营养与慢性病防治 ppt课件.ppt

糖尿病监测 * 2型糖尿病监测内容 血糖(mmol/L) HbA1c(%) 血压(mmHg) 体重 血脂 尿微量蛋白 眼底 至少每周一次 每三个月一次 至少每周一次 至少每周一次 每三个月一次每三个月一次 每年一次 * 2型糖尿病控制目标 血糖(mmol/L) HbA1c(%) 血压(mmHg) BMI(kg/m2) TC(mmol/L) HDL-C(mmol/L) TG(mmol/L) LDL-C(calculated) 空 腹： 4.4–6.1 ≤7.0 7.0 非空腹： 4.4–8.0 ≤10.0 10.0 6.5 6.5–7.5 7.5 130/80 130/80 ≥140/90 140/90 23 25 ≥27 4.5 ≥4.5 ≥6.0 1.1 1.1–0.9 0.9 1.5 2.2 ≥2.2 3.0 2.5–4.0 4.0 理想 尚可 差 * 谢谢大家！ * * * * * * * * * * * * * * * * * * TZDs Decrease Insulin Resistance at Target Tissues Pictorial representation of the major organ systems that are susceptible to insulin resistance. Resistance at the level of the adipose leads to excessive lipolysis. Resistance of the muscle to the actions of insulin leads to a decrease in glucose uptake (additional effect of available free fatty acids may compete with glucose for fuel source). Resistance of the liver results in the excessive release and production of glucose. This all occurs in the presence of defective beta-cell secretion of insulin that is insufficient to overcome the insulin resistance resulting in high blood glucose levels. The thiazolidinediones decrease insulin resistance in the adipose, muscle cells and in the liver. As a result of the increase in insulin sensitivity there is an enhancement in glucose uptake in the peripheral target tissues while there is a decrease in the hepatic glucose output. This class has also demonstrated improvements in estimates of pancreatic beta-cell function by homeostasis model assessment (HOMA). This suggests a possible improvement in insulin secretion defects within the pancreas. Data on file. * 正常情况下（右图）静脉持续稳定滴入葡萄糖后，血浆胰岛素浓度的变化为双相变化。在葡萄糖滴入体内的2-5分钟出现血浆胰岛素的迅速升高