课件：型糖尿病的胰岛素治疗及其诺和锐的临床应用.ppt

* * * * * 美国进行的一项研究显示，在无糖尿病的人群中，华裔美国人的胰岛素抵抗力及?细胞功能均低于非西班牙裔白种人（89%vs98.3% P=0.0011）[1] 1.Diabetes Care 27:354-361,2004 * 中国人群，女性的代谢综合征患病率高于男性，可能与亚洲人群女性的平均腹围高于男性，而HDL的水平低于男性有关。 * 。 。 * 研究结果： 部分NGT者已经出现早相分泌缺失，他们是发展为糖尿病的高危人群 在IGT人群中，胰岛素抵抗并不严重 在非肥胖的IGT人群中，胰岛素抵抗大约占16.2％ 从NGT到IGT再到DM，在日本人群中胰岛素分泌能力的降低为主导地位 在日本人群中，晚相胰岛素分泌反应升高可能是早相胰岛素分泌受损引起的继发性反应，而不是由于胰岛素抵抗引起 * * * * 在既往的治疗建议中，生活方式干预和二甲双胍联合治疗不能达标的患者，建议加用第二种降糖药物，胰岛素往往被用作三线或四线药物。但在本共识中，基础胰岛素治疗方案(主要指早晨或睡前使用长效胰岛素类似物甘精胰岛素或睡前中效胰岛素NPH)被提升至二线治疗地位，与磺脲类药物和胰岛素增敏剂相同。 * * * * 单次皮下注射0.3U/kg胰岛素，诺和锐30在注射后1小时后药效达到峰值。 NovoLog? Mix 70/30: Absorption in Healthy Male Volunteers This graph shows faster onset and faster peak activity with NovoLog? Mix 70/30 versus Human Premixed 70/30. Because NovoLog? Mix 70/30 has peak pharmacodynamic activity 1 hour after injection, it should be administered with meals. The rate of insulin absorption and consequently the onset of activity is known to be affected by the site of injection, exercise, and other variables. Differences in pharmacodynamics between NovoLog? Mix 70/30 and products to which it has been compared are not associated with differences in overall glycemic control. Key words: NovoLog Mix 70/30 Pharmacokinetics Pharmacodynamics Weyer C, Heise T, Heinemann L. Insulin aspart in a 30/70 premixed formulation. Pharmacodynamic properties of a rapid-acting insulin analog in stable mixture. Diabetes Care. 1997;10:1612-1614. * 诺和锐30 能更好的模拟生理胰岛素分泌模式 * ANA 038 Comparison of the efficacy and safety of NovoMix? 30 and BHI 30 in a twice-daily meal-related regimen, in a mixed population of patients with type 1 and type 2 diabetes. In this 12-week, randomised, open labelled, parallel-group comparison, 294 adult male and female subjects who had been using insulin in a twice-daily regimen were randomised to receive NovoMix? 30, injected within 10 minutes before breakfast and dinner (n = 143), or BHI 30 injected approximately 30 minutes prior to breakfast and dinner (n = 151). Of these, 140 patien