
complications. Diabetes affects our blood vessels and nerves and therefore
can affect any part of the body.
However, certain parts of our body are affected more than other parts.
Diabetic complications will usually take a number of years of poorly
controlled diabetes to develop. Complications are not a certainty and can be
kept at bay and prevented by maintaining a strong level of control on your
diabetes, your blood pressure and cholesterol.
These can all be helped by keeping to a healthy diet, avoiding cigarettes
and alcohol, and incorporating regular activity into your daily regime in order
to keep blood sugar levels within recommended blood
glucose level guidelines.
The effect of diabetes on the heart
Diabetes and coronary
heart disease are closely related. Diabetes contributes to high blood
pressure and is linked with high cholesterol which significantly increases the
risk of heart attacks and cardiovascular disease.
Diabetes and strokes
Similar to how diabetes affects the heart, high blood pressure and
cholesterol raises the risk of strokes.
How diabetes affects the eyes
A relatively common complication of diabetes is diabetic
retinopathy. As with all complications, this condition is brought on by a
number of years of poorly controlled or uncontrolled diabetes. Diabetic
retinopathy has a number of symptoms.
Retinopathy is caused by blood vessels in the back of the eye (the
retina) swelling and leaking. High blood pressure is also a contributing factor
for diabetic retinopathy. Diabetic retinopathy can be treated so it’s best to
catch it as early as you can. The best way to do this is to attend a retinopathy
screening appointment, provided free on the NHS, once each year.
The effect of
diabetes on the nerves and blood vessels can also lead to problems including:
·
Trouble
with digestion
·
Sexual
dysfunction
·
Slow
wound healing
People with
diabetes have an increased risk of developing complications but not everyone
does. People with normal blood pressure, cholesterol and well controlled diabetes
have a better chance of avoiding or significantly delaying long term damage to
the body.
To reduce the chances of developing problems associated with diabetes,
people are advised to take steps to improve their health and blood sugar
levels. A good diet and regular activity is an important step in helping to
reduce blood pressure and cholesterol and improve blood sugar levels.
Medication can also play a part where lifestyle changes are not
sufficient. With type 1 diabetes, or other diabetes types where not enough
insulin is being produced, insulin will need to be administered by injection or
insulin pump.
Effect of diabetes on the kidneys
The kidneys are another organ that is at particular risk of damage as a
result of diabetes and the risk is again increased by poorly controlled
diabetes, high blood pressure and cholesterol. Diabetic
nephropathy is the term for kidney disease as a result of diabetes.
Damage to the kidneys takes place over a period of years and can picked
up by nephropathy screening before it gets too serious. Treatment includes
lifestyle changes and may include medicine to treat high blood pressure and
cholesterol.
Diabetes and its effects on the nerves
The effects
of diabetes on the nerves can be serious as the nerves are involved in so
many of our bodily functions, from movement and digestion through to sex and reproduction.
The presence of nerve damage (neuropathy) is commonly noticed by:
·
Numbness
or tingling in the hands or feet
·
Lack
of arousal in the penis or clitoris
·
Excessive
sweating or
·
Diagnosis
of delayed stomach emptying
Treatments for neuropathy concentrates on reducing pain but medication
such blood pressure lowering drugs may also be prescribed to help prevent
development of the condition.
Diabetes and its effect on digestion
Diabetes can affect digestion in a number of ways. If diabetes has caused
nerve damage, this can lead to nausea, constipation or diarrhoea.
An alternative cause of disturbed digestion can be the result of diabetes
medication. Some type 2
diabetes medications for instance are prone to causing digestive issues,
although these tend to settle down after the body gets used to them.
CHAPTER
III
CLOSED
A.conclusion
Diabetes
is a chronic disoder of carbohydrate, protein, and fat metabolism resulting
from insulin deficiency or abnormality in the use of insulin
Diabetes
have 3 types there is
1. Types
1 (insulin dependent diabetes melitus (IDDM)
2. Types
2 (non insulin dependent diabetes melitus (NIDDM)
3. Gestational
diabetes (GDM)
BIBLIOGRAPHY
Tanto, chris. 2014. KAPITA SELEKTA KEDOKTERAN JILID I.
Jakarta: Madia Aesculapius.
Tanto, chris. 2014. KAPITA SELEKTA KEDOKTERAN JILID II.
Jakarta: Media Aesculapius.
Young. 1996. Tubuh manusia. Jakarta: Arcan
