CODHy大会GLP-1临床新进展卫星会.ppt

GLP-1 RA with basal insulin – HbA1c reduction Lancet 2014; 384: 2228–34 GLP-1 RA with basal insulin – hypoglycemia Lancet 2014; 384: 2228–34 GLP-1 RA with basal insulin – HbA1c reduction Lancet 2014; 384: 2228–34 GLP-1 RA with basal insulin – weight change Lancet 2014; 384: 2228–34 Anti Hyperglycemic Drugs Efficacy Safety and Side Effects Mosenzon O, Pollack R, Raz I; Diabetes Care 2016 Israel National Diabetes Council Guidelines for Treating Type 2 Diabetes Diabetes Care 39 (Suppl 2):S146-S153; 2016 Endocrine Practice, 2016 AACE Glycemic Control Algorithm GLP-1临床新进展讨论 GLP-1与胰岛素 谢谢！ 各位老师，大家好。 今天和各位老师分享中国T2DM超重且中心型肥胖的治疗策略。 * Speaker Notes: Type 2 diabetes (T2D) is a disorder of energy metabolism involving several organs, including adipose tissue, muscle tissues, the liver, pancreas, gastrointestinal tract, nervous system, and kidneys. Multiple defects collectively contribute to the pathogenesis of T2D: Decreased insulin secretion: Progressive decline in pancreatic β-cell function leads to decreased insulin secretion from β cells Increased hepatic glucose production: Insulin resistance in the liver of patients with T2D results in continued overproduction of glucose despite elevations in fasting insulin Decreased glucose uptake: Insulin resistance in the muscles of patients with T2D results in impaired glucose uptake following carbohydrate ingestion, leading to postprandial hyperglycemia Increased lipolysis: Fat cells contribute to elevated free fatty acid concentration that stimulates glucose production and contributes to insulin resistance in muscle and the liver Decreased incretin effect: T2D leads to both deficiency in and resistance to the insulin stimulatory effects of incretin hormones produced in the gut Increased glucagon secretion: Elevated fasting plasma glucagon levels produced from pancreatic α cells correlate with increased hepatic glucose production in patients with T2D Neurotransmitter dysfunction: Insulin resistance in the brain contributes to increas