原创力文档SitagliptinMetformin Clinical Slide Kit - Josephine Carlos sitagliptinmetformin临床幻灯片-约瑟芬卡洛斯.ppt
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SitagliptinMetformin Clinical Slide Kit - Josephine Carlos sitagliptinmetformin临床幻灯片-约瑟芬卡洛斯
MWPdpiE61521_MK431APhIII_Mod1_v11.ppt The Modern Comprehensive Approach for Treating Type 2 Diabetes Table of Contents Diabetes Pathophysiology Comprehensive Approach is Pathophysiology Based Therapy with DPP-4 Inhibitor The Pathophysiology of Type 2 Diabetes Involves Multiple Organ Systems Incretins Modulate Insulin and Glucagon to Decrease Blood Glucose During Hyperglycemia Summary of Diabetic Pathophysiologies Islet-cell dysfunction Dysfunction of both beta cells (insulin production) and alpha cells (glucagon production) occur Dysfunction begins years before diagnosis of type 2 diabetes Dysfunction is progressive both before and after diagnosis Incretin defects contribute to islet cell dysfunction Insulin Resistance Insulin resistance begins years before diagnosis After diagnosis of type 2 diabetes there is little worsening of insulin resistance Insulin resistance reduces glucose uptake and utilization Hepatic Glucose Overproduction Overproduction is a result of islet-cell dysfunction and insulin resistance The Incretin Effect Is Diminished in Individuals With Type 2 Diabetes Characteristics of an Ideal Therapy Characteristics of an ideal oral antidiabetic agent Lowers HbA1c to normal levels Decreases insulin resistance and hepatic glucose production and increases or preserves beta-cell mass while restoring first-phase insulin response Does not cause weight gain Does not increase risk of hypoglycemia Does not cause edema or congestive heart failure = Therapy with DPP-4 Inhibitor DPP-4 Inhibitors Improve Glucose Control by Increasing Incretin Levels in Type 2 Diabetes DPP-4 Inhibitors Sitagliptin Sitagliptin is a DPP-4 inhibitor that improves glycemic control in patients with type 2 diabetes.1 Sitagliptin is a potent, highly selective, once-daily oral therapy.1 Sitagliptin is 2,600 times more selective for DPP-4 in vitro than DPP-8, DPP-9, and other related enzymes.2 Sitagliptin 100 mg once daily has shown near maximal and sustained DPP-4 inhibition
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