Patologia diabetica: il burden of disease, le policies, i programmi di gestione

Translated title of the contribution: [Autom. eng. transl.] Diabetic pathology: the burden of disease, policies, management programs

Anna Maria Ferriero, Maria Lucia Specchia

Research output: Other contribution

Abstract

[Autom. eng. transl.] The "Diabetes Mellitus" (DM) represents a group of metabolic disorders characterized by hyperglycemia. The DM is currently classified on the basis of the pathogenetic mechanism underlying its onset and the most important categories include type 1 diabetes and type 2 diabetes (DM1 and DM2). DM1, which represents about 10% of all cases of this disease, is also known as Insulin-Dependent DM and is the result of synergistic effects of genetic, environmental and immunological factors, which determine an autoimmune process that leads to destruction of pancreatic ß cells, resulting in insulin deficiency. The disease can affect people of all ages but usually occurs during childhood or adolescence as the mass of ß cells of subjects with genetic susceptibility is normal at birth, and then reduced as a result of an autoimmune process, probably triggered by an infectious or environmental stimulus, which occurs over months or years. The clinical manifestations of this form of diabetes are not evident until about 80% of the ß cells are destroyed and the residual cells are unable to maintain glucose tolerance. Subjects with DM1, therefore, need injections of insulin for life to vicarious pancreatic function. DM2 is the most common form of diabetes and accounts for about 90% of the cases of this disease; DM2 refers to a heterogeneous group of alterations characterized by varying degrees of insulin resistance, impaired insulin secretion by the pancreas and increased hepatic glucose production. Responsible for the onset of DM2 is the interaction between various risk factors such as familiarity, poor exercise, overweight and belonging to certain ethnic groups. The disease occurs after 30-40 years and its response is often accidental; it is estimated that the clinical diagnosis of DM2 is on average preceded by an asymptomatic phase of about 7 years, during which hyperglycemia exerts deleterious effects in the target tissues, so that complications of the disease are often present at the clinical diagnosis. Other categories of diabetes include gestational diabetes (a condition of hyperglycemia that develops during pregnancy) and other rare causes (genetic syndromes, acquired processes such as pancreatitis, diseases such as cystic fibrosis, exposure to certain drugs, viruses and unknown causes).
Translated title of the contribution[Autom. eng. transl.] Diabetic pathology: the burden of disease, policies, management programs
Original languageItalian
Publication statusPublished - 2014

Keywords

  • Burden of disease
  • Diabetes
  • Management
  • Policy

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