糖尿病高血压基本知识课件.pptVIP

“中心性肥胖综合征” * 小 结 血 压 降低风险 血 糖 预防血管并发症（微血管/大血管） 减少心血管事件 保护胰岛细胞 靶器官 理想、持久、 安全、综合达标 保护靶器官 早期、联合、安全、良好降压 * 实践出真知！ 具体问题具体分析！ 入门容易，精通困难！ 悟空，伴为师去找真经全文吧！ * * * 当前糖尿病治疗决不仅仅是为了降糖而降糖 理想控制应包括：消除高血糖症状，防止远期血管并发症的发生和进展，因此需要严格血糖控制，实现HbA1C达标 严格血糖控制的不足：费用过高，多种药物的副作用，低血糖风险,以及体重增加 根据近期的临床循证，应强调每位患者的个体化治疗，同时要重视生活方式管理和综合干预 * * * 糖尿病患病率在过去20年中上升了4倍。根据IDF的估计，中国糖尿病人数仍在快速增长，2007年约为3980万，2025年将达到5930万。 * * Slide 6-6 TYPE 2 DIABETES…A PROGRESSIVE DISEASE Natural History of Type 2 Diabetes The natural history of type 2 diabetes shows the progressive emergence of the disorder. Well before diagnosis, patients may have had significant hyperglycemia for years, perhaps more than a decade. Patients with type 2 diabetes have altered islet b-cell function and impaired insulin action in varying degrees. Plasma glucose may rise above normal in early adulthood, and as age-related declines in b-cell function occur—together with less physical activity and increases in adipose tissue mass—plasma glucose continues to rise. By the time diabetes is diagnosed, plasma glucose may range from 180 to 220 mg/dL. It has been estimated that only about one third of the population has acceptable glycemic control by current standards. Based on the progressive nature of diabetes, complications that may take years to develop are often already present at the time of diagnosis. Riddle MC. Tactics for type II diabetes. Endocrinol Metab Clin North Am. 1997;26:659-677; Skyler JS. Insulin therapy in type 2 diabetes mellitus. In: DeFronzo RA, ed. Current Therapies of Diabetes Mellitus. St Louis, Mo: Mosby-Year Book Inc; 1998:108-116. * Slide 6-4 TYPE 2 DIABETES…A PROGRESSIVE DISEASE Progressive Decline of b-Cell Function in the UKPDS In 1996, results of 6 years of follow-up of the patients in the UK Prospective Diabetes Study were reported. Although the patients who received intensive treatment maintained significantly better glycemic control, all groups showed progressive hyperglycemia over the 6 years, with asso