中国2型糖尿病患者胰岛素治疗方案的应用.ppt

* * This observational study in 100 type 2 diabetes patients failing oral agent therapy, with or without basal insulin, investigated whether addition and self-titration of NovoMix? 30 could achieve glycaemic targets of HbA1c ≤ 6.5 and 7%. Enrolled patients had been receiving a stable antidiabetic regimen for at least 3 months (minimum of two oral antidiabetic drugs (OAD) or at least one OAD plus once-daily basal insulin ≤ 60 U). Patients discontinued prior basal insulin and added one injection of NovoMix? 30 (12 U or 70–100% of prior basal insulin dose within 15 minutes of dinner initiation). NovoMix? 30 dose was self-titrated with investigator guidance every 3 or 4 days to achieve pre-breakfast FBG of 80–110 mg/dL. At 16 weeks, a pre-breakfast injection of 6 U of NovoMix? 30 was added if week 15 HbA1c exceeded 6.5%; the added dose was titrated to achieve pre-dinner BG of 80–110 mg/dL. After an additional 16 weeks, 3 U of pre-lunch NovoMix? 30 was added if HbA1c exceeded 6.5%. This added dose was adjusted based on 2-hour post-lunch BG to achieve postprandial glucose of 100–140 mg/dL. Subjects achieving HbA1c ≤ 6.5 at 15 and 31 weeks completed the study at weeks 16 and 32, respectively. * 低血糖发生率 仅6例患者（2.5%）发生7次低血糖，均为轻度低血糖 未发现其他不良反应 冯凭等，2型糖尿病住院患者每日三次诺和锐30注射的血糖控制多中心研究，《国际内分泌代谢》杂志：20（6），428-429，2007 研 究 结 论 对不需静点胰岛素治疗的新入院2型糖尿病患者，采用诺和锐? 30每日3次皮下注射（联合或不联合口服降糖药）治疗，可在1～2周内安全、迅速、有效地控制血糖； 一天三次治疗所需诺和锐? 30日剂量较小 对新入院的2型糖尿病患者，该疗法为一种简便易行、疗效显著、可安全迅速纠正高糖毒性的胰岛素强化治疗方案 易于过渡到更为简便、适于门诊治疗的诺和锐? 30每日2次皮下注射的治疗方案。 诺和锐? 30 ——从起始到强化治疗方案的调整更简单 中国T2DM患者β细胞功能衰竭较西方人更为明显，I相分泌受损严重，同时，血糖异常分布以餐后血糖升高最为突出 针对中国T2DM患者的特点，在控制空腹血糖的同时重视餐后血糖的控制，是实现血糖长期达标的保证 总 结 总 结 诺和锐? 30同时提供基础与餐时胰岛素，可有效控制HbA1c，是适合中国T2DM患者的胰岛素起始治疗方案 诺和锐?30起始治疗可实现血糖的全面达标 诺和锐?30一天两次注射起治疗到一天三次注射强化治疗，治疗方案的调整简单易行，有利于血糖的长期达标 * * * * 美国进行的一项研究显示，在无糖尿病的人群中，华裔美国人的胰岛素抵抗力及?细胞功能均低于非西班牙裔白种人（89%vs98.3% P=0.0011）[1] 1.Diabetes Care 27:354-361,2004 * 中国人群，女性的代谢综合征患病率高于男性，可能与亚洲人群女性的平均腹围高于男性，而HDL的水平低于男性有关。 * This graph is often used to understand the di