2014糖尿病盘点.ppt

盘点2014年糖尿病及相关治疗之进展--不断尝试，有成功、有失败 福建医科大学附属协和医院 林益川 降糖与调脂的目的不一样 为什么调脂？ 预防急性并发症 缓解症状 维持瘦体块、体力 增进幸福感 阻断或延缓微血管病变 减少大血管病变的发生率及事件的发生 减少死亡率，延长寿命 为什么降糖？ 预防急性并发症 缓解症状 维持瘦体块、体力 增进幸福感 阻断或延缓微血管病变 减少大血管病变的发生率及事件的发生 减少死亡率，延长寿命 ADA第一个 1型糖尿病的指南 First-Ever ADA Guidance Specifically for Type 1 Diabetes TREATMENT TARGETS A new pediatric glycemic control target of HbA1c?less than 7.5% across all ages replaces previous guidelines that had called for different targets by age (less than 8.5% for children aged under 6 years, less than 8% for those aged 6 to 12 years, and less than 7.5% for adolescents between the ages of 13 and 19 years). 胰岛素之外的治疗 老药 二甲双胍 新疗法 β-CELL REPLACEMENT THERAPY Pramlintide Incretin-Based Therapies Sodium-Glucose Cotransporter 2 Inhibitors 胰岛移植 胰岛微包囊技术 人工胰岛 （胰岛素泵） Threshold-Suspend(阈值暂停): The First Step in the Artificial Pancreas Bionic（仿生） Pancreas a wearable, bihormonal, automated, “bionic” pancreas (bionic-pancreas period)? Artificial Pancreas Impressive in 4-Week, Nightly Home Use Studies with the artificial pancreas, the amount of time that patients had glucose levels above the upper target limit (hyperglycemia) decreased from 53.8% of the time to 37.9% of the time (P?= .001). Similarly, the amount of time they had glucose levels below 3.9 mmol/L (hypoglycemia) decreased from 2.9% of the time to 1.9% of the time (P?= .014) during use of the artificial pancreas. Verapamil（维拉帕米） Hope for Reversal of Type 1 Diabetes A first-of-its kind trial in patients with type 1 diabetes is scheduled to get under way next year, in which researchers will try to reverse the disease process by attempting to increase beta-cell mass with the help of a common cardiovascular medication. TXNIP Dr Shalev explained that over a decade ago, the UAB team was able to identify a protein called thioredoxin-interacting protein (TXNIP), which is dramatically increased in human islet cells in response to high glucose levels. Since its known that hyperglycemia is toxic to b