糖尿病医学营养治疗对策.pptVIP

Gastric Inhibitory Polypeptide 促胰岛素分泌因子或抑胃肽，葡萄糖依赖性促胰岛素激素glucose-dependent insulinotropic polypeptide,? GIP Figure 2 Glucagon-like peptide-1 (GLP-1) increase insulin secretion lowers blood glucose and inhibits appetite. The ingestion of food promotes the release of GLP-1 from L-cells in the intestine, which activates vagal afferents. Activated GLP-1 neurons of the nucleus of the solitary tract (NTS) project to the hypothalamic arcuate nucleus (ARC), to modulate vagal motor outflow to the pancreas and other tissues not depicted, increasing insulin secretion from the b-cells in states of hyperglycaemia and suppresses glucagon from the a-cells, leading to lowering of blood glucose. Systemic GLP-1 may also access the brain via leaks in the blood–brain barrier such as the subfornical organ and the area postrema, as demonstrated to occur in rats. In the brain, release of GLP-1 within the NTS and from projections of GLP-1 neurons to the paraventricular neurons (PVN) leads to GLP-1-R activation, which promotes satiety and anorexia. Besides from the actions depicted in the picture GLP-1 has numerous other actions including slowing gastric emptying and thereby flattening glucose excursions, as well as cardiac effects. Adapted from Torekov et al., Obesity Reviews 2011 (429), and Williams, Endocrinology. 2009; 150: 2997–3001 (430). * * * The latest trend in the highly lucrative, yet often fickle, diet industry is a resurgence of low-carbohydrate, high-protein, high-fat diets. Findings of a February 2004 survey by ACNielsen, a leading market information company, revealed that 17.2% of households included someone on a low-carbohydrate diet. Slightly more, 19.2%, included someone who had tried a low- carbohydrate diet but had quit. Individuals with diabetes should be offered sound guidance about how to interpret truths and mistruths of any diet trend. Confusing labeling information on packages of manufactured foods can create unique challenges for individuals with diabetes who m