糖尿病治疗新观念—培训课件.pptVIP

无线血糖仪 与胰岛素泵进行联接 Insulin Pump 无线血糖探头 与胰岛素进行联接 糖尿病管理软件 *Investigational device only, not yet approved by the FDA 完整的糖尿病管理方案 Advanced Infusion Sets 餐后血糖升高 良好的血糖控制 Bladder-drained (BD) pancreatico/duodenal transplant alone (PTA) Enteric-drained(ED) SPK transplant 胰岛移植的步骤 * Slide 6-6 TYPE 2 DIABETES…A PROGRESSIVE DISEASE Natural History of Type 2 Diabetes The natural history of type 2 diabetes shows the progressive emergence of the disorder. Well before diagnosis, patients may have had significant hyperglycemia for years, perhaps more than a decade. Patients with type 2 diabetes have altered islet b-cell function and impaired insulin action in varying degrees. Plasma glucose may rise above normal in early adulthood, and as age-related declines in b-cell function occur—together with less physical activity and increases in adipose tissue mass—plasma glucose continues to rise. By the time diabetes is diagnosed, plasma glucose may range from 180 to 220 mg/dL. It has been estimated that only about one third of the population has acceptable glycemic control by current standards. Based on the progressive nature of diabetes, complications that may take years to develop are often already present at the time of diagnosis. Riddle MC. Tactics for type II diabetes. Endocrinol Metab Clin North Am. 1997;26:659-677; Skyler JS. Insulin therapy in type 2 diabetes mellitus. In: DeFronzo RA, ed. Current Therapies of Diabetes Mellitus. St Louis, Mo: Mosby-Year Book Inc; 1998:108-116. * * 《中国居民膳食指南》是根据科学研究成果的成果以及营养学原则，结合我国国情，由中国营养学会制定的。它是指导群众采用平衡膳食，摄取合理营养、促进健康的科学依据。实际上，糖尿病患者的健康饮食和非糖尿病患者的健康饮食没什么本质上的差别。中国居民膳食指南》的原则适用于糖尿病人即：食物多样谷类为主；多吃蔬菜和水果；常吃如素、豆类或其制品；经常吃适量鱼、禽、蛋、 瘦肉、少吃肥肉或荤油，食量与体力活动要平衡，保持适宜体重。吃清淡少盐的膳食，成人每人每日食盐用量不超过6克为宜。饮酒要适量，注意饮食的卫生。 * 为重新建立与非糖尿病者尽可能接近的生理性胰岛素分泌谱，理想的餐时胰岛素应该是在餐后半小时内即快速上升，达到与非糖尿病者相同的浓度。然后胰岛素迅速下降，在下一餐前回复到基线水平。进食后半小时内迅速起效，可在最小胰岛素浓度下，达到最好的血糖控制效果（正如前一张幻灯所示）。餐后胰岛素快速下降，则可减少低血糖风险，以及因高胰岛素血症而造成的体重增加，而维持接近正常的基线胰岛素水平，又可改善代谢控制，降低糖尿病慢性并发症风险。 与可溶性人胰岛素相比，速效胰岛素类似物较难形成六聚体，这样就更容易从注射部位快速吸收。其结果是起效