糖尿病介绍,医学生可以参考ppt课件[精品].ppt

* * Most of the doubling in diabetes projected to occur over the next 20 years (90–95%) will be type 2 diabetes, primarily due to growth of the middle-aged and elderly population. It is likely that these numbers will be matched or exceeded by people with impaired glucose tolerance and impaired fasting glucose who are at increased risk of developing diabetes, greatly adding to the future burden of disease. * * It is important that we understand just what the impact of this condition is. Already diabetes accounts for up to three million deaths per year, mostly as a result of the cardiovascular complications of the disease. But it is also the leading cause of limb amputation and one of the leading causes of kidney failure and blindness. The direct costs of managing the disease are in excess of US$150 billion per annum but this does not account for the huge amount of lost productivity resulting from incapacitation of people with diabetes and the need for others to care for them. But what is most alarming is the prediction by IDF and WHO that between 2000 and 2030 the number of people with diabetes is set to double to around 366 million people. The vast majority of these will suffer from type 2 diabetes. * * * * 诺 和 龙 的 作 用 机 理 是 关 闭 胰 腺 b 细 胞 膜 上 ATP 敏 感 的 钾 离 子 通 道 ， 抑 止 钾 离 子 从 细 胞 内 向 细 胞 外 流 动 ， 使 细 胞 膜 去 极 化 ， 细 胞 外 钙 离 子 向 细 胞 内 流 动 ， 导 致 细 胞 内 钙 离 子 浓 度 增 加 ， 从 而 刺 激了 胰 岛 素 的 分 泌 。 诺 和 龙 与 磺 脲 类 的 根 本 不 同 是 ： (如 图 所 示 )在 b细 胞 膜 上的 结 合 位 点 不 同 * * Hans Christian Hagedorn 1923 胰岛素第一次用于治疗糖尿病， 1938鱼精蛋白锌胰岛素（诺和公司）， 1953lente长效胰岛素，由于动物胰岛素存在提纯不好，抗体反应等缺点， 1973单组分胰岛素被纯化，但是仍不能解决动物胰岛素存在的根本问题；到1987第一支人胰岛素问世，并于同年应用于人，因为与人的天然胰岛素氨基酸序列完全相同，所以抗原性大大降低，但是直到1996年才上市。从动物胰岛素到人胰岛素是胰岛素历史的极大进步，但是由于外源性胰岛素与内源性胰岛素的吸收途径不同，在临床应用上仍然存在缺点：提前给药，高峰延迟，所以胰岛素类似物概念应运而生。 Hans Christian Hagedorn was apparently the first to use insulin in humans in (although Lilly would have it first used in 1922); however Lilly would also have their first commercially available insulin i