降糖药的临床应用-培训课件.pptVIP

* 噻唑烷二酮类(TZD)与PPARr结合后,激活PPARr-RXR(视黄醇X受体)复合物，与DNA的的特定反应位点结合，启动与胰岛素敏感 相关的基因转录，既增加葡萄糖转运子4（GLUT4）、脂肪酸转运蛋白（FATP）、脂肪酸结合蛋白（aP2）脂蛋白脂酶（ENZ） 等物质的蛋白合成。从而增加葡萄糖和脂肪酸的摄取。 * 39 The traditional stepwise approach aims primarily to control acute symptoms. Dietary measures and exercise are not usually sufficient to control glycemia beyond the first year of therapy. If monotherapy with an OAD (oral anti-diabetic) proves inadequate, combination therapy is usually started. If this also proves unsuccessful, conversion to insulin is the next step, either alone or in combination with an oral agent. In the majority of