1. DIABETES MELLITUS pathophysiology, diagnosis, treatment
T. Rechciński, MD, PhD

2. Complications of DM

3. Diabetic retinopathy

4. vasculopathy

6. „New criteria” – since 1997

7. Global distribution and INCREASE OF PREVALENCE - DM

12. Demografic and social factors - DM

13. Costs of treatment - DM

14. Mortality rate due to DM

15. Clinical manifestation of DM
Polyuria
Polydypsia
Polyphagia
Coma

16. diagnosis

17. diagnosis – SI units

18. DM - screening

19. Self-control

20. Treatment – Oral agents (1)
Biguanides
Sulfonylureas
Gliclazide
Glipizide
Glibenclazide

21. Treatment – Oral agents (2)
Metformin
Metformin

22. insulin

23. Particle of insulin - modifications

25. Insulin activity – onset & duration

29. Disorders of the Pancreas pathophysiology, diagnosis, treatment
T. Rechciński, MD, PhD

30. Pancreatitis – chronic - acute
Alcohol
Biliary tract diseases
Drugs
Trauma
Viral infections
Metabolism
Connective tissue diseases

31. symptoms Abdominal pain Nausea Vomiting Peritonitis
acute
chronic
Abdominal pain
Radiates to back
Relief by sitting
Nausea
Vomiting
Peritonitis
Pain – intermittent
Unresponsive to antiacides
Increased by alcohol, heavy meals
Weight loss
Abnormal stools

32. Diagnosis Amylase Lipaze Sonography CT
pancreatic enzymes in body fluids
Imaging techniques
Amylase
Lipaze
Sonography CT
Endoscopic retrograde cholangio- pancreatography

33. sonography CT

34. Endoscopic ultrasound
ECRP

35. treatment Analgetics Fluids i.v. No oral alimentation
acute
chronic
Analgetics
Fluids i.v.
No oral alimentation
Nasogastric suction
Antibiotics
Peritoneal lavage
Surgery
Pain relief
Diet restrictions
Pancreatic extract
Vit. A,D,E,K

36. Disorders of the Gallbladder and Bile Ducts - diagnosis, treatment
T. Rechciński, MD, PhD

37. Bile Composition

38. Symptoms of Gallstone Disease
Inflammation
Fever
Nausea
Vomiting
Soreness in RUQ
Obstruction following migration into cystic duct or bile duct
Biliary colic
Jaudince (25%)

39. Sonography of the gallbladder

40. treatment Gallstones dissolution CDCA, UDCA effectiveness 13,5%
surgery
medical therapy
Gallstones dissolution
CDCA, UDCA effectiveness 13,5%