Diabetes MellitusDDTEXtREAd BoBo BoBo3Bo%Bo.Bo7uBo@BoIBo RBo  DIABETESELLITUS **DEFINITIONType 1M:llausesfiabet`resultingromestruction (>80-90%)pancreatic aells. Canccurtnyge (highPncidencePXucasians*10-14);ate/(tendsoPpidQchildren,lowad0s (may|overears,lledPn0utoimmune?,ADA)lassifia(tA, aveLAR3d/orX4),hichsoXcommoidiopat (1BaAntibodiXtheytopmqisle (60-7sensitivePglutamax carboxy`GAD65, 85a,ong)@ inhP(5 yrosiphosphat-likroteIA-2 ABapp8fore(insȔ`a goodarkerrcespsoybyԉD[Th1]AHowe`,;aSy-ph@Œi ootvelop(teith 5titIRdiseriskaEm@d T0.1%fpW, 6f, 4mo< 25.o9'sirth, D>=OOIP2-foldXћPPiagndMz1pUpY1gsewlyMؤ-r(I:XAfr0r)origiɐngind,IociXon. *2.0m'!charac iz#`bin`istHpdeficqse 㓵'&-bsoؒ9H@supran8ɦ0e3Vȫ^funkdprioisOylaimimpair)sirstTqѦQn (h1enHce`ctwoncordJ((f./,33-R fsprps 4؜o Haffe@d;two,Majty (75E AobesH8fuϒsyndH dysliemia,PrhsЭioscl0vasculX1T`(val:縡gorldwXabout 18illں*ic2U.S.@+opY17œaHý00], unG؟"8O]dugnxy,sual)Ӽ3rrimer;/-vompl`ω~135,000ses/yr13/4T6a`ystorp heyȵ(17-63%B5-160ndexsubsequrmуr0Il8-mnii(6eekstumafXwpAl t y 3)I]glucytoPʉ.4氐q,@eopld 20-74)jf:ж=Hu PؘⴸhzinAxnBL;p6-amW+/ (espeؗQIGT@0/IFGҫ`cedegadultaAud*8{(ervHdifhyv"goals: >= weys8uft13otcalPs؍сB@,媘ib15/1kxercA3)n/d)ax 58%Hwronha며0mea3.2XNojЀ4$*𹭭D$Ю(ProgramAlsphXd`t85gizI `e30(leejiAld8ЀڇiO *0exocx (hemochato8,titqcycAis0ac galpheocyt,usg's^,rug-(e.g.8ntd`,azPHIVotinhibtlimus >cHpieinZonxgeHrubellMVStiffPn Xٿ0ssotedithM (Downyndrome,linefelter's,olfram),eneticctsfetaellunction (MODYwvinsuTtyperesistance). **DIAGNOSIS Diagnodiaesitus (confirma`peat t): 1.ymptompolyuria, Qdipsaunexplaeightosskglucosndeton)l ompasma|e >= 200g/dL.Wholeloodalu8are8wery 10-15s]@2.astingǂ126Ł6(mBtheorn1afbseP)calorintakeoe 8ours3.GTT (oralt`H\Pケ2؄a 75-gequientـanhymdissolvwa()cannormbePelevaҕfW1 ge @seenBߗgz(?<: Scrqdon8Cweeks 24-28 (also1initivisipf蓠isk:besprevimacrosomZfant,1HdegȚ lhv8h`oryL}plyl,ispanic,΁mean,nf-PacifIsl%50ؑwPloadladaW땬1;t4t,P3q ,GaHwoye@xceeded:.95; 80;у05%ZImpairǘĂ<2-Xߗs;/<'!-Ǣ1eW ?y0s@lЖeve3eappeop> 45oldEarlifr@ lyy" (>=120%sirabXBMI7ON=gh-thhpHadelaa0> 9bIOaȴrtensr{/90dyslipide(HDL <= 3d/TG5'IGTIFG,CLINICALEATUREhCsPs:"wu!phag1weakneX&//) RegardbreathНrre@orpһ~Xl(QPp0smayot1 (-ÿX󮑩Jptohrign8/ݺg(l9ecs0,uroPnumb ềlfeexity,@mi'f, 0xfunon-heagropH@thoHjaЀynig¼ Mivascularompl (neuthxrnmneph)ay@ictBconlOffafDCCT,b88Sillxd0ducetjproC'yby)pit(gepِiɶy(hemoglobiPmn\b.