西格列汀在老年人中的应用.pptVIP

肠促胰岛激素治疗是以胰岛功能异常为靶目标治疗的更好选择 Meece J. Curr Med Res Opin. 2007, 23(4):933-44 小 结 胰岛功能异常是2型糖尿病病理生理核心 以胰岛为靶目标的药物是重要选择 肠促胰岛激素类治疗优化胰岛功能,有利胰岛整体健康 肠促胰岛激素类治疗以葡萄糖依赖的方式实现精准降糖 西格列汀是口服的肠促胰岛激素增强剂(incretin enhancer)，证实在2型糖尿病治疗中具有优异的利益/风险比 * * Among patients who received sitagliptin during period 1, a substantial carryover effect was seen during placebo treatment in period 2. Because the results from period 1 were not confounded by the carryover effect, these data are presented on the slide.1 As shown, combination therapy with metformin plus sitagliptin produced significantly greater improvements in 24-hour WMG than metformin monotherapy (p0.001).1 Additionally, combination therapy was associated with significantly greater reductions in mean daily glucose (p=0.046) and FPG (p0.001) versus metformin alone.1 Importantly, glucose levels were reduced throughout the day during both the postprandial and fasting periods.1 1/Brazg, Slide 9 (n’s) Slide 10 1/Brazg, Slide 8, Bullets 2-4, Slide 10 1/Brazg, Slide 10 1/Brazg, Slides 11,12 1/Brazg, Slide 10 Reference 1. Brazg RL, Thomas K, Zhao P et al. Effect of adding MK-0431 (sitagliptin) to ongoing metformin therapy in type 2 diabetic patients who have inadequate glycemic control on metformin. Poster presented at the 65th Annual Scientific Sessions of the American Diabetes Association, San Diego, California, June 10–14, 2005. 我们来分析下2型糖尿病老年患者的特点： 老年患者低血糖发生率高， 老年患者使用长效磺脲类药物或强化胰岛素方案低血糖发生风险高；在那些服用多种药物、认知损害，营养障碍，刚刚出院或者住老人院的患者低血糖发生风险增高。 * * * Both GLP-1 and glucose-dependent insulinotropic peptide (GIP) are incretins; i.e., gut peptides that are released from the GI tract in response to a meal to potentiate glucose-dependent insulin release.1 The physiologic role of incretin hormones in maintaining glycemic control suggests that the incretin axis is a potential target for therapeutic intervention in type 2 diabetes.1 After their release into the circulation, both GLP and GIP are degraded by the enzyme dipeptidyl pe