糖尿病患者精细降糖治疗策略病例分析PPT课件.ppt

Case 3 Highlights 对于胰岛素作用与胰岛素分泌均存在明显障碍的患者，应注意在改善胰岛素抵抗的同时使用胰岛素补充治疗。 联合使用二甲双胍与胰岛素是这类患者的最佳选择。 谢 谢! * Normally, insulin secretion can be divided into two basic components, basal and stimulated. Basal insulin is secreted continuously between meals and throughout the night, reduces hepatic glucose production. In diabetic patients, treatment with intermediate-acting or long-acting insulin attempts to mimic the basal secretory pattern. Stimulated insulin secretion occurs in response to a meal and results in insulin concentrations of 60 to 80 mU/L from just before to 30 minutes after the meal. Concentrations return to basal levels in 2 to 4 hours. Regimens of regular insulin attempt to mimic the stimulated insulin secretory pattern. * Normally, insulin secretion can be divided into two basic components, basal and stimulated. Basal insulin is secreted continuously between meals and throughout the night, reduces hepatic glucose production. In diabetic patients, treatment with intermediate-acting or long-acting insulin attempts to mimic the basal secretory pattern. Stimulated insulin secretion occurs in response to a meal and results in insulin concentrations of 60 to 80 mU/L from just before to 30 minutes after the meal. Concentrations return to basal levels in 2 to 4 hours. Regimens of regular insulin attempt to mimic the stimulated insulin secretory pattern. 与开始胰岛素治疗患者的早期类似实验结论一样，增加Lantus?的剂量可能会引起夜间低血糖症。 * * Tier 1: well-validated core therapies These interventions represent the best established and most effective and cost- effective therapeutic strategy for achieving the target glycemic goals. The tier one algorithm is the preferred route of therapy for most patients with type 2 diabetes. Tier 2: less well-validated therapies In selected clinical settings, this secondtier algorithm may be considered. When hypoglycemia is particularly undesirable , the addition of exenatide or pioglitazone may be considered. Rosiglitazone is not recommended. If promotion of wei