ԏXUKPDS!th(1% wHbA1GGBف35%۾aߍߍٷle( 3-hx;xxoscotɞQdisȒIk0ip/+)b8jnfinito`nromoo񐯐nJ:caudeXD47Ў A┢__s8iscXИ0mon)0T2annualhaccou,0s, 4myoar13**MEDTIONga Mechanisma" EffcS(f񭉛"dSulfony8p b (nzsa 2.5-2;ly112);еzG, 5-4ǀLchl8m !00-5&mepiCAmary1-80)tolaz:1106IBWMur< 5rXni8 s1 < 40/d,PG < 220g/dL,oodetaellunction (highasting-peptide),bsencefnti-isletabrglutamiccidecarboxylase. Secondary(ilureatepo 10%/yr0Averageduˆ60-7HbA1c 1.5-2%. 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MayakeeveraleeksoeaximeffectxAssociatedithncreasesPoLDLndȀ@(nohange:ratio)articlxizeTroglitazonepiwrdewtriglycerid(up26%).nCOS,heagents`yesultapregnancy Fouretardros80imou(modelfyperlipmialsduceP,AI-1,lXlet gn,ascularontracsmoImuignmSdisbuteatromis(ubcutane. _Xwasdrar@diosy(cepatocellinjury,hicjPde (mortaP 160,000,pmɀ3oulfonylux metmin)qli菘ansnt suallolvaft0Ȋinux@rug2%it00lopvBALT;A@n[ǕǖL(0) mi9hHcebo 㚂0faiϘrepedJaj nitogly: IyٞxHyrRn3sne,}"if 1.5-2PULN,u>=; H|)yea횈iodic ez_weighta(~3g)lu8Ȝ,am+(caclII,VHFƂ`headachdizziness.oodjmreinsufficcXrd0**Biguanz (Glucoph0,t 5mgd/biDmeals,by4/P2ӎ(ax 255p 80-85zum烙lowng 1hew: R (tabxv(`bua +,25/2h(iPi٪apy92.5/, : (viQp,R)IPrriʫs3pproHaen0Y!lin-stHdnR ZbHe:PG-7ߺ0,j(10-15%to躈olesPol;R'slɒolo(2-rh`opausovo0wo(]ڹ!؎9ɺGGGC!20-30%bdollong, empfullarr,tf-l(helٗ2titakYAfooR:hta,cMB12hsorp haHh0.03/1j-yrbinIdysfunAvo0( >y4ۺI[(rC=],tHndhonsѷpx0:lcoism,a,ͧsinhypoxsurgHShoul(ad@lQnYr &otahull ݫ cu龠48rYq**ID humayb`(HuNovXvehiPȲhrؼ:olubc-(Tx@thos0tNPHh1tl, rabAhogȤ6Yѵast,arg!(LhusivQubcue𝸦i 1PLs 1U/mLMan@ypeКbequicd"Bind8-Xuyep w hxtiv0yre qitf0t.uinhibiook0 Vup`>lipolydpssuDegreeol)-@;cXp)19JHЭmia PicQ0 s%g@ (aX菈 6o@cئmacrs(zos`lg@s )3ĸLȥ80phЁx198js!umwiڸ0occur,spelf=poh!bcosmves=Ƚ(plasma;Ѐtpl͡ Ns CA`GEsludeuȿ"ܰ if0ymhficS(exercxyHmo(sʽsIcarHiskc8xeipidshošl~ Thmayesultnchievementflycemicoals (HbA1c < 7%ndastingbpreprialucose 80-120g/dL). Ifot,hemeasuhouldeonuedor`ag`sgunAbsencenutrition/weightanpjeopardizpuccessdrugreat1. Steppcareppro@:insithg8o(herapy;fpisXils,0ocetotmbinaaш*n׀׃YHulin,himatel8oqbetaellBahccurred,onlyNewly gnd2M (posve-peptide):u@ forgy: 1.