[工程科技]胰岛素.pptVIP

胰岛素泵调节的基本方法 四、某2型糖尿病患者男69岁,身高175厘米,体重66公斤 空腹血糖 11.8mmol/L 餐后2h 23.8mmol/L 口服二甲双胍,格列吡嗪 现改用胰岛素泵，请定治疗方案？ 答:某2型糖尿病患者男69岁,身高175厘米,体重66公斤 现改用胰岛素泵，请定治疗方案？ 胰岛素泵起始剂量=66×0.6=40U 基础率总量=40×50%=20U 餐前大剂量=40×50%=20U 早餐量=40×20%=7U 中餐量=40×15%=6.5U 晚餐量=40×15%=6.5U 答:某2型糖尿病患者男69岁,身高175厘米,体重66公斤 现改用胰岛素泵，请定治疗方案？ 敏感系数X=1500/40×18=2.0U 补充量=23.8-10/2=6.9 立即追加---4.1U(6.9*60%) 谢 谢! 3 Normal Pancreas Simplest level - a small amount of glucose, measurable in millimoles, circulates in the blood continually. After eating, the normal pancreas secretes insulin in response to glucose need. In the diabetic state, the balance of insulin and glucose is disrupted, putting patients at risk for hyperglycemia. 4 2 Injections Per Day The Manichean view: that intensive therapy is “good on one hand, but bad on the other” that it necessarily carries the risk for more frequent hypoglycemia that it is in principle, not applicable to the vast majority of type 1 diabetic patients Difficult to achieve ideal balance between hyper- hypoglycemia with exogenous insulin - barrier to the generalization of intensive treatment to all patients. Challenge has been to design a therapeutic regimen that provides: adequate flexibility. meeting the changing metabolic needs throughout the day. freedom to enjoy a relatively normal lifestyle. Regular and intermediate insulin regimen of insulin injections twice a day requires adherence to a relatively strict diet and exercise schedule. Inconsistencies between insulin effect and metabolic requirements can result in large variations in blood glucose levels. ALL this is due to attempts to utilize non-physiological methodologies to address a physiological problem The solution to the problem is dependent on the control of the variables REF: Diabetes Care 22 Supplement 2 1999 p b43 5 4 Injections Per Day Offers a more physiologic approach. Allows more freedom in terms of diet and exercise. Yields greater flexibility in lifestyl