常见的社区医院全面控糖PPT.ppt

* * * The ideal treatment for Type 2 diabetes would have the characteristics shown in the slide. It would target a fundamental cause of Type 2 diabetes – insulin resistance. It would have the potential to slow deterioration of beta-cell function. It would reduce the risk of diabetes-related complications through lasting glycaemic control and reduction of the metabolic consequences of insulin resistance. It would be acceptable to the patient in terms of side effects and treatment regimen. It would have a low potential for drug interactions – a particularly important consideration in this mainly elderly population group who may be receiving several concomitant medications. * * ？ * * * 在中国，糖尿病治疗的低达标率也令人担忧。 2003年中国地区的糖尿病现状调查显示：糖尿病患者的平均HbA1C为7.5±1.6%。 仅小部分(11.5%)的患者血糖控制理想（HbA1C＜6.5％），而绝大多数（ 88.5％）的患者血糖控制未能达标（ HbA1C ≥6.5％），且 HbA1C＞7.5％的患者占38.6％。 可见，中国糖尿病血糖控制的现状与治疗指南的控制目标差距甚远。糖尿病在中国的严峻形势更是发人深省。 潘长玉 中国区合作调查组. 中国糖尿病控制现状──指南与实践的差距．国外医学内分泌分册 2005;25(3):174-8. * ADA/EASD: Metabolic Management of Type 2 Diabetes This algorithm is part of a consensus statement by the ADA and European Association for the Study of Diabetes (EASD) for the management of hyperglycemia in patients with type 2 diabetes. Lifestyle modification is the most cost-effective means of controlling diabetes, but rarely effective long-term. Nevertheless, it should be included as a part of any diabetes management program unless contraindicated. The goal of this algorithm is based on achieving and maintaining glucose levels as close to the nondiabetic range as possible, initiating or changing therapy when the patient’s A1C level is ≥7%, and changing interventions, if necessary, as rapidly as titration of medications allow. Selection of antihyperglycemic agents is primarily based on their glucose-lowering efficacy. Exenatide, glinides, pramlintide, and a-glucosidase inhibitors are not included due to their lower overall efficacy in glycemic control, limited clinical data, and/or relative expense. Metformin thera