{"id":40,"date":"2019-07-28T12:43:00","date_gmt":"2019-07-28T12:43:00","guid":{"rendered":"https:\/\/avo6.com\/index.php\/2019\/07\/28\/le-diabete-la-classification-le-depistage-et-le-diagnostic\/"},"modified":"2022-09-28T20:43:43","modified_gmt":"2022-09-28T20:43:43","slug":"le-diabete-la-classification-le-depistage-et-le-diagnostic","status":"publish","type":"post","link":"https:\/\/avo6.com\/?p=40","title":{"rendered":"Le Diab\u00e8te: La Classification, Le D\u00e9pistage et le Diagnostic"},"content":{"rendered":"
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Introduction<\/span><\/b><\/div>\n
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Le diab\u00e8te sucr\u00e9 est une maladie m\u00e9tabolique fr\u00e9quente, de diagnostic biologique.<\/span><\/div>\n
Le laboratoire joue un r\u00f4le primordial dans le d\u00e9pistage, le diagnostic, \u00a0<\/span>la surveillance et le diagnostic des complications de cette affection.<\/span><\/div>\n
classification du diab\u00e8te sucr\u00e9\u00a0:<\/span><\/b><\/div>\n
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1.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Diab\u00e8te type 1<\/span><\/b>\u00a0: \u00ab insulino-d\u00e9pendant \u00bb <\/span><\/div>\n
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Correspond \u00e0 une destruction, le plus souvent immunologique, des cellules \u00df des \u00eelots de Langerhans. Ce diab\u00e8te se manifeste surtout chez le jeune (diab\u00e8te juv\u00e9nile) et qui se complique par des pouss\u00e9s acido-c\u00e9tosiques<\/span><\/div>\n
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2.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Diab\u00e8te type 2. <\/span><\/b><\/div>\n
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L\u2019hyperglyc\u00e9mie dans ce cas est multifactorielle. Elle est due surtout \u00e0 une insulino-r\u00e9sistance accompagn\u00e9e d\u2019un d\u00e9faut de s\u00e9cr\u00e9tion de l\u2019insuline<\/span><\/div>\n
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3.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>MODY<\/span><\/b><\/div>\n
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Terme issu de l’acronyme anglais maturity-onset diabetes of the youth, d\u00e9crivant une vari\u00e9t\u00e9 de diab\u00e8te rappelant le diab\u00e8te de type 2 (ne n\u00e9cessitant pas d’insuline pour \u00eatre trait\u00e9) et dont la transmission se fait selon le mode autosomique dominant\u00a0; li\u00e9 \u00e0 des d\u00e9fauts g\u00e9n\u00e9tiques de la fonction des cellules b\u00eata pancr\u00e9atiques. (exemple. : mutation du g\u00e8ne de la glucokinase).On d\u00e9crit plusieurs 6 sous vari\u00e9t\u00e9 de ce diab\u00e8te selon les g\u00e8nes impliqu\u00e9s.<\/span><\/div>\n
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4.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Diab\u00e8te gestationnel\u00a0: <\/span><\/b><\/div>\n
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Toute intol\u00e9rance au glucose apparaissant ou d\u00e9couverte au cours de la grossesse d\u00e9finit le diab\u00e8te gestationnel. Les complications maternelles et f\u0153tales de ce type de diab\u00e8te ne seront pas trait\u00e9es dans cet article.<\/span><\/div>\n
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5.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Diab\u00e8te secondaire<\/span><\/b>\u00a0: <\/span><\/div>\n
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R\u00e9sultant d’une pathologie ou d’un traitement associ\u00e9s directement responsables de l’hyperglyc\u00e9mie, ils sont majoritairement li\u00e9s \u00e0 l\u2019existence de :<\/span><\/div>\n
– Pancr\u00e9atopathies<\/b>: pancr\u00e9atites, n\u00e9oplasies, mucoviscidose, h\u00e9mochromatose, ex\u00e9r\u00e8se chirurgicale.<\/span><\/div>\n
– Endocrinopathies<\/b>responsables d’une hypers\u00e9cr\u00e9tion d’hormone hyperglyc\u00e9miante (cortisol, hormone de croissance, glucagon, hormones thyro\u00efdiennes, ph\u00e9ochromocytome).<\/span><\/div>\n
– Causes iatrog\u00e8nes : cortico\u00efdes, interf\u00e9ron, antir\u00e9troviraux …..<\/span><\/div>\n
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Le D\u00e9pistage <\/span><\/b><\/div>\n
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1.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Diab\u00e8te type 1<\/span><\/b>\u00a0: <\/span><\/div>\n
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La recherche d\u2019auto AC et de d\u00e9terminants g\u00e9n\u00e9tiques est possible mais n\u2019est pas recommand\u00e9e actuellement. <\/span>(Anti illots, anti insuline, anti glutamic acid decarboxylase, anti tyrosine phosphatase). \u00a0<\/span><\/span><\/div>\n
