老年糖尿病的最新治疗.ppt

流 行 病 学 步入20世纪90年代以来 , 随着社会的发展糖尿病已经成为一种全球性疾病。在工业发达国家中 , 它仅次于癌症、艾滋病和心血管病之后列入第四位需要优先考虑的疾病。 在亚洲,糖尿病(2型DM)已成为一个新的流行性疾病。 美国91－93年近750万人群糖尿病调查 全球老年糖尿病患病人数增长迅速 中国己进入老龄化国家 我国新诊断血糖异常随增龄而增加（OGTT结果） T2DM患者GLP-1分泌受损而非GIP 胰高糖素-1（GLP-1）是重要的肠促胰素 一种由31个氨基酸组成肽链 由胃肠道L-细胞分泌 通过进食反应分泌(直接腔内刺激和间接神经刺激) 可作用于胰腺 β 细胞和 α 细胞、胃肠道、中枢神经系统及心脏等 西格列汀(捷诺维?) 24小时增强肠促胰激素 西格列汀使用方法 口服给药 100mg，一日一次 无需滴定剂量 可与或者不与食物同服，不限定给药时间 整体心血管评估是选择阿司匹林的基础 * 如果这只鳄鱼只有上颚没有下颚，它的危害性可能没有那么大。 有证据证明低血糖是血糖无法达标的重要障碍，低血糖是一个短期的、很快表现出来的临床症状。高血糖和低血糖构成了对糖尿病患者的严重的威胁。 * 低血糖的常见危险因素分为两大类： 一类是由于病理生理或生理状况决定的，这是人们无法改变的。 另一类的5个因素是可以改变的。 * 随年龄的增加不仅DM患病率增加,单纯餐后血糖升高的患者也明显增加 AIMS/HYPOTHESIS: To estimate the prevalence and incidence of diabetes mellitus and impaired glucose regulation (IGR) in a Chinese population aged 20-94 years. SUBJECTS AND METHODS: A group of 5,628 randomly selected adults, aged 20-94 years, living in the Huayang and Caoyang communities in Shanghai, China, were investigated between 1998 and 2001. During 2002-04, 2,666 subjects were followed up. All the participants underwent anthropometric measurements, blood biochemical analyses and a 75-g OGTT. RESULTS: Based on the 2000 census data of China, the age-standardised prevalences were 6.87% for diabetes and 8.53% for IGR at baseline. More than two in five cases with diabetes were undiagnosed. The age-adjusted prevalence of diabetes and IGR increased with age. The age-adjusted prevalences of hypertension, dyslipidaemia and overweight in males were significantly higher (p < 0.001) than in females. The 3-year cumulative incidence rates of diabetes and IGR were 4.96 and 11.10%, respectively. The relative risk of developing diabetes was significantly higher in subjects with IGR than in subjects with NGT (p < 0.001). CONCLUSIONS/INTERPRETATION: The prevalence and incidence rates for diabetes or IGR have increased dramatically over the last decades, especially in younger age groups. A large proportion of cases are undiagnosed. We strongly recommend that population-