׉imodteplasmaelevs(150-25%,qzerusmetm(Pazoliddes)aobe0Pdyslip(mia,ypertoxrtuxiaxehnonal,ɖcep8culParyfficiy8U؄e ҃'!n` 28)_Y;keton0a,[),ymptomf6@#8`l׻i(especȿibleq< 0.3-0.4/kЦpbpchor;ƶP1IjxicH,hichehEiveǾ@1.u 埩Xpna 9dpacu8injury/on,qessurg(yocfarOn25%hi@m(FPG <= 14Pmo𐇸GB@(2Csz1aogI disor;3tim ajorrequib8\clqzHbA1c (Ptmp)IPy23%earlyc`raqPiXondfai98Hl GrpxOr5sManyoY0si1)ul@x-eU(e.g. +q(`);fonylurea +-glucosidasenhibitor;etformin(repaglinide;hhtazoneN). PatientsurrHlynsuayebleobtaequivalruperiHglycemicontrolnd nificahweightossithdditiofPalherapy (especialxhicllows ducdose. **INSULINHERAPY Subcutaneous Regular Onset 30 - 1ouPeak 240Dur`4 6 Lispro/AspartU15TS1 -2O3h5LNPH8012 Ult0efփ0'3MGPgitLj:nو~2 IVnbolɊsimmediaC^3\Alsovaily:rhxed 70% ,%Ѝ; 5I75aL, 2Hl.fxing0 s,ast-aHslddrawysyreirstL!uretard5FonIr1:Ӂtot@d0yj = 0.2lbs;HPp"(T1M)P3WS2Rore, 08Sf8xicityres)NHVec:as(0.5-1/hr) mepXXXrx- garbohy(tehHow1simhthis? Insiv:sutakesyinjezsinuQssinfus(CSII):1.9 (Ug8t(dtimէȒea؇iI,ю0-ׁӕ-4pAim:ispsX4d!noҁnter`s2MLlunchO-dinner,qhsBjgȗsAM &!Radjust0lySuiа!8eedwh4 3. 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Lis:`stactingN[LYS(B28),ROP9)]Recombinant,邘s ctoumanvexceptorransposi fቈe &ysIat 28, 29C minusBhainȆjectSCes mexamers (whichissociatlowly)s(ula., @why4absor8oapidlyenef;thcbeihbeeal,(parՄmus\30-60 Qt8.mixUNPH8L,#ammedȐ InteЖ(thT1Mzma 3-foldHcXsriskIhypoglycemiaؕY2-4%orhitAThehpati ؏ybecauPtheyde+levelX0nhandarȓlglucagpesmakYmXpenepphr,Ial(of0uAhAvoidance2-3Hek@ticymptompio ()H7a:Jciou@tt315#(3^t0, 6sav, 4z.uic1/2 sod`1lZgHhoney);p؃Еip@isnextZ> 1-2puPaway,(tȢnackswal,1gɣIM~;0IVnla7 2`L1D50zREzpbvaryy habdo>HmghPbuttockȕ`roH ((>>>@H)Variabi1ffvolu(8gzXs@ae)h([typ٪<~<(uljAss@(C)duri{G񰡫 ng-l费aog4wnognifPhCEبzdsa (10%24% noctur?9qg (0.9"3.1hz܊dirH:rxg;tw suc{2Pfirstwkstart 10hstite6Pa(lcid0(maQph)Ӹ9p`ipithАeu HbcutaneȺI/Pt|fj?dӳr2ؔsd!DKA,HNK08eIpudeɀQ9`X0roᦈ,PO3yXQ9æmoni`PJ(U/hr) = (BG - 60)FHSҿ2SF0.02a@3djؤh1 sntil 100-140:A40X/dL'1ꁿ,achang<6Ȭ5`T`)u(^r~Perio裨vem8tY58̤at8hydK/ketoRmoouh, mizeXukocy0funڡ(voi`a0/h(e.(D5JNS +PEqClɴ/hC9Bo س acgoorfuxPip`'`ll- rolledɸusuگ=AM-uppl?]q4-6rqachi **TREATMENTUIDELINES HbA1XXp: P%) -FrequencyQu`eAZ si캙meehԫ0)t9-TG:ϐyhx%;< 7Xall >= 8%)Flh(rofi(LDHH)TC G:ɡxialp-ysbHdepie(:!@t{׆TC02A; <=X45e> 5H(wPn);XY5lDe8HS!micrbuurY(0@tediphckhgIN{(< 3ijug/mg ᣀ8 OffvisiJ diabetes -ncludXweight,P,ootxamination -FrequencyDaily(ritiof`sulin;`ekrallucose-loweringgent. 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