亚莫利.ppt

* 小结 1.理想的胰岛素促分泌剂，全面控制血糖,疗效佳 既恢复早期（Ⅰ相）胰岛素分泌→餐后血糖 又兼有长效SU的优势→基础血糖 2.独特的胰岛素增敏，临床效果明显优于其它促泌剂 既减少内源性胰岛素分泌 又减少外源性胰岛素用量 3.可单用,多联合，可与所有的降糖药物联合应用 足量达标，推荐4mg/d 4.安全性佳 低血糖少，不增重，受体选择性特异 5.服用方便，调药简单，依从性好 谢谢 DISCUSSION By decreasing β-cell workload and improving β-cell response, the incretin glucagon-like peptide 1 (GLP-1) is an important regulator of glucose homeostasis A thorough understanding of the five GLP-1 glucoregulatory effects is important to assess the value of GLP-1 in controlling glucose levels, particularly during the postprandial period Upon ingestion of food, GLP-1 is secreted in into the bloodstream and enhances glucose dependent insulin secretion from β-cells GLP-1 suppresses inappropriately elevated glucagon secretion from alpha cells Lower levels of glucagon lead to a reduction of glucose output from the liver and indirectly reduce the β-cell workload By slowing the gastric emptying rate, GLP-1 slows the release of nutrients into the gut allowing more time to control the postprandial increase in glucose levels GLP-1 promotes satiety, potentially through centrally mediated mechanisms BACKGROUND GLP-1 is secreted from L cells of the small intestine GLP-1 decreases β-cell workload, hence the demand for insulin secretion, by: Regulating the rate of gastric emptying such that meal nutrients are delivered to the small intestine and, in turn, absorbed into the circulation more smoothly, reducing peak nutrient absorption and insulin demand (β-cell workload) Decreasing postprandial glucagon secretion from pancreatic alpha cells, which helps to maintain the counterregulatory balance between insulin and glucagon Reducing postprandial glucagon secretion, GLP-1 has an indirect benefit on β-cell workload, since decreased glucagon secretion will produce decreased postprandial hepatic glucose output Having effects on the central nervous system, resulting in increased satiety (sensation of satisfaction with food intake) and a reductio