课件：型糖尿病口服药物治疗进展.ppt

拜唐苹?上市后监测研究包括了2735名医师，用拜唐苹?治疗了10462例患者，治疗12周患者HbA1c平均降低1.5%，不仅HbA1c接近正常或控制稳定的糖尿病病人，而且控制较差的病人经拜唐苹?治疗后均获得了改善。这一研究也显示了治疗前HbA1 c水平越高，拜唐苹?治疗后HbA1c的下降幅度越大。HbA1c高达13%的患者经过拜唐苹?治疗，HbA1c降低至10%，下降了3%。这一发现一方面更加确定了拜唐苹?卓越的降糖效果，也解释了为什么世界各地进行的几个临床研究的结果存在差异，这是由于不同的临床研究入选患者治疗前的HbA1c水平不同。 因此，评价拜唐苹?的降糖疗效应该具体分析患者的情况，如果认为拜唐苹?的降糖作用弱，对于血糖难以控制、HbA1c 很高的患者不予使用拜唐苹? ，反而会错失治疗良机，同时也无法正确评价拜唐苹?的疗效。 拜唐苹?可以显著改善2型糖尿病患者胰岛素敏感性，与安慰剂相比有显著性差异。 [1388-P] Effects of GLP-1 on the Characteristics of Beta Cell Function after Meal Ingestion in Humans BO AHRéN, JENS J. HOLST, ANDREA MARI. Lund, Sweden; Copenhagen, Denmark; Padua, Italy. Sunday, June 15, 2003, 12:00 PM, Poster Presentation: Integrated Physiology - GLP-1, GIP, and other Gut Hormones (12:00 PM - 2:00 PM) To characterise influences of GLP-1 on beta cell function in humans, we served eight overnight fasted human females (age 42-61 years, fasting glucose 3.7-10.3 mmol/l, BMI 22.4-43.9 kg/m? a breakfast (450 kcal) together with intravenous infusion of saline or synthetic GLP-1 (0.75 pmol/kg/min for 90 min). Beta cell function was characterised using a mathematical model of the relationship between glucose concentration and insulin secretion (calculated by deconvolution of C-peptide data). GLP-1 markedly augmented insulin secretion, in spite of lower glucose. Total insulin secretion was 29.7?.2 nmol/m?with GLP-1 vs 21.0?.6 nmol/m?with saline (P=0.048). GLP-1 increased the dose-response relationship between glucose concentration and insulin secretion (slope being 70?6 with GLP-1 versus 38?6 pmol min-1 m?mmol-1 l without, P=0.037; insulin secretion at 7 mmol glucose being 249?0 with GLP-1 vs 103?1 pmol min-1 m?with saline; P=0.036) and markedly augmented the potentiation factor which modulates the dose-response (ratio of the 60 min to 0 min values 2.71?.42 with GLP-1 vs 0.97?.17 with saline, P=0.005). The potentiation factor correlated to GLP-1 concentration (r=0.41, P0.001) and the fold increase in potentiation correlated to