糖尿病医疗课件.ppt

Choose of oral antihyperglucemic agents Older patients：short term SU Obesity or hyperinsulinism patients：biguanides or acarbose 2hPG ：α－glucosidase Concentration of plasma glucose：270 ? 300mg/dl. the symptoms of hypertension are evident .Insulin therapy is available Impaired liver and kidney function：avoid using OHA Lean 、 fasting and after-excitation insulin all ：insulin Drug-Combined therapy Reasonable diet and poor plasma glucose control by monotherapy SU 、biguanides 、TZD and α- glucosidase inhibitors all can be used in combination with each other Small dosage combined with of all kinds of drugs ;enhancing effects of reduce glucaemia ;side effects of single agents Oral agents with insulin Drugs of the same class cannot be used in a combined way. Insulin therapy Indications of insulin Type 1 DM Type 2 DM Acute complications Severe chronic complications of diabetes Emergency Severe dysfunction of liver or kidney Gestation and bleeding women Without tolerance OHA， curative effect of OHA ，SU invalidation Distinct lean With diseases treated by glucocorticoid Some specific types of DM：secondary pancreas disease 、endocrinopathies、genetic diabetes Obstacles to using Ins in T2DM old notion： NIDDM The doctor uses OHA only and does not see the need to use Ins. The patient does not want to use In for fear of developing insulin dependence after useing it. Hyperinsulinism can lead AS to CVD？ hypoglycemia，BW↑ 国内常用胰岛素一览表 产品名 生产厂家 种属来源 包装(U/瓶) 短效胰岛素 普通胰岛素(RI) 上海生物制药厂 猪 400 U/瓶 优泌林R 礼来 基因重组 400 U/瓶 诺和灵-R 诺和诺德 基因重组 400 U/瓶 Lispro 礼来 基因重组 400 U/瓶 中效胰岛素 优泌林 N 礼来 基因重组 400 U/瓶 诺和灵-N