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2.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Diab\u00e8te type 2\u00a0<\/span><\/b>: <\/span><\/div>\n
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\u00fc\u00a0 <\/span><\/span><\/span>La glyc\u00e9mie<\/span><\/b>\u00a0: Veineuse \u00e0 jeun. +++<\/span><\/div>\n
\u00fc\u00a0 <\/span><\/span><\/span>La glycosurie<\/span><\/b>\u00a0: m\u00e9thode de d\u00e9pistage, tr\u00e8s peu sensible, reste tr\u00e8s sp\u00e9cifique. son utilisation en m\u00e9decine g\u00e9n\u00e9rale et en m\u00e9decine du travail (souvent \u00e0 l’origine du diagnostic initial de diab\u00e8te) \u00e0 n’importe quel moment de la journ\u00e9e est susceptible d’accro\u00eetre sensiblement le nombre des diagnostics de DNID. Cet examen n\u00e9cessite bien entendu une confirmation biologique (glyc\u00e9mique) du diagnostic<\/span><\/div>\n
\u00fc\u00a0 <\/span><\/span><\/span>Le test de tol\u00e9rance au glucose par voie orale (HPO)<\/span><\/b>\u00a0: m\u00e9thode destin\u00e9e \u00e0 la seule recherche clinique.<\/span><\/div>\n
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3.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Diab\u00e8te gestationnel<\/span><\/b>\u00a0: <\/span><\/div>\n
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Test d\u2019O\u2019sulivan<\/span><\/b>\u00a0: 50 g de glu per os, le jeun n\u2019est pas n\u00e9cessaire, et dosage de la glyc\u00e9mie \u00e0 H1.<\/span><\/div>\n
Population cible\u00a0: toutes les femmes enceintes entre 24 et 28 SA (semaines d\u2019am\u00e9norrh\u00e9e) <\/span><\/div>\n
Femmes enceintes \u00e0 risque (Age>35 ans, ob\u00e9sit\u00e9, ATCD familial de diab\u00e8te, ATCD (Ant\u00e9c\u00e9dent) \u00a0<\/span>personnel de diab\u00e8te gestationnel, de pr\u00e9 \u00e9clampsie, de macrosomie, de MFIU (Mort Feotale in Ut\u00e9ro) ou de malformations)<\/span><\/div>\n
Si valeur H1 entre 1,3 et 2 un test d\u2019HGPO \u00e0 100g est recommand\u00e9 pour poser le diagnostic<\/span><\/div>\n
Si glyc\u00e9mie H1> 2 le diagnostic est confirm\u00e9.<\/span><\/div>\n
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Diagnostic positif\u00a0<\/span><\/b>:<\/span><\/div>\n
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Nouveaux crit\u00e8res de Diagnostic\u00a0: ADA 1997(American Diab\u00e8tes Association)\/ OMS 1999\/ ANAES 1999<\/span><\/div>\n
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1.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Diab\u00e8te<\/span><\/b>\u00a0:<\/span><\/div>\n
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\u00a0<\/span>\u201cGlyc\u00e9mie \u00e0 jeun (8 heures de je\u00fbne au moins) sup\u00e9rieure ou \u00e9gale \u00e0 1,26 g\/l (7 mmol\/l), v\u00e9rifi\u00e9e \u00e0 2 reprises.<\/span><\/div>\n
2.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Intol\u00e9rance\u00a0 <\/span>au glucose\u00a0<\/span><\/b>: <\/span><\/div>\n
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Glyc\u00e9mie \u00e0 jeun sont comprises entre 1,10 g\/l et 1,26 g\/l.<\/span><\/div>\n
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\u00fc\u00a0 <\/span><\/span><\/span>L\u2019HGPO n\u2019est plus recommand\u00e9e pour poser le diagnostic de diab\u00e8te<\/span><\/div>\n
\u00fc\u00a0 <\/span><\/span><\/span>L\u2019h\u00e9moglobine glyqu\u00e9e (HbA1c) n\u2019est pas recommand\u00e9e pour le diagnostic du diab\u00e8te+++.<\/span><\/div>\n<\/div>\n
Le site www.avo6.com propose un contenu \u00e9ditorial pour pr\u00e9server au mieux sa sant\u00e9. Des conseils et astuces qui vous accompagneront dans votre quotidien autour de la nutrition, les m\u00e9dicaments, beaut\u00e9, les analyses m\u00e9dicales, le bien-\u00eatre et les actualit\u00e9s m\u00e9dicales.<\/div>\n","protected":false},"excerpt":{"rendered":"

Introduction Le diab\u00e8te sucr\u00e9 est une maladie m\u00e9tabolique fr\u00e9quente, de diagnostic biologique. Le laboratoire joue un r\u00f4le primordial dans le…<\/p>\n","protected":false},"author":2,"featured_media":404,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[5],"tags":[],"class_list":["post-40","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biochimie","entry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/40","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=40"}],"version-history":[{"count":1,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/40\/revisions"}],"predecessor-version":[{"id":405,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/40\/revisions\/405"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/media\/404"}],"wp:attachment":[{"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=40"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=40"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=40